Virginia Health Care Foundation Launches Defeating the Deadly Double, a New $1.2 Million Initiative to Address Diabetes and Depression

Richmond, Virginia –   It is a startling statistic:  the incidence rate of depression is two to three times higher in people with diabetes.  Unfortunately, many of these cases are under-diagnosed.  Studies show that only 30-50% of diabetics with major depression are recognized and treated.   This can be deadly, because depression increases the rate of mortality among people with diabetes by 30% due to nonadherence with treatment plans.

The free clinics and community health centers that care for many uninsured and medically underserved Virginians see this a lot.  Diabetes and depression are among the top three conditions with which their patients present. “Many health safety net organizations recognize that depression is often a co-morbidity of diabetes, but they have not had the tools, staff, or time to ensure that all of their diabetic patients are screened for depression and treated as necessary,” explains Deborah D. Oswalt, Executive Director of the Virginia Health Care Foundation (VHCF).

Recognizing the critical importance of these challenges, VHCF is launching Defeating the Deadly Double: Depression and Diabetes (DDD) today.  This special initiative will help participating clinics and health centers evaluate and redesign their operations and workflows for this targeted and very sick population of patients.  “DDD will help  these health safety net organizations treat the whole person and address the mental health challenges many patients face that can make it so difficult to manage diabetes and other medical conditions,” continues Oswalt.

Interdisciplinary teams from the following five organizations were selected through a competitive grant application process to receive DDD funding:

  • Blue Ridge Medical Center, Nelson County – $222,000 to increase the level of integration and coordination of medical and behavioral health services by building self-management skills for diabetics with depression. The grant will enable BRMC to hire a full-time Nurse Care Manager and a full-time Dietitian who will provide 1:1, family, and group education on nutrition and healthy lifestyles.
  • Hopewell-Prince George Community Health Center – $148,800 to strengthen its current integrated model of care by increasing educational components available to patients with depression and diabetes. Funds will be used to increase the hours of a Health Educator and to hire a new part-time Health Assistant.
  • CrossOver Healthcare Ministry, Richmond – $270,140 to hire needed behavioral health personnel and an interpreter who will screen diabetic patients for depression and provide necessary treatment. Ultimately, they will create new protocols to help identify and treat patients with diabetes and depression.
  • Neighborhood Health, Alexandria – $294,475 to improve its current model of collaborative care. Funds will be used to hire a Nurse Certified Diabetic Educator, an LPN-level Integrated Case Manager, and for staff training and education.  
  • New Horizons Healthcare, Roanoke – $259,435 to enhance coordinated care for patients with dual diagnoses of diabetes and depression. Funds will hire a new full-time Diabetes Program Coordinator, contract with a group therapist, and increase hours for a Community Health Worker.    

There are four specific indicators that will be recorded quarterly for each of the grantees’ DDD patients to determine progress on health outcomes:  score on the PHQ-9 depression screen; Hemoglobin A1C reading of blood sugar; weight; and Body Mass Index (BMI).

In addition to funding for their specific projects, the initiative also includes quarterly meetings with learning circles.  “This is an innovative new approach, and we want grantees to share information and receive any needed assistance from experts.  Ultimately, we expect the DDD participants to institutionalize changed protocols and workflows, and perhaps apply the same approach to other specific patient populations,” Oswalt added.

Defeating the Deadly Double is a $1.2 million initiative that is funded by a $500,000 1:2 challenge grant from the Collis Warner Foundation.  Other major supporters include the Dominion Energy Foundation, Anthem Blue Cross and Blue Shield Foundation, Kaiser Permanente Health Plan of the Mid-Atlantic States, and the Virginia Association of Health Plans.

The Virginia Health Care Foundation is a non-profit public/private partnership whose mission is to increase access to primary health care for uninsured and medically underserved Virginians.  The Foundation was initiated by the General Assembly and its Joint Commission on Health Care in 1992.  Since its inception, it has funded 407 community-based projects across the Commonwealth, and its programs and partnerships have touched the lives of more than 700,000 uninsured Virginians.  For more information about VHCF and its programs, visit  or call 804-828-5804.

Last Updated on June 11, 2018