Debt support should be integrated with healthcare services

In recent years, the cost-of-living crisis has quickly become a mental health crisis too. Research published in July by the Money and Mental Health Policy Institute, of which I am interim chief executive, showed almost half of UK adults report feeling anxious or “unable to cope due” to financial concerns, while as many as one in six UK adults said they had felt suicidal due to rising costs.

For people with existing mental health problems, the impact has been felt even more acutely. We’ve spoken to hundreds of people with recent experience of mental health problems who have told us that the cost-of-living crisis has compounded their poor mental health, leaving them in an almost constant state of anxiety and dread.

This group is three times more likely to be behind on at least one key payment like rent or energy bills compared to the general population. They are also three times more likely to have felt anxious, unable to cope or dread receiving communications from essential service providers about missed payments.

Not only do debt problems make people’s mental health worse, but they also make it harder for people to recover from poor mental health. But despite the high numbers of people with mental health problems struggling financially, only 9 per cent have received debt advice since the cost-of-living crisis began. This gap in support is trapping people in a vicious cycle of mental health and money problems, leaving many unable to recover, more likely to fall ill again in the future and require support from mental health services on a long-term basis.

With the fall-out of the cost of living crisis set to last years, the NHS must be equipped to deal with the knock-on effect on its services. But, that doesn’t have to mean a costly overhaul of the system. Instead, relatively small, evidence-backed reforms to better link up mental health and debt support could reap significant benefits, both vastly improving outcomes for people struggling with this combination of problems and relieving some of the pressure facing the NHS.

In particular, our research published in July shows the potentially transformative outcomes that could be gained from integrating money advice services into the NHS Talking Therapies programme, which treats over 1.2 million people with mild to moderate mental health problems each year.

The analysis suggests that linking up these services could help an additional 27,000 people experiencing depression or anxiety to recover each year in England alone. It could also double recovery rates for those struggling with depression and debt – from 24 per cent to 51 per cent. For people with anxiety and debt, it could increase the recovery rate from 41 per cent to 53 per cent.

Our research estimates the impact on mental health recovery rates could save the public purse £144m each year in England alone

A good starting point would be adding a question about people’s finances to the initial assessments for Talking Therapies. That will help to identify people who are struggling with money problems as well as poor mental health, helping them get simultaneous support for both issues quicker and kickstarting the recovery process.

All mental health settings work differently, so it’s crucial that this process works flexibly, with multiple ways for people to be directed to the support they need. This could range from co-locating services in the same building – so that someone receiving support for their mental health could walk down the corridor to get help with their debt problems too – to making digital referral pathways more seamless.

Ultimately, these changes would help people struggling with their mental health and finances to get better faster. They would also help free up hours of valuable clinical time that NHS staff tell us they sometimes spend on helping people with their finances, filling in forms or talking through financial worries. Importantly, these steps could also generate considerable savings for the NHS.

Our research estimates the impact on mental health recovery rates could save the public purse £144m each year in England alone, even when the costs of providing additional debt advice support are factored in. This includes £39m in healthcare savings, which could be reinvested into mental health services to reduce ever-growing waiting lists.

The coming years will continue to be very difficult for both people struggling with their mental health and finances and for overstretched health services. There is an urgent need for smart interventions that help more people get better and reduce the pressure on the NHS, but which don’t cost the earth.

Integrating money advice and talking therapies is a relatively small change that could transform outcomes for people struggling with money alongside their mental health, during the cost of living crisis and beyond. Given the urgent need to cut waiting times and save the NHS money, this is a reform policymakers and commissioners can’t afford to overlook.