Debt advice and mental health - our joint event with Citizens Advice

Yesterday, we launched a new report exploring how well mental health professionals are able to deal with the growing debt crisis and the impact it’s having on their professional practice. Through a new survey of over 200 mental health professionals and 22 depth interviews, we’ve uncovered the extent to which mental health nurses, psychiatrists, psychologists, social workers and more are often finding themselves having to focus on non-medical issues, like benefit appeals and letters to creditors, instead of providing clinical treatment.

Offering this support uses up valuable clinical time, and often goes beyond the boundaries of professionals’ knowledge and training. But, in many cases, without this help the patient’s mental and financial health will continue to deteriorate. We joined forces with Citizens Advice yesterday to consider what the solutions might be.

Early yesterday morning, we were joined by 25 leaders from the health, social care, advice and political sectors at Citizens Advice HQ to discuss the growing practical issues faced by people with mental health problems, the impact this is having on mental health professionals, and what can be done to better equip professionals to support patients by integrating practical advice and support into mental health care settings.

Alongside our new research, Mette Isaksen, Policy Researcher at Citizens Advice, summarised their new analysis, revealing that the number of their clients reporting a mental health problem in England has increased by 9% in the past year. Mette went on to say that of those who accessed the NHS in need of support with both their mental health and financial difficulties, less than a third (32%) were referred onto specialist help – despite twice as many (64%) saying this would be helpful.

Paul Scates, a member of our advisory board and also a mental health expert with lived experience of mental health problems, spoke passionately about how he did not receive support with his finances from mental health professionals, and described how, in his current roles with NHS services, he often receives the response “it’s not my job” when he asks practitioners why they are not discussing a patient’s wider problems. Paul brought the consequences of failing to support service users with these pressing practical problems vividly to life.

Andy Buck, Chief Executive of Citizens Advice Sheffield and Clare Mahoney, Senior Programme Manager at Liverpool Clinical Commissioning Group shared some detail of how they had made integrated advice work in their areas, and what the benefits had been. Tom Ayers, from the National Collaborating Centre for Mental Health, helped us move the conversation to the national level, saying that there is a “level of hope” that NHS England will publish guidance as part of the new mental health care pathway recommending integrated advice, but that the onus would then sit with experts across the country to implement it effectively.

James Plunkett then challenged the room to join the conversation and we heard from representatives from Think Ahead, Rethink Mental Illness, Association of Mental Health Providers, Royal College of Psychiatrists, Luton Citizens Advice, Unite and NHS England. Two key barriers to replicating the success demonstrated in Sheffield and Liverpool were discussed:

1. The need to spread understanding of how integrated advice works in best practice areas, to help NHS commissioners and services elsewhere see how they can make it work.
2. More concrete evidence that advice doesn’t just improve financial outcomes, but improves mental health too, so commissioners know they can justify funding it from health budgets.

Although the discussions within the room were enormously encouraging, we are aware that achieving our goal of integrating debt advice within mental health care settings will be a marathon, not a sprint. All attendees agreed that this is a hugely important topic, but the recommendations and aims, whilst appropriately ambitious, need to be mindful of the challenges that the current operating environment for the NHS and social care present. In line with our work exploring debt advice within talking therapies last year, the room seemed united that a sensible step to getting there was an evaluation of the impact of embedding advice within Improving Access to Psychological Therapies (IAPT) service, starting with localised trials.

Following yesterday’s event we are optimistic, and encourage those who can promote integration, whether on a local or national level, to join the conversation and share their thoughts with us.

If you currently work within IAPT and would like to discuss our pilot trial project, or could help fund this work, please get in touch with us at [email protected]

Our report: Whose job is it anyway? How mental health practitioners help navigate financial difficulty

Citizens Advice report: Joining the dots: Integrating practical support in mental healthcare settings in England