Schizophrenia and financial difficulty: a personal perspective

Having worked on a psychiatric intensive care unit during the first 3-and-a-half years of my career, I saw first-hand the ways in which schizophrenia is stigmatised, and the relentless problems it can cause for the approximately 1 in 100 people who live with it. 

Ahead of National Schizophrenia Awareness Day on 25 May I want to help bring to the surface this often overlooked mental health condition – and the role it can play in financial difficulty.

Despite significant progress in destigmatising mental health problems, one condition in particular seems to have been left behind. In both news and pop culture, schizophrenia is marred by misunderstanding, unhelpful narratives and alienation. For example, people with schizophrenia have continually been portrayed in the media in a negative light, often as perpetrators of violent crimes – rather than victims of violence, which is unfortunately more common.

On top of this, people living with schizophrenia are othered in society as a whole. Schizophrenia and its symptoms are often seen very differently from ‘normal’, everyday mental health problems such as depression and anxiety. Schizophrenia becomes something more unknown, more feared. 

But it shouldn’t be seen that way. There is nothing extraordinary about schizophrenia – it is an often severe and enduring mental health problem – no more, no less. It’s high time that it is better understood – time for us to collectively consign the stigma and othering to the past, making room for the complex realities for people living with schizophrenia.

On a ward supporting people with a diagnosis of schizophrenia, I saw first-hand the dire impact of the condition, and the way in which stigma and systemic problems can wreak havoc on people’s lives. There is not enough support for those living with schizophrenia and their families, and hospital admission is not a long-term solution. This leads to a vicious cycle and very high rates of readmission and relapse, often in part due to a lack of support outside of hospital. The stigma around schizophrenia can permeate everything, from the way staff treat patients to the way patients understand themselves. If the world is labelling you as violent, someone to be feared, is it so surprising that you start to believe it? 

I learned that money plays a consistent and devastating role in perpetuating this cycle. Far too often I would sit down with a patient telling me how they were in significant debt or that they were awaiting the outcome of a benefits assessment. Where hospital admission should be a time for recovery, so often I saw that it comes at the expense of people’s financial wellbeing.

I saw people stuck on wards for months while they waited for support with their accommodation, pushed towards relapse from the stress of limbo. They were stuck in the vicious cycle of money and mental health problems, with neither health services nor the welfare system offering a way out.

Our own research shows that schizophrenia impacts people’s ability to earn and manage money. Symptoms of schizophrenia can be highly distressing, and can make it impossible for people to engage with work and earn money whilst they are acutely unwell. For some, their illness can be too severe to hold down a job for any significant period of time, requiring wider support throughout their lives. Others may be able to work, but need time off during periods of mental health crisis.

Up to a third of people with a mental disorder are in problem debt – and an even greater proportion of people have missed a payment for an essential bill like rent or council tax. Given what we know about debt collection, this presents a significant challenge and risk for people with schizophrenia. The financial impacts can spiral, going hand-in-hand with periods of mental health crisis, leaving people unable to escape as arrears and extra charges mount and multiply.

Firstly, we can improve debt collection systems with some common sense changes. It’s unacceptable that under current council tax rules, for example, someone can be charged for a whole year’s worth of payments within just a few weeks of missing just one bill. With the government’s recent announcement of a consultation into this very practice, we are hopeful that changes will be made to protect people from these rapidly escalating debts. 

Next, we should improve the take up of Mental Health Crisis Breathing Space. It is currently an underutilised resource – and unlocking its potential could benefit tens of thousands more people each year. No-one in a mental health crisis should be chased for debts during the most vital stages of their recovery, and better uptake would help ensure this. 

Finally, there’s plenty more that banks and building societies can do to improve the third-party access mechanisms they offer. That would help to give people more control over their finances when they need it, such as the ability to grant a trusted person access when they need extra support.