Guest Blogger: Dr Catherine Norwood, GP, The Kings Family Practice

#StopTheCharge campaign: A GP’s perspective

Why I support Money and Mental Health’s campaign


A small change can make a big difference
The “Stop the Charge” campaign launched this week by the Money and Mental Health Policy Institute is an excellent way to encourage my profession to make a small change to our practice to help vulnerable patients coping with the problem of debt and mental ill health. Many of us do not charge patients in debt for the ‘Debt and Mental Health Evidence Form’, or other supportive letters requested by debt charities they are working with. However research suggests up to a third do charge. It may be the GP is unaware the patient has been charged for the form to be completed – our receptionists are very good at explaining to patients that forms have a fee, or it may just be that as it is easier to stick to the Practice policy so we are not seen to discriminate between who we charge and who we don’t.


I am a GP, who has an interest in debt and mental health, and I would encourage those colleagues to review your Practice policy, talk to your staff and to do this for no fee. It really makes no sense for patients who have debt and mental health difficulties to be asked to pay. We know how difficult it is for patients often to come in and tell us about their mental health symptoms. Explaining how it is affecting every aspect of their lives such as relationships, housing, employment and finances really does take a lot of courage. Asking for this evidence form to be completed is another big ask for help.


The importance of asking, not just waiting to be told
The unique role of a GP is to treat our patients holistically. I know it is not always possible to deal with everything the patient asks in a 10 minute consultation and our primary concern in treating mental illness is to ensure our patients are safe and we provide appropriate medical and psychological therapies. But often we know our patients and have already started a treatment journey with them when they ask for help with ‘non-health related’ problems, such as debt.


I would encourage GPs to think about the link between debt and mental illness. Routinely asking patients who present with depression and anxiety if they have any financial concerns will quickly reveal a high co-prevalence. And asking patients with Bipolar Disorder or psychosis what their spending habits are like when they are unwell will be similarly alarming. 36% of clients helped by Christians Against Poverty Debt Counselling Charity in 2015, considered or attempted suicide before contacting them for help. By taking patients’ financial difficulties and debt seriously, proactively offering help by completing the Evidence Form, and signposting to free and confidential sources of help we really are treating our patients holistically, and in some cases saving their lives. Debt really is a sickness of our society, which we can do something about.


Let’s do what we can
I have completed (for free) Debt and Mental Health Evidence forms and it is really very straightforward. There are eight questions with guidance on the form to help you consider how their mental health and treatments may affect the way the patient can manage their money or work with the creditors. If you are asked to write a letter by a debt charity helping your patient then consider these same questions.


So I really want to add my endorsement of this campaign and appeal to my colleagues to firstly fill this form in for free, but secondly use this as a reminder to ask patients presenting with mental illness about their finances and think about how we can help that little bit and signpost to one of the free debt counselling charities. I have written to the Royal College of General Practitioners today suggesting a proactive response to the Money and Mental Health Policy Institutes campaign by developing resources to train GP’s and other primary care professionals. We need to do all we can to provide the best care possible to this vulnerable group of patients we are sadly increasingly seeing in General Practice.


Find out more: To learn about the campaign and show your support, visit the #StopTheCharge page.


Resources for GPs:

Debt and Mental Health Evidence Form version 3:

Primary Care Guidance on Debt and Mental Health listed on the RCGP website:

(please note that the Debt and Mental Health factsheet listed on their website is the 2009 edition – the most recent edition (2014) can be found below)

The Debt and Mental Health Factsheet (2014):


Sources of free, confidential advice: 0808 808 4000 0800 328 0006 (face-to-face home visits) 0800 138 1111