Recovery space – a Psychiatrist's perspective

Money and Mental Health are to be congratulated for their work on finances, debt and mental health. Investigating the misty waters of the financial, credit and benefits sectors in relation to people with mental health conditions is fraught with spectres, contradictions and prejudices.

During a mental health crisis, so neatly defined in this report, people with mental health conditions are particularly vulnerable to developing financial difficulties. Anyone working in the field of acute mental health services is familiar with these, along with the barriers to resolving or mitigating them. Importantly, practitioners recognise the knock-on effects of developing financial problems and the vicious circle that can result from a deteriorating mental, financial and social state, which has consequences beyond the crisis. These conditions are costly, in more ways than financial, to the individual, their family and to health and social services.

These knock-on effects are succinctly summarised by the term deteriorating ‘financial resilience’ used in the report, from which a person may take many years to recover and may increase the likelihood of further crises. In the shorter term, it is worth remembering that for many people, a ‘mental health crisis’ itself takes time to recover from, something that we often underestimate. Getting back on one’s feet after such a crisis is difficult enough, without adding financial or other strains.

Practitioners do not ignore these additional problems, but they do face barriers when helping to resolve them. They are familiar with the ‘grey areas’ of capacity and consent outlined in the report and the need to often make decisions on behalf of individuals before matters worsen. Finding information from third parties may be difficult, interacting with benefit and financial agencies can be bewildering and practitioners encounter a range of legal barriers.

Practitioners will welcome the recommendations made in the report, particularly that of extending the ‘Breathing Space’ scheme to people in mental health crisis. The language and intent of this recommendation chimes neatly with the purpose of managing a crisis – to give the individual time away from their usual life and responsibilities, to protect them against further harm and to help them to begin to resolve some of their present difficulties. In short, to gain them ‘breathing space’ to repair and to avoid exacerbating their already troubled position.

Overall, perhaps the central message here is that crises need to be looked at for what they are: a time of great difficulty, a decisive moment, and a turning point. Help in these moments calls for urgent action in a setting that can pull together the relevant agencies to help promote change and prevent unnecessary deterioration, supported by policies that reduce troublesome barriers to recovery. In this case, a greater integration of health, social and financial advice services would be a welcome step.