Merlyn Holkar, Research Officer, Money and Mental Health

Fair access to essential services for vulnerable consumers

“I find the process of hunting for deals overwhelming. My brain can crash, then I’ll just take whatever deal is closest to me. Or I’ll get stuck, and not be able to take any deal. Last time I needed a new mobile it was awful, it took me more than six months to decide which deal to get.”

We know that mental health problems can affect people’s financial capability, making it harder to navigate markets. However, the way that products and services are designed, and that essential service markets are organised, can often exacerbate these difficulties. As a result, people with mental health problems are more likely to pay over the odds, experience poorer service, and end up in financial difficulty.

Today we’re thrilled to be launching Levelling the playing field, a research paper which considers how regulators can better support consumers with mental health problems in markets for essential services – water, energy, financial services and telecoms.

What's going wrong?

We surveyed more than 500 members of our Research Community, and found systemic access barriers and disadvantage. We found that people with mental health problems commonly experience difficulties when choosing, using and paying for essential services. For example:

Choosing services:

  • Disengagement from the market – often because of low motivation or anxiety
  • Difficulties comparing options
  • Being unable to contacting suppliers to organise a switch

“It can be difficult as my brain is not able to process the information. I keep revisiting the different sites to remember who has said what as I do not retain details for very long.”

Using services:

  • Difficulties with certain communication channels, most commonly using the telephone or opening post.
  • Problems getting financial management support from friends and family – because current third party access systems are inadequate.
  • Reliance on disclosure of health problems in order to get support, when many people with mental health problems don’t feel comfortable doing this.

“I have massive anxiety about talking to strangers on the phone. I frequently end up feeling at best exhausted or at worst suicidal afterwards.”

Paying for services:

  • Struggling to understand complex essential service bills or tariffs.
  • Choosing more expensive payment options, because Direct Debits are too inflexible or difficult to keep track of.
  • Rationing consumption or self-disconnecting from essential services, because of money worries.
  • Poor collections practices which have a profound impact on consumers’ mental health

“Bills are often so entangled with legal jargon to cover the company’s backs that it is too easy to misunderstand the basics that the customer needs.”

What should regulators do?

Part of the challenge for regulators is the scale of this problem. One in four of us will experience a mental health problem each year, and most mental health problems fluctuate, so this is not a static group. By some estimates almost half of us will be affected at some point in our lives.

Identifying these consumers is also a challenge. Most people with common mental health problems aren’t receiving NHS treatment, and many don’t realise that their symptoms amount to a diagnosable health problem, or don’t feel comfortable telling providers about their condition. Many find it particularly difficult to advocate for themselves when they are acutely unwell, and need support most.

Given these challenges, it seems impractical, even impossible, to apply targeted interventions or adaptations for all consumers struggling as a result of mental health problems. Instead, we propose a shift in regulatory approach – so that regulators adopt principles of inclusive design, and configure markets so that they are accessible to even the most disadvantaged consumers.

In the report we set out immediate priorities for regulators – practical steps that could quickly be taken, to improve outcomes for consumers with mental health problems, and explore how regulators can make their markets more inclusive in the long term. Two key considerations are:

New technologies – Those who are least able to engage, often for reasons beyond their control like mental health problems or digital exclusion, tend to miss out on the benefits of competitive prices in essentials service markets. However, new technologies offer the potential to automate some of this engagement and to lessen the burden on consumers. In the hands of disreputable companies, however, these tools could also be used to discriminate against less active consumers. The new Centre for Data Ethics and Innovation should explore the ways in which artificial intelligence can improve market outcomes, and the regulation necessary to ensure this is a positive force for consumers.

Minimum standards – Mental health problems affect people’s consumer behaviour, and their access needs, regardless of the particular provider they are dealing with, or the regulator sitting above it. Inconsistent approaches to these problems make it harder for people to access the support they require. Regulators should collaborate to develop minimum standards of accessibility and support for people with mental health problems, that can be expected across essential services.