NHS 75: how the NHS can help break the link between mental health and debt problems

This week the NHS turns 75. Since 1948 the NHS has been a cornerstone of our society, providing universal health care that is free at the point of delivery. As we celebrate the NHS this week, it also provides an opportunity to consider the future possibilities for reducing demand on mental health services through prevention, and avoiding escalation in mental health cases through timely and joint-up financial support. 

For us here at Money and Mental Health, that should include a focus on ensuring that people get the help they need to deal with the financial issues that too often accompany mental health problems — and which can make it much harder to recover. We will be publishing new research in the coming weeks about the impact that linking up mental health and money advice could have in improving recovery rates in the NHS Talking Therapies programme. But in this blog we explore some of the ways highlighted in our previous research that health care professionals can play a critical role in breaking the cycle between mental health and financial problems.

It is well-established that individuals experiencing mental health problems are more likely to face financial difficulties. In fact, our research has shown that in England alone, over 1.5 million people are experiencing both debt and mental health problems. Similarly, half (46%) of people in problem debt also have a mental health problem. 

For many, the stress and worry caused by financial difficulties can hinder recovery and further exacerbate mental health conditions. More than eight in ten (86%) respondents to a Money and Mental Health survey said that their financial situation had made their mental health worse. 

Health and social care services therefore need to be identifying when mental health problems and financial difficulties arise. This will allow for more preventative measures, as GPs can flag and direct people with mental health problems towards appropriate financial support services, thus reducing the burden on an already overstretched NHS. Yet, too often diagnosis is isolated into health considerations, and ignores external factors such as problem debt. This means many are missing out on the holistic support they need to manage their mental and financial wellbeing.

A survey we conducted of nearly 500 people with mental health problems found that just under two thirds (64%) felt they would have recovered more quickly from their mental health problems if they received financial support. Many also indicated that they would have appreciated such support when they first received a diagnosis or treatment, or when they first asked for help with their mental health. 

However, despite primary care professionals, including GPs, having a vital opportunity to assist individuals with mental health problems in avoiding financial difficulties, our research suggests that very few people are actually receiving such support from their GPs. Only one in twenty respondents who had received treatment from a GP reported being offered help with managing their money.

Clearly, there is an opportunity for primary care professionals to be playing a bigger role in directing people with mental health problems towards easily accessible money advice services. We would particularly like to see the government consider the role primary care professionals such as those working in GP practices can enhance the support they offer people  with mental health problems to prevent financial difficulties. An introduction of ‘Brief Intervention’ programs for GPs, similar to existing interventions addressing smoking and domestic abuse, would allow individuals accessing primary care with information about the link between mental health problems and financial difficulties, followed by referrals to local support services.

But primary care is only half the story. For many, their mental health diagnosis requires treatment within the secondary care system, such as Community Mental Health Team’s or psychiatric hospitals. Yet our research has highlighted that many in this scenario are facing significant financial harm during their treatment. We found over two-thirds  (68%) of people receiving secondary mental health care experience an income drop while receiving support from secondary mental health services. This financial strain can leave many people struggling to cover basic costs and bills while acutely unwell. Alarmingly, nearly six in ten (58%) respondents reported not receiving any support with their finances while under the care of secondary mental health services.

As such, we are calling on the government to take decisive measures to protect individuals in secondary care, especially during this ongoing cost of living crisis. In particular, we would like to see people detained in hospitals routinely asked about financial difficulties and automatically offered a referral to the Mental Health Breathing Space scheme – which provides people in crisis respite debt collection activity and escalating fees and charges for the duration of their care. Additionally, we would like financial circumstances to be considered as a routine part of Care and Treatment plans, health checks, and other support measures for those with mental health problems – thus ensuring financial wellbeing is always considered through an individual’s recovery journey.

As the NHS turns 75, we have an opportunity to look towards the next 75 years and embrace the chance to address the connection between mental health and financial difficulties. By prioritising the holistic wellbeing of individuals, we can ensure that mental health support goes beyond clinical care and includes the essential financial support that is also often needed for recovery. Together, we can make a positive difference in the lives of those struggling with mental health and debt.