Welfare advice should be a core component of a well functioning, efficient mental health service, says Sean Duggan
Mental health services have known for a very long time that their role goes far beyond providing traditional clinical care for people with mental health conditions.
‘People using mental health services have dramatically higher rates of unemployment and personal debt than the general population’
Ever since community care was first developed, professionals have realised that they are much more effective even in the narrowest definition of clinical terms if they address the social, economic and cultural needs of the people they serve as well as offering good medical and clinical care.
And if they have had to be reminded of this, people who use mental health services have consistently given the clear message that the support they want is not just to manage their illness but to build a life worth living.
From the creation of the care programme approach to the current mental health strategy, No Health Without Mental Health, the significance of a person’s financial situation to their recovery has been widely recognised, yet it has not consistently been considered a key aspect of mental health care.
Evidence reviewed by the Centre for Mental Health, however, has shown just how important advice about personal finance, housing, legal matters and work can be, not just to the lives of people who are struggling with debt, poverty and housing insecurity but also to the NHS itself.
Using the example of Sheffield Mental Health Citizens Advice Bureau, we found that offering specialist welfare advice as a core component of mental health care and support is likely to be highly cost effective for the NHS and its local partners.
Good quality, timely advice on housing, on work, on benefits or on debt can make a life-changing difference. It can, in some cases, avert a crisis that could lead to homelessness, to relapse and to an expensive hospital admission.
People using mental health services have dramatically higher rates of unemployment, housing insecurity and personal debt than the general population. Many will find it hard to gain access to mainstream debt, housing or employment services, exacerbating the exclusion they already experience and causing financial problems to escalate, while mainstream mental health services lack the expertise to negotiate the complex legal and financial systems many people have to deal with.
‘Welfare advice is a core component of a well functioning, efficient mental health service’
Expert support to negotiate these systems is not, therefore, merely desirable: it should be regarded as fundamental to good quality mental health care. Alongside employment and housing support, specialist welfare advice will make mental health services more efficient, more effective and more responsive.
For commissioners of mental health care, specialist welfare advice might appear to be an add-on to a service that is already struggling with spending reductions and pressures from every direction.
Our review, however, suggests that the financial pressures experienced by people with severe mental illness, and the impact this can have on the NHS, make welfare advice a core component of a well functioning, efficient mental health service.
Sean Duggan is chief executive at the Centre for Mental Health