Tasneem Clarke, Research Officer, Money and Mental Health

From pillar to post: why signposting is not enough

Mental health professionals know that solid mental wellbeing rests on social pillars like good relationships, getting a sense of meaning from our daily activities, and knowing we can make ends meet. It may, therefore, be no surprise that people experiencing a mental health problem are more than twice as likely to have financial problems, and problems with money often contribute to their mental health problems.

“It’s the sort of thing that wakes you in the early hours, and makes you feel sick with nerves and worry.”

Unfortunately, when you’re feeling mentally unwell, it can be extremely hard to take action to help yourself with such practical issues, particularly if what you are trying to do is the very thing that causes you to feel anxious or depressed.

“Going to the bank to pay bills brought on panic attacks where I was unable to breathe, dripped with sweat – it ran off the end of my nose! – but would be frozen to the spot. I couldn’t ask for help whilst in the grip of an attack.”

Out of reach

Luckily support with these practical needs is available, at least in theory. Whether it’s support from your financial service provider, a free debt advice charity, or the welfare state system, help to address financial difficulty can make a crucial difference not only to someone’s practical situation, but also to the stress and fear of being pursued by creditors. Yet services that exist to do just that can be strangely hard to access for those who need them most. For someone too frozen by anxiety, or too paranoid to answer the phone, it’s easy to miss a crucial appointment. For someone weighed down with depression, finding the motivation to undertake a series of phone calls and explain your difficulties over again can be next to impossible.

“Because I was ill at the time I couldn’t fight my case, having a mental illness or a disorder which is ongoing for me it’s hard to have the confidence to ask for help.”

Mental health professionals like myself therefore often find themselves doing the “asking” on behalf of the people they are working with. Whether it’s supporting people to navigate the benefits system, speak to creditors, or access free financial advice, this can take up valuable hours, days and even weeks liaising with professionals outside of the mental health system to get people the practical support they need before being able to focus on getting well.

Joining the dots

In researching our report The Other One in Four, we came across several services that had recognised this dilemma, and pioneered simple ways to make it easier for people with mental health problems to access advice and support. Where they exist, such initiatives show that when good links between mental health and advice services are in place, both services become more effective. Referrals become easier and quicker when the referrer and the advice provider trust each other’s services, thanks to being in close contact. They each have a better understanding of what help is needed and what is available. Work is not duplicated, and responsibilities are more clearly defined. Missed appointments are less likely because people can be supported and encouraged to attend, and because the advisor would have at least a basic understanding of mental health.

Unfortunately such coordinated systems are patchy across the UK, despite the fact that there are many effective ways to link public services together. Examples include using partnership working, social prescribing, or co-commissioning to make a debt advisor physically available at an NHS site. Any of them can bring enormous advantages to someone in desperate need of reliable and accessible advice, but also to the services trying to support them with limited resources.

“The initiative required to phone, book an appointment and go, was too much for almost all the patients with mental health issues. Now I give the patient an appointment…and they almost invariably attend.”

It’s not rocket science, but with advice and mental health services both increasingly stretched, and pulling back at the edges of what they offer, what should be an overlap between them can risk becoming a gap. The evidence from those mental health services that have gone beyond signposting is encouraging, and should be built on by others. Even more of a challenge will be forging better links with the benefits system, creditors, employers, or housing providers. For us though, it’s an aim worth pursuing to prevent both professionals and service users wasting their time and energy fighting through a thicket of bureaucracy just to get appropriate support.