Helen Undy, Chief Executive, Money and Mental Health Policy Institute

A surprising policy solution to help tackle gender inequality

27 September 2022

Looking at the relationship between two factors (like money and mental health) is relatively straightforward – mental health problems make you more likely to have money problems, and vice versa. Add in a third factor (gender) and it’s harder to understand – and to explain – the relationships in the data. But understanding this is important, and has real-world impacts, so it’s vital that it’s not just those with a passion for stats who can follow what’s going on. 

For that reason, I thought it might be useful to walk through some of the conversations we’ve been having in the office lately to unpick what we’ve found, what we think it means, and why it matters.

Is gender even relevant?

Take a group of people without mental health problems and ask them whether keeping up with regular bills feels like a burden, 43% say yes. That’s quite a lot, you could stop your research here and start designing a policy intervention to help.

Now compare the men and women in that group. What do you think you’d find? Perhaps surprisingly, not that much. There’s only a 2 percentage point difference between men and women when it comes to whether they say keeping up with bills feels like a burden. So having dug a bit further, it would be tempting to end the experiment there, conclude there’s not much of a gender difference and design policy solutions that don’t factor in gender at all.

But if we take a group of people who have experienced mental health problems and ask them the same question; 56% say yes, keeping up with bills feels like a burden. As we might expect, experiencing mental health problems appears to make our financial situation worse. So now we know our policy intervention to support people with money worries should consider our mental health – and probably be targeted at those with mental health problems, perhaps through mental health services.

If we also then compare the men and women in that second group, suddenly the gap is significantly bigger – 59% of women say yes, bills are a burden, compared to 52% of men, which is a 7 percentage point difference. All of a sudden gender does seem like a relevant factor to consider when designing your policy intervention.

What difference does it make?

So while it’s complicated, it’s worth taking the time to unpick what’s going on here. On average, women are experiencing a slightly greater burden from household bills than men, but for women with mental health problems the issues are compounded even further. It’s important to say at this point that unfortunately the data isn’t available to be able to compare the experiences of those who are transgender, non-binary and gender-diverse – although from the qualitative data that we’ve gathered it’s clear there are additional compounding factors for this group too.

It’s worth trying to understand these differences so that we can get support right – because at the moment it isn’t working very well. In our research, not only did we find that women with mental health problems are the group most likely to say bills are a burden, but they are also much less likely to be asked about their money when accessing mental health services. And then if they are asked, they’re less likely to report being taken seriously and signposted to help and support as a result. So the gender difference appears to be being exacerbated by an unequal response to people’s needs.

Why are things worse?

These findings need exploring in more detail and across larger samples. To be honest, we don’t yet know from this initial exploration what’s really happening behind these findings. Women and men with mental health problems are roughly equally likely to report being actually behind on bills, but women are more likely to report cutting back on essential spending in response, rather than having savings as a safety net. It seems logical that the increased burden associated with bills for women with mental health problems would be at least in part a result of this need to ration heating, food or other essential costs. But there could be other factors at play too – like the feeling of burden itself being more significant.

Now that we know, what should we do?

Whatever the drivers behind it, the need for support is clear. Struggling with money makes mental health recovery harder and slower. Our research has shown that most people with mental health problems would welcome being asked about their financial situation by mental health professionals, and that effective signposting to money support can make a real difference to both people’s financial situation and their mental health. Asking about money is not routine in mental health services, and it appears that this may be even worse for women. 

We want asking about money to be baked into mental health services in the way that asking about smoking is already. Making it absolutely standard to ask if someone is struggling with money (and make an effective referral when they are) should reduce the gender differences by making it a default for everyone. It might also help to make mental health professionals aware that fewer women are being asked about their money, and what impact this is having.

Evidence based policy making needs complete evidence

Unpicking the data has taken us from a policy intervention to address financial difficulty, to one targeted at people with mental health problems, and then to a more nuanced solution that also takes into account the effect of gender inequality. More research is still needed into the links between money and mental health problems for people who are transgender, non-binary or gender-diverse too.

Sometimes you have to look quite hard to really understand the problems being faced by different groups of people – but if we don’t take the time to do it properly our policy solutions run the risk of widening existing inequalities. The more we understand, the more effective our solutions can be.


Through the lens: Gender, money and mental health is the first in a series of papers exploring the relationship between different demographic factors and mental health. Sign up to our professional network or mailing list to receive the next paper on age later this year.