BARRIERS TO DIABETIC EDUCATIONdesign, they may not only be disappointment, but they may not fully understand the finer nuances of whatit means to live with SMI, nor might they understand the true meaning of provision of health care. Employing extra personnel may cost more in the short term, but this expense may be offset by the longer term financial savings in preventing co-morbid disease states such as diabetes in the SMI population (Ohlsen, Peacock, & Smith, 2005).Tranter, Irvine, and Collins (2012) conducted a review of the literature of assessment tools useful for the mental health nurse in promoting diabetes and physical health screening and education, including the Health Improvement Profile and the Physical Health Check. The authors noted that “policy makers may be justified in championing physical health assessment and surveillance as a central tenet of service provision” (p. 1211). In other words, clinic leaders in administration must insist and expect systematically structured physical screening and assessment tools to be the backbone of accepted best practice guidelines. The championing of these structured tools must be embraced at the clinic, state, national and institutional levels of healthcare (Tranter, Irvine, &Collins, 2012).