Nearly 30 years ago, clinical psychologist Amy Walters, PhD, volunteered at a children’s diabetes camp. Her training helped her understand the emotional side of chronic illness, but working directly with young people with diabetes sparked a deeper interest. She became committed to supporting the two-way connection between physical health and mental health.
Today, Walters is the director of behavioral health at the Humphreys Diabetes Center and a clinical consultant in integrative medicine and pediatric endocrinology at St. Luke’s Health System in Idaho. She focuses on how emotional and behavioral factors affect chronic conditions such as diabetes, prediabetes, obesity, and metabolic syndrome.
Managing diabetes requires a broad and coordinated approach. Walters works closely with endocrinologists, nurse educators, dietitians, and social workers. Their goal is to provide whole-person care. They help patients prevent or manage diabetes, build healthy habits, and address mental health challenges that can influence quality of life and long-term outcomes.
Transitioning From Private Practice to Integrated Care
After volunteering at the camp, Walters began receiving referrals to her private practice. But many families didn’t follow through. Campers said they didn’t need a “shrink,” showing a clear divide between behavioral care and medical care. Walters and the camp’s medical director agreed that mental health support should be built into routine diabetes care. She began working at the diabetes center one day a week in 2008. As demand grew, her role expanded into a full-time position.
Why Diabetes Benefits From Integrated Care
Diabetes is largely self-managed, yet it requires constant attention. Patients must check blood sugar several times a day, count carbohydrates, and take precise doses of powerful medications. Too much insulin can cause dangerous low blood sugar. Too little can lead to long-term complications.
This constant decision-making creates emotional and cognitive stress. At the same time, patients need to eat well, exercise, sleep enough, and manage stress. Walters helps them develop skills to handle both the medical tasks and the emotional load.
How Mental Health Influences Physical Health
Mental and physical health affect each other. Anxiety is a clear example. When someone feels anxious or panicked, the body releases cortisol and adrenaline, which raise blood sugar levels. Chronic anxiety or stress makes blood sugar harder to control. Depression can also reduce motivation, making it more difficult for patients to stay active or follow healthy routines.
Better diabetes control can also improve mental health. Living with a chronic illness is stressful, but when patients feel more in control, they feel more capable and less overwhelmed. Because diabetes is a high-risk and costly condition, psychologists play an important role in helping prevent hospitalizations and improving long-term health.
Working With the Medical Team
Walters shares office space with other specialists. They read each other’s notes, discuss patient needs, and meet weekly to review complex cases. She also trains medical staff in psychological best practices, such as managing difficult interactions or supporting behavior change. She creates tools like stress-management handouts that doctors and nurses can use in appointments.
Using Psychological Expertise to Support Patients
People with diabetes have higher rates of anxiety, depression, and substance use. New patients receive mental health screenings from a nurse educator or dietitian. When needed, they are referred to Walters or another mental health provider. She offers individual therapy and leads group programs focused on weight management and binge-eating disorder. She also runs ongoing support groups for patients who have finished earlier programs.
Her team maintains an open-door policy. Providers can immediately call on behavioral health staff when needed. For example, Walters recently helped a newly diagnosed patient who was having a panic attack. She guided her through calming breathing techniques and scheduled a follow-up appointment.
Supporting Families in the Treatment Process
Patients manage diabetes within the context of family and community. Strong support leads to better outcomes. Walters encourages families to help with healthy routines like meal planning and physical activity. She also helps families address relationship stress, which can affect diabetes control.
Some patients struggle when diabetes complications prevent them from enjoying hobbies such as hunting or fishing. Walters may invite spouses to join sessions to discuss how to adapt activities and offer support without becoming overly controlling or critical.
What All Psychologists Should Know
Psychologists should ask about chronic illness during assessments and understand how conditions like diabetes affect identity, relationships, emotions, and finances. Validating these challenges is essential. Screening for stress, anxiety, and depression—and supporting behavior change—can significantly improve patient outcomes.
Many patients say, “I know what I’m supposed to do, but I don’t know how to do it.” Psychologists are uniquely equipped to help people build healthier habits and stick with treatment, even without specialized training in diabetes.
As integrated care continues to grow, Walters hopes more psychologists will enter medical settings. Addressing the emotional, social, and behavioral sides of chronic illness offers a powerful way to improve both health and everyday life.
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