Tasneem Clarke, Research Officer at the Money and Mental Health Policy Institute, based at King’s College London, discusses the Institute’s latest research, which asks: what can mental health practitioners do to support people in financial difficulty? Please take this two minute quiz to register your interest and help her come up with pragmatic solutions to this difficult issue. (736 words)
Money and mental health – a toxic relationship
As practitioners in mental health services know, life can be messy. The people we work with are rarely only facing one issue; from relationship breakdown to past traumas, economic disadvantage or long-term physical and mental health problems – issues interweave and make each other worse.
This is particularly true of money and mental health problems. More people have anxieties and fears about money, finances and debt than about any other issue or concern. The more debts a person has, the more likely they are to develop a mental health problem, even after adjusting for income and other factors, and those in problem debt are twice as likely to think about suicide as those not in financial difficulty. With debt levels rising, this is an issue that is having an increasing impact on our mental health services.
As well as practising as a social worker I work as a researcher for the Money and Mental Health Policy Institute. Money and Mental Health is a charity set up last year by Martin Lewis (of Money Saving Expert), aiming to tackle this toxic link between financial difficulty and mental health problems.
How mental health undermines your financial capability
Living with a mental health problem makes you three times more likely to be in problem debt. Mental health problems can cause cognitive difficulties such as difficulties making decisions during a period of depression, difficulties processing information during an episode of psychosis, or loss of impulse control caused by ADHD or a manic episode. Then there are emotional or psychological factors such as lack of motivation to phone a debt advisor because you don’t expect to be alive next month, or crippling anxiety about opening bills. Other practicalities also play a role, for example being unable to maintain employment, needing to spend on treatments not available on the NHS, or being reliant on the benefits system which can be extremely difficult to navigate when you’re unwell.
How debt impinges on recovery
But this is not just one-way traffic, being in financial trouble can affect your mental health too, making recovery harder. Having to cut back on essentials can affect our self-worth and make it more difficult to do things like have a warm bath in the evening as recommended in your relapse prevention plan, or to travel to visit your social support network or do some exercise. Then there are the psychological effects – anxiety over creditors coming knocking can be debilitating, as can the guilt of hiding problems due to the stigma around debt. Four in every ten people who experience both a mental health problem and financial difficulty do not tell their mental health professionals about the financial difficulties, even when they acknowledge these are making their mental health worse, and even though advice can easily solve most financial problems. As a social worker, it’s hard to help when we don’t know there’s a problem.
What can we do about it?
Working with service users, carers, health professionals and the financial services industry, Money and Mental Health is trying to tackle exactly this kind of scenario. We believe there is a significant opportunity for mental health services to do more to meet this challenge and improve outcomes for patients – but that practitioners may need more information or support to do it. Mental health professionals don’t need to be debt advisors, but they do need to be aware of the importance of financial issues that may be affecting their patients’ mental health, and be confident about referring onwards to someone who can help sort it out. Alleviating money worries can have a powerful impact. Four out of five people feel more in control of their financial situation after receiving debt advice, and our research has shown that tackling financial difficulty alongside mental health problems could dramatically increase recovery rates.
So what can mental health practitioners do to support people in financial difficulty? How much do they already know about the issue and how do they approach it? What training and support are they given? What gets in their way? These are the questions we want to answer with our next piece of research, and if you work in secondary mental health services, we need your help to do so. Please take our two minute quiz to register your interest and help us come up with pragmatic solutions to this difficult issue.