"Depression, anxiety, and other disorders causing serious psychological distress (SPD) frequently complicate the health care of persons with diabetes." To assess the prevalence and effects of SPD among adults with diabetes, the New York City Department of Health and Mental Hygiene (DOHMH) analyzed data from approximately 10,000 adults who participated in the 2003 New York City Community Health Survey (CHS). The results indicated that 1) adults with diabetes were twice as likely to have SPD as those without diabetes, and 2) adults with both SPD and diabetes were more likely than those with only diabetes to live in poverty, report poor health, lack access to health care, and to have lost a spouse or partner to separation, divorce, or death. An integrated program of physical and mental health care that addresses socioeconomic barriers and improves access to treatment might improve the overall health of persons with diabetes and SPD.