Nikki Bond, Interim Head of Research and Policy, Money and Mental Health

A debt advice service fit for the future: meeting the diverse needs of people with mental health problems

11 April 2024

  • With almost half of people in problem debt also having a mental health problem, the demand for quality, accessible debt advice is high.
  • However, despite this demand, there is a long-standing, significant gap between the number of people who need it and the number who are getting it.
  • Our estimates suggest that by 2030, 2.1 million people experiencing mental health problems will be in need of debt advice. Approximately one million of those will have mental health problems that impact their day-to-day functioning to a severe or significant degree – making mainstream debt advice difficult to access and engage with. 
  • We’re making recommendations to the Money and Pensions Service (MaPS), which commissions debt advice services, on how best to reach people who are at risk of falling through the cracks of current services due to the severity of their mental health conditions.
  • Our recommendations include proactively reaching out to people with severe or significant mental health problems and ensuring services are located in areas with the greatest need.

On the back of the pandemic and the cost of living crisis, people’s budgets are being squeezed like never before. A record number of people are accessing debt advice, but demand has long outstripped supply, and this shows no signs of abating. 

8.1 million adults in the UK (15%) needed debt advice in 2023. But, based on 2019 figures, we estimate that only 2.6 million people accessed it. For each person on the receiving end of that support, debt advice can be a lifeline. For the nearly half of people in problem debt who have a mental health problem and who are likely to need debt advice, help to wade through reams of arrears letters and calls, and support to find a sustainable debt solution really can save lives.

While it is certainly a positive that more people are accessing advice, the gaping need-access gap of 5.5 million people is hard to ignore. That’s why we’ve been pleased to respond to The Money and Pensions Service (MaPS) consultation on their proposals for the future delivery of debt advice

With the links between mental health problems and financial difficulties broadly recognised, we focus on the different accessibility and support needs of people with mental health problems.

Greatest numbers vs greatest need

MaPS currently commissions a mix of debt advice services. That includes national delivery through digital contact centres, and community-based services, which are delivered locally and, in many instances, in person. Currently, funding is heavily weighted towards national delivery, which can serve more people for less. MaPS’ figures suggest that a community-based session costs over five times as much as delivering each nationally delivered advice session (£188 vs £36). Given the significantly lower cost, it’s easy to understand why funding has focused on national delivery. 

But in serving more people for less, it’s essential to consider how well national services cater to the needs of people with common mental disorders (CMD) – such as anxiety and depression – and those with severe mental illness (SMI) – such as bipolar, psychosis, schizophrenia and personality disorder –  those in an acute phase of their mental illness or crisis. 

Symptoms of CMDs, such as difficulties communicating, impaired clarity of thought and reduced problem-solving skills, can make it difficult for people to engage with debt advice. For people experiencing SMI, whose conditions can include more acute difficulties and challenges in their ability to function day-to-day, engaging with debt advice can be overwhelming. And acting on advice is often impossible.

The scale of need for people whose mental health problems impact their day-to-day lives the most

MaPS has set a target of increasing the number of people accessing debt advice by 2 million by 2030. We estimate that by this time, 2.1 million people experiencing mental health problems will be in need of debt advice. It is, therefore, vital that any plans to increase the provision and accessibility of debt advice include meeting the diverse support needs of this group.

To help understand what this means, we explored the extent to which people’s mental health impacts their day-to-day functioning, ranging from ‘no impact’ to ‘severe’. The table below presents our latest analysis and an illustration of the scale of debt advice delivery based on people’s mental health needs and capabilities.


Illustration of proportionality of funding in England by 2030 for debt advice based on the 46% (equivalent to 2.1 million) of people in need of debt advice who are experiencing mental health problems by segmentation of need

Functional impact of mental health problemsLevel of additional need in accessing debt adviceNumber of people this equates to in 2030
Severe impact (22%)Very high – People who are acutely unwell and/or whose mental health problems severely impact their ability to function day to day. These may include people who are hospitalised or under the care of Community Mental Health Teams (CMHTs).465,000
Significant impact (27%)High – People who are unwell and whose mental health problems significantly impact their ability to function day to day.570,000
Slight impact (26%)Medium – People who experience some slight cognitive and psychological challenges arising from their mental health problems, which can make engaging with debt advice tricky.549,000
None (25%)Low – People with mental health problems but who do not feel this impacts their day-to-day functioning.528,000

What should specialist services for people with severe or significant needs look like?

A quarter (26%) of people with mental health problems are likely to experience a slight impact on their day-to-day functioning. Their needs – along with the 25% of people whose mental health problems don’t impact their day-to-day functioning – are likely to be able to be met by universally designed, nationally delivered services.  

Yet, for one in two (49%) people with mental health problems, their mental health impacts their day-to-day functioning to a severe (22%) or significant (27%) level. This equates to just over one million people to whom MaPS aims to deliver debt advice to in 2030. 

This substantial group is unlikely to be able to engage with digital debt advice services, and the current design, commissioning and funding of debt advice services are likely to prove insufficient and inaccessible for their needs. These one million people will likely require a more tailored specialist approach to debt advice. 

We make four proposals for what this should include: 

1) Commission debt advice services that offer support proactively and reach out to people with severe or significant mental health needs. 

2) Deliver services (remotely and in person) where people are in greatest need: in psychiatric hospitals, Community Mental Health Services and Talking Therapy services. 

3) Equip advisors with training to understand how severe and significant mental health problems can impact people’s capabilities.

4) Offer debt advice casework and casework to maximise people’s income – as standard.

Meeting this scale of need is no easy feat. However, if MaPS is to achieve its ambitious goals and ensure they do not disproportionately help those who are easy-to-serve through digital self-service debt advice routes – at the expense of people with severe and significant support needs – this will require concerted effort and funding. 

Positively, MaPS is not starting from scratch. Examples of excellent services already exist that do some of this work; Mental Health and Money Advice provide telephone-based advice to people with severe mental health problems. The Mental Health Crisis Breathing Space scheme supported more than 1,300 people in mental health crisis last year and has substantial funding to increase this number ten-fold.

There are opportunities to build on these services to ensure that debt advice can help everyone, regardless of the severity of their mental health problems. 

It’s vital that MaPS takes this opportunity and carries out its own analysis to understand the proportionality of service delivery and funding required to meet the needs of people whose mental health problems have a severe or significant impact on their day-to-day functioning