Becca Stacey, Senior Research Officer, Money and Mental Health Policy Institute
21 April 2023
Through the lens: unpacking the diversity of experience among people with mental health problems
When it comes to finances, people with mental health problems fare worse on average than the rest of the population. But we also know that there’s rarely ever one factor that leads to someone struggling financially. Those of us with mental health problems have many other characteristics – including our gender, age, and ethnicity – that can all play a role.
Our ‘Through the Lens’ series seeks to better understand how these different factors interact and overlap, creating inequality in how people experience the cycle between poor mental and financial health. By better understanding this diversity of experience, we can deliver more targeted and effective support so everyone has equal access to good mental and financial health.
Compounding barriers to good mental and financial health
People with mental health problems are not a homogenous group. Accounting for characteristics such as gender, age and ethnicity can illuminate the additional and compounding barriers to good mental and financial health many within this group experience. For example, we know that people with mental health problems are more likely to be in debt. But when you take a deeper look at different people with these conditions’ experiences of debt, we see some important inequalities.
Among those with mental health problems, women are more likely to find it a burden to keep up with domestic bills and credit commitments (59%, versus 52% of men with mental health problems), and people from minoritised ethnic groups are more likely to be in a household that’s behind on bills. This ranges from 9% of White people to 33% of people who identify as Black, Black British, Caribbean or African. Younger people with mental health problems are also more likely to have had to borrow money or use credit to pay for everyday outgoings (34% of 18-34 year olds, in contrast to 26% of those aged 35-54 and 10% of 55-65 year olds with such conditions).
“I got into debt when I was younger, I was less good at managing my finances around my mental health. I have developed better systems as I have got older.” Expert by experience
Debt is just one area where the diversity of experience among those with mental health problems is noteworthy, and across the series we explored other areas including access to a good income and levels of savings.
Inequalities in access and quality of support
In light of these compounding barriers to good mental and financial health that certain groups experience, we were especially concerned to discover how unequal access to support can be.
Let’s take mental health services, for example. Being able to access good quality support can prevent poor mental health from taking such a toll on someone’s finances. It can also be a great opportunity for healthcare professionals to investigate whether someone’s financial situation is impacting on their mental health, and refer to support such as debt advice if needed.
Not everyone has equal access to these services, though. By failing to take into account different cultural norms, and not reflecting at a staff level the communities they are there to support, services can be less accessible to people from minoritised ethnic groups. Those who have accessed support told us how practitioners can fail to understand or address the role that ethnic identity can play in the development of mental health problems, with people also feeling ignored, invalidated or discriminated against on the basis of their ethnic identity. This can deepen and extend mental and financial health problems, and discourage seeking help in the future.
“I’ve never had an appointment with a mental health professional who wasn’t White. I end up having to explain the nuances of why a particular incident was so bad. […] That’s another layer of difficulty and extra work. More emotional labour.” Expert by Experience of White and Indo-Caribbean ethnicity
When it comes to gender, despite facing greater financial difficulty than men, women are less likely to be asked by a healthcare professional in a mental health setting whether they had any financial difficulties, and how their financial circumstances were affecting their mental health. And while disclosure of financial difficulties is low across all age groups, older people are less likely to speak to a mental health provider about their financial health than younger people.
Our ‘Through the lens’ series also looks at other services including banks and debt advice services, where this disparity in levels of access and support also exists. It explores where vital opportunities to break the link between poor mental and financial health are therefore being missed for certain people.
The need for more targeted interventions
After months of pressure from the cost of living crisis, it’s more important than ever that people are prevented from falling into the toxic cycle of money and mental health problems in the first place, or are able to access timely and effective support if they do.
Yes, interventions that aim to narrow the financial inequality between people with and without mental health problems will deliver real benefits for those of us with these conditions, regardless of our gender, age and ethnicity. But our research has also shown that to maximise the effectiveness of interventions, ensuring resources aren’t wasted and opportunities aren’t missed, action must address the diversity of experience among people with mental health problems.
If those delivering policies and services are serious about helping those struggling with these twin issues, they urgently need to reflect on what we’ve heard from people with mental health problems, and provide more targeted action that is responsive to the specific challenges different groups face.