Nikki Bond, Senior Research Officer, Money and Mental Health Policy Institute

How Mental Health Act reform could prevent financial difficulty for people with severe mental illness

28 June 2022

When you’re in hospital for your mental health and possibly too unwell to keep yourself safe, your finances are often the last thing on your mind. But that doesn’t stop your income from dropping, due to not being able to work, or benefit losses due to difficulties keeping up with requirements to maintain your claim. Despite these income drops and being acutely unwell, rent and council tax still need to be paid, electricity and gas standing charges continue to add up, and credit card debts need to be dealt with.

During periods of acute mental ill-health, treatment is often provided through secondary mental health services, such as Community Mental Health Teams or psychiatric hospitals. The support these services provide is vital and saves countless lives. Yet, against the backdrop of income reductions and difficulties keeping up with payments, it baffles me that there are no widespread systems in health services to routinely ask about people’s finances and link people up with existing and established sources of welfare rights and money advice support.

Lasting damage and patchy support

Seven in ten people we surveyed experienced an income drop while under the care of secondary mental health services. Sadly, these income drops come at a time when the cognitive and psychological effects of our mental health problems mean we can least manage disruptions to our finances. Consequently, more than eight in ten survey respondents experienced financial harm while under the care of secondary mental health services – such as missing a payment for an essential bill or incurring bank charges for going overdrawn.

Despite the clear links between mental health problems and financial difficulties, nearly six in ten (58%) survey respondents were not offered any support with their finances while under the care of secondary mental health services. And eight out of ten (81%) respondents said their crisis or relapse prevention plan did not mention finances.

There are some amazing staff working in secondary mental health services who go above and beyond and ask about people’s broader financial circumstances. There are also examples of good practices where local money advice services provide outreach support in secondary mental health services. But the provision of joined-up money and mental health services is patchy. Relying on exceptional staff and pockets of engaged voluntary services is insufficient. This is an issue that should be addressed systematically by the government and NHS services.

Two opportunities in Mental Health Act reform to integrate money advice in mental health services

政府正在推进其整合保健和社会护理的计划。但是,将金钱建议纳入二级精神服务健康的努力在很大程度上被遗忘了。尽管有证据表明金钱和心理健康之间的联系,以及对康复的不利影响,但英国卫生和社会福利部和英国国家医疗服务体系尚未建立一个系统的过程,以确定在其护理中需要经济支持的人。

The one exception is the Treasury’s introduction last year of theMental Health Breathing Space机制。这是一项可以保护处于精神健康危机中的人们免受债务和欠款不断上升影响的法定文书。但是,如果没有一个系统可以在第一时间查询人们的财务状况,成千上万本可以从该工具提供的支持中受益的人可能会错过,原因很简单,因为他们不知道它的存在,也没有人问。

However, a vital opportunity to embed routine screening for financial difficulties among people in secondary mental health services is currently in progress, with the ongoing reform of the Mental Health Act. Two key changes would address the often predictable financial needs of people in secondary mental health services.

  • Include a financial difficulty prompt in statutory Care and Treatment Plans-As part of the ongoing Mental Health Act reform, the template for Care and treatment plans (the document that healthcare professionals complete with services users outlining people’s care and support needs) – are being reviewed. The government should take the lead frompractice in Wales,其中“财务和金钱”提示包含在护理和治疗计划文件中,并在新的模板文件中包括财务部分。
  • Include a financial planning prompt in Advance Choice Documents– Advanced Choice Documents, which will be a statutory requirement under the reform of the Mental Health Act, are primarily intended to enable people to express their care and treatment preferences in advance of admission to hospital. Current plans propose to include prompts around the care of children or pets in these documents. In a similar spirit of personalisation and prevention, plans should also include preferences for any help you might anticipate needing with managing your finances.

Without such intervention, there is a risk that we will miss this once-in-a-generation opportunity to embed screening for financial difficulties in secondary mental health services. As the cost of living crisis continues, and people with mental health problems are among those at the brunt of the crisis – it’s more important than ever that the government makes good on its commitment to support people with mental health problems through the crisis and beyond.

To find out more, you can read our full report, Not a secondary issue,here.