Helping people with mental health problems who are in debt

People with mental health problems are often prone to debt and practitioners need to be aware of solutions for service users in this position. Vern Pitt reports

When Deborah* had a manic episode caused by her bipolar disorder a few years ago she lost control of her spending. When she came down, the debt she’d accrued took its toll and she had to sell her flat. “I felt very ashamed of what I’d done because part of being an adult is being able to manage my finances,” she says. “It definitely worsened my mental health.”

Deborah is not alone, for many clients tackling money troubles can prove a strain on their mental health. Often their illness affects their bank balance in turn. It’s a complicated area where it’s easy to feel inhibited about interfering. There is, however, action that social workers can take to help, as highlighted by the Royal College of Psychiatrists in its booklet Final Demand: Debt and Mental Health.

Cutting back on necessities sometimes indicates debt trouble, says Jim Fernley, head of research at the Money Advice Trust: “It can be evidence that people are cutting off their fuel or heating for example, or it might be that they let slip they are not eating properly.”

Losing independence

People will often ignore the problem for fear of losing independence if they seek support. Chris Fitch, research fellow at the Royal College of Psychiatrists, says: “I had one person who threw all their letters into the toilet. I only found out they had financial problems when I asked to go to the loo and had great difficulty opening the door because of the vast number of envelopes trapped behind it.”

Free, impartial advice can make a huge difference. However, some people will feel they can resolve their own money problems. And there is a careful balance to be struck between assisting the client and empowering them to help themselves. “Sometimes the response of social care officials is a protective one and that’s understandable,” says Fitch. “They sense that, ‘They shouldn’t be borrowing this money and they’re being exploited, they’re vulnerable’.

“However, access to credit and financial services should be available to everyone, regardless of whether they’ve got a mental health problem or not. The decision should be based on their ability to pay.”

Research by the charity Mind found that 63% of people with a mental health problem who had debt trouble did not report their mental health problem to their creditor. It is these people that are most likely to need support in seeking advice.

Confidentiality fears

But fears over confidentiality and worries about giving the right information can stifle the ability of social workers and debt advisers to work together. The Royal College of Psychiatrists is devising a new form for professionals to use to communicate this information easily. Fernley, who has been involved with the project, says: “It provides a systematic way for a client to ask an advice worker to approach a mental health professional on their behalf to solicit information which is relevant about their condition.”

Social care workers are not expected to become money experts, says Fitch. Simple practical help can make the process work smoothly. “Whatever paperwork can be brought together, fantastic, do it. The most important thing is not delaying getting in touch,” he adds.

Routes out of debt

However, having some knowledge of the routes out of debt is important to understand the potential effects it will have on a client. Bankruptcy is rising but for many it’s not the solution because the restrictions it places on your finances adds stress. It also means that assets, including homes, will need to be sold to pay back as much as possible.

Other solutions may involve lengthy (but realistic) repayment plans, suspension of repayment or full and final repayments in one sum, usually lower than the total debt.

Once an action plan is in place social workers can still be of help. “The social worker may not be in a position to renegotiate things with the creditors but they may well be in a better position to contact the advice worker and flag up that something has broken down,” says Fernley.

If a trusting relationship exists between all parties it should be possible to get the client on track to being back in the black.

* Name has been changed

Case study

DAN, service user

‘I’m still in debt but I can see an end to it’

It was 2001 when Dan understood that he had a problem with debt and his mental health. He only realised this after meeting the woman who was to become his wife, who recognised the signs because she suffered from depression herself.

“Before that I’d thought spending six months without being able to open a letter and sitting next to an unplugged phone, shaking, was normal,” he says.

Dan was diagnosed with bipolar disorder. During his manic phases he would run up crippling debt followed by bouts of depression. “My credit rating ended up shot to pieces and bank charges built up and up while my ability to do anything about it went down.”

Debt worries only steepened the decline. “I assumed the moment I told anyone I’d be thrown out of home the banks would send people round to beat me up.”

He praises his wife for helping him get back on his feet. Dan now works as an administrator by day and a novelist by night. “I’m still in debt, but I can see an end to it,” he says. “The main thing has been facing up to talking to the banks, but it took a lot of support from my wife to gain the confidence to do it.”

• For more information see the Royal College of Psychiatrists booklet Final Demand at http://www.rcpsych.ac.uk/mentalhealthinfo/debtmentalhealthcontents.aspx