Rose Acton, Policy and Research Officer, Money and Mental Health

The missing link roundtable

Bringing together the mental health, debt advice and political sectors


Yesterday we launched new research into the main NHS talking therapies programme (IAPT), at a high level roundtable attended by experts from the mental health, debt advice and political sectors. The Missing Link: How tackling financial difficulty in IAPT can boost recovery rates sets out how problem debt is impeding recovery rates from common mental health conditions, and proposes ways that the IAPT programme could help.


How to close the recovery gap
Our new modelling suggests that the stress, anxiety and psychological burden of financial difficulty is holding people back from recovery from mental health problems, and is acting as a drag on recovery rates across the IAPT programme. We found that problem debt halves the chances of recovery for people with depression.

Currently the IAPT programme does not formally recognise the link between financial difficulty and mental health, and is therefore not adequately identifying service users in financial difficulty or referring them on to help.

Our new report makes the case that the IAPT programme should recognise, and put in place steps to mitigate, the link between financial difficulty and mental health – by developing national Positive Practice Guidance on financial difficulty for healthcare professionals, introducing basic one-question screening to identify service users in financial difficulty and referring them on to specialist help.

In the longer term, we recommend that the IAPT programme fully embeds and funds money advice, making it easier for service users to access advice, while making savings to the NHS budget due to reductions in health care costs.


Cross-sector support
We were delighted to receive unanimous, cross-sector support for tackling financial difficulty in the context of the IAPT programme, with senior figures in both mental health and debt advice saying it’s a ‘no brainer’ and that our recommendations are ‘pragmatic’, ‘incredibly timely’ and ‘helpful’.

One mental health practitioner described how when you ask people what they want their life to be like in five years, they talk about the issues that impact their mental health, not their symptoms, showing how clinical treatment has to recognise the impact of factors outside of the counselling room, such as problem debt. Representatives from the debt advice sector discussed the additional benefit of embedding advice into IAPT, rather than referring out, as it would make it as easy as possible for service users to access the help they need.


Building the evidence base and testing the impact
Attendees agreed that, while the modelling suggests an intervention on financial would improve recovery rates, we don’t yet have the evidence for a full national roll-out. We therefore need to build a stronger evidence base, that looks at the scale of the issue, as well as evaluating the impact of an intervention.

IAPT with its centralised programme structure and routine data collection is uniquely placed to run local pilots and comparative studies. To build up the evidence base, we agreed the best way forward would be to test the intervention across a number of local pilot sites. This evidence could then be used to inform future interventions and to put forward the case for further investment and roll out.


Next steps
We are excited to say that we are working with various partners to look at how to make this happen. If you work within the IAPT programme or debt advice sector and this sounds like something you would like to be involved in, then please do get in touch at [email protected]


Read the full report here