Making Power of Attorney work for people with mental health problems

A few weeks ago we launched our latest report “A little help from my friends”, which looked at the challenges people experiencing mental health problems face getting support with managing their finances. These difficulties are often not about a lack of appropriate support networks, but about problems with the limited tools available to people to help them safely share financial decision-making.

Experiencing a mental health problem can affect our ability to think clearly, problem-solve or process and remember important information. This in turn can make paying bills, managing a budget or simply contacting service providers tricky. Having a trusted friend or family member’s support can be the difference between keeping yourself financially afloat or not. 

People can feel overwhelmed with the responsibility of the decisions they are required to make on a day to day basis when dealing with essential services firms. Often for those experiencing mental health problems, it is not that they lack the capacity to make a specific decision, but that their ability to make that decision may be reduced, impaired or fluctuate. 

People don’t necessarily want someone to make decisions for them, but instead want support to understand the decision at hand and weigh up the information, and assistance to both make and communicate that decision.

Our research found that people experiencing mental health problems often don’t use the existing tools to enable a third party to help manage essential services like banking or energy. Mechanisms such as Power of Attorney (PoA) and third party mandates are often unappealing, as people said they give away too much power, allowing a third party to take all manner of decisions and actions on their behalf. They also share too much private financial information about what a person spends, when and where.  

While PoA is grounded in principles of promoting independence and autonomy, these ideals are often lost at an implementation level within firms. While it is possible to write a very specific PoA which only shares some limited permissions with a third party, it can be difficult within firms’ existing systems and structures to differentiate granular levels of actions and data. This often means that when a person appoints a third party, the firm delegates powers and access permissions wholesale, and the responsibility sits with the third party to limit their actions to the specific permissions that have been granted.

The Mental Capacity Act (MCA) legislates for how people should be supported to make their own decisions. It embodies the principles of empowerment and autonomy. A founding principle of the MCA states that people should be supported to make decisions wherever possible, and every effort should be taken to support and encourage them to do so. 

Supporting a person to make a decision can be a tricky task. It requires creativity, patience and a willingness to discard your own views, objectively presenting information in a way the person can understand. This might mean breaking the decision down, presenting it verbally, in writing and giving a person time to digest information, ask questions and seek clarity.

This understandably takes time. For those who simply want to support their loved one, it’s understandable that with the full range of powers and access that existing mechanisms currently delegate, it can be easy to fall into making decisions on another person’s behalf instead of supporting them. 

You can read the full report, A little help from my friends, here.