Nikki Bond, Senior Research Officer, Money and Mental Health Policy Institute

Making debt advice accessible to people with serious mental health problems

26 October 2022

While debt advice can be a lifeline for tens of thousands of people each year, demand for this advice has long-outstripped support. But for people with mental health problems, particularly those experiencing serious mental illness (SMI) – such as bipolar or psychosis – difficulties accessing debt advice extend beyond issues of demand and supply. The real issue is that mainstream debt advice services, as they are currently configured, are ill-suited to the needs of people experiencing SMI.

Mental Health Crisis Breathing Space, introduced in May last year, affords people in crisis respite from debt collection activity and escalating fees and charges. This was a huge step toward targeting support for people who need it most. However a year into the rollout of Breathing Space, the Treasury is considering what the future of the service should look like to fulfil its potential of supporting people who are acutely unwell with problem debt. Therefore, we’re calling on the Treasury and the Money and Pensions Service (MaPS) to expand Breathing Space and fund a specialist mental health debt advice service specifically targeted at and tailored to the needs of people with serious mental health problems.

Mental health problems can severely impact our ability to get help with our debts

When someone is acutely unwell with SMI or in crisis, it can affect their ability to earn and manage money. Common symptoms, such as low mood, difficulties with motivation or periods of acute distress or altered realities, can mean people can struggle to work or manage benefit claims. As a result, incomes fall away. Other symptoms, such as reduced clarity of thought or concentration, can make it harder to manage budgets and ensure bills are paid, resulting in bounced direct debits or fees and charges. At this crucial point, people with SMI need urgent support with their finances. But precisely when people need debt advice, they face significant challenges in accessing it.

Problem debt has long been shrouded in stigma and shame and often means people delay seeking debt advice. For people with SMI, this is compounded by feelings of hopelessness, despair and a sense of unworthiness, which can prevent people from taking steps to seek help with their debts. Other people are often simply too unwell to seek help. When you feel unable to complete seemingly simple tasks, such as taking a shower or preparing a meal, looking for and engaging with debt advice can be impossible.

Mainstream debt advice is ill-suited to the needs of people with serious mental health problems

These challenges are further exacerbated by how mainstream debt advice services are delivered. Despite half of people in problem debt experiencing a mental health problem, mainstream advice services, particularly those which are delivered remotely, are not required to provide advisors with mental health training. This means people can find advisors have little understanding of how their mental health impacts their ability to manage money or communicate. The result is that advisors are sometimes unable to tailor their approach to ensure people can appropriately engage in and understand debt advice.  

“With an ordinary service, they don’t understand how things have happened and why you have made what seem to them illogical choices. They can become irritated when you find it difficult to understand because your brain is muddled. Worse, they assume you understand, which you would if you were well, but not when you are ill.” Expert by experience 

Often debt advice services require clients to have a certain level of capability – for example, to understand and process information and to act on guidance and support provided. But these steps can be beyond the capabilities of many people experiencing SMI or in crisis. Being acutely unwell and faced with tasks beyond their abilities, people can disengage from support.

5 principles for the design of a specialist mental health debt advice service

In a recent survey, we asked people with experience of severe mental illness or crisis about their needs in accessing debt advice when acutely unwell. Overwhelmingly, people told us they wanted a debt advice service designed around an understanding of their needs, with eight in ten respondents reporting they’d be more likely to seek support from such a service. 

These challenges mean we’re calling for the Treasury and MaPS to invest in a specialist mental health and debt advice service that:

  • Offers support proactively and reach out to people with SMI 
  • Delivers advice services to people with SMI where they are, including in psychiatric hospitals and Community Mental Health services 
  • Equips advisors with the training to understand how SMI can impact people’s capabilities
  • Offers casework as standard and tailors tasks to people’s capabilities 
  • Trains advisors to deliver welfare rights support in tandem with debt advice 

Sadly, as living costs continue to rise, those with serious mental health problems are likely to be among the hardest hit. That means the need for debt advice by people with mental health problems is likely to increase. To ensure that these people can get the vital support they need, the Treasury and MaPS must invest in specialist mental health debt advice services, ensuring they are designed around the needs of people with severe mental health problems and delivered swiftly to those with the highest level of need. This is crucial if we are to avoid further harm to people’s mental health and finances. 


If you’re in need of support with your money and/or mental health, it’s important to know that you’re not alone and help is out there. You can find information about organisations that can help here.