Defeating the Deadly Double: Depression and Diabetes (DDD)

In 2017, to mark its 25th anniversary, the Virginia Health Care Foundation (VHCF) announced Beyond Blue, a multi-pronged behavioral health initiative designed to increase access to mental health services for medically underserved and uninsured Virginians.

Defeating the Deadly Double: Depression and Diabetes (DDD), a component of Beyond Blue, was designed to enable health safety net (HSN) organizations that offer co-located behavioral health services and primary medical care to elevate the degree of integration of these services for HSN patients with the co-morbidities of depression and diabetes.

The goal of DDD was to reduce the severity of depression in participating diabetic patients so they could more fully engage in creating and adhering to their diabetes treatment plans. Five organizations were selected to participate in the initiative, which launched on February 1, 2018.

  • Blue Ridge Medical Center
  • Central Virginia Health Services
  • CrossOver Healthcare Ministry
  • Neighborhood Health
  • New Horizons Healthcare

The success of this two-year $1.3 million initiative was measured by a reduction in: severity of depression on a PHQ-9 test; blood sugar via hemoglobin A1c test; and weight and BMI.

More than 600 patients were ultimately enrolled in DDD. Of the patients enrolled for at least 12 months and with more than one score for the tracked indicators:

  • 61% reduced their levels of depression.
  • 60% improved their hemoglobin A1c scores, and
  • 52% lost weight and decreased BMI (all DDD patients combined lost more than 4 tons of weight).

Participating organizations reported higher levels of collaboration and significant advances integrating the delivery of behavioral health and medical services. Workflows were also changed to ensure that all diabetic patients were screened for depression and treated, as appropriate.

To learn more about the DDD initiative, contact Andrea Lancaster, Chief Program & Impact Officer at (804) 525-1483 or

DDD was supported by the Anthem Foundation, Kaiser Permanente, the Collis-Warner Foundation, the Dominion Foundation, Richmond Memorial Health Foundation, the Gwathmey Trust, and the Virginia Association of Health Plans. VHCF is grateful for the input and advice of leaders from the Virginia Community Healthcare Association, the Virginia Association of Free and Charitable Clinics, and Community Health Solutions in developing this initiative.

Last Updated on September 22, 2021