Mental Health Outcomes in Times of Economic Recession

The UK is currently navigating the ‘biggest’ recessions many of us have ever witnessed, that together with a huge political instability, could spring UK population mental health at risk. Understanding when we need help is vital, specially when it comes to finances, a fascinating research published by BMC Public Health show us in detail this phenomenon. Countries in recession experience high unemployment rates and a decline in living conditions, which, it has been suggested, negatively influences their populations’ health. The present review examines the recent evidence of the possible association between economic recessions and mental health outcomes. Economic recessions have been estimated to significantly affect the population’s health and wellbeing, which applies to vulnerable groups of people. In countries that have been hardest hit by the latest recession, the living and working conditions have substantially worsened. Work became more precarious and unemployment rates increased because of the slowdown in global growth and consequent deterioration of the labour markets. For instance, almost half of the citizens of Europe reported knowing someone who had lost his/her job as a direct result of the crisis. Rates of involuntary part- time employment have also been rising since the beginning of the recession. Overall, people are more fearful about losing their employment since competition for jobs is rising and finding work quickly is perceived as unlikely. Levels of poverty and social exclusion have worsened, mainly in groups that were already at risk. During this recession, more people have been reporting being at risk of being unable to cope with unexpected expenses and even facing difficulties with paying ordinary bills or buying food over the coming year. It is known that the health of populations is shaped by the socioeconomic context, welfare systems, labour markets, public policies, and demographic characteristics of countries. There are strong reasons to believe that changes in these key determinants may be reflected in the mental wellbeing of populations. Therefore, mental health should be a health area regarded as possibly vulnerable during a recession, especially if mental disorders were already highly prevalent even before the crisis began. People facing these major life changes are more prone to mental ill-health. It has also been theorised that economic pressure and unemployment have a devastating impact on families, in particular children, since the family is the most important context for their healthy development. Other factors that add to the country instability is COVID and Brexit as many people in our circles has been affected with poorly health and or have leave the country due to non-existing work permits - all this is affecting a collective mental health in our country. Even though the economy can shape populations’ mental wellbeing, better mental health can in turn be a major contributor to economic growth. Policies and cost-effective measures may affect the extent of the risk factors faced by populations and the occurrence of mental health disorders during and after an economic recession. The World Health Organisation has argued that the mental health effects of economic crises depend on action in five key areas: ·active labour market programmes

· family support programmes

· regulation of the marketing of alcoholic beverages, restrictions on their availability, and taxation

· provision of quality and equitable access to primary care for those people at high risk of mental health problems

· debt relief programmes.

Our Society will be conducting various programmes in the following months targeting this issues if you wish to be involved please contact us.

Mental health and money problems are often intricately linked. Our research shows that in England alone over 1.5 million people are experiencing both problem debt and mental health problems. People with problem debt are significantly more likely to experience mental health problems

• Half (46%) of people in problem debt also have a mental health problem.

• 86% of respondents to a Money and Mental Health survey of nearly 5,500 people with experience of mental health problems said that their financial situation had made their mental health problems worse. PEOPLE WITH MENTAL HEALTH PROBLEMS ARE ALSO MORE LIKELY TO BE IN PROBLEM DEBT

• Almost one in five (18%) people with mental health problems are in problem debt. People experiencing mental health problems are three and a half times more likely to be in problem debt than people without mental health problems (5%).

• 72% of respondents to Money and Mental Health’s survey said that their mental health problems had made their financial situation worse. • HOW DOES BEING IN FINANCIAL DIFFICULTY AFFECT YOUR MENTAL HEALTH? Financial difficulties are a common cause of stress and anxiety. Stigma around debt can mean that people struggle to ask for help and may become isolated. The impact on people’s mental health can be particularly severe if they resort to cutting back on essentials, such as heating and eating, or if creditors are aggressive or insensitive when collecting debts. Financial difficulty drastically reduces recovery rates for common mental health conditions. People with depression and problem debt are 4.2 times more likely to still have depression 18 months later than people without financial difficulty. People in problem debt are three times as likely to have thought about suicide in the past year. There is rarely one single factor that drives people to take their own life. Instead, typically, a range of social issues, life events, cognitive and personality factors are combined. However, there is a strong link between problem debt and suicide, and more than 100,000 people in England attempt suicide while in problem debt each year. HOW DOES HAVING A MENTAL HEALTH PROBLEM AFFECT YOUR INCOME? The income gap for those with mental health problems is significant. People with anxiety and depression have a median gross annual income of £8,400 less than that of people without those conditions. Less than half of people with mental health problems in the UK were in employment in 2018/19 compared to four in five of those without mental health problems (48% vs 79%). When in work, people with mental health problems are more likely to work part-time (37% vs 24%), and are overrepresented in low paying roles. More than one in three (37%) of those in work who have a mental health problem are in the three lowest-paid occupational groups, in contrast to one in four (26%) of those who have not had mental health problems. People with mental health problems are more likely to receive benefits, which provide a low level of financial suppor t. A third of Housing Benefit claimants (35%) and nearly half (47%) of adults aged 16-64 in receipt of some kind of out-of-work benefit have a common mental disorder, such as depression or generalised anxiety disorder. This rises to two thirds (66%) of people claiming Employment and Support Allowance (ESA), a benefit aimed at those unable to work due to poor health or disability. Acute episodes of mental health problems can disrupt incomes too. People can struggle to attend work, maintain their benefit claims, or keep on top of managing their money. In England in 2018, 23,000 people were struggling with problem debt whilst in hospital for their mental health, with thousands more managing debt in the care of a crisis team in the community. HOW DOES HAVING A MENTAL HEALTH PROBLEM AFFECT YOUR EXPENDITURE AND ABILITY TO SAVE? Common symptoms of mental health problems, such as increased impulsivity and memory problems, can make it harder to keep on top of financial management or to get a good deal in complex markets, increasing the likelihood of financial difficulty. Many people with mental health problems report that their spending patterns and ability to make financial decisions change significantly during poor mental health periods. Recent national polling of people with mental health problems found that, while unwell six in ten (63%) people found it harder to make financial decisions, 42% put off paying bills and 38% took out a loan that they would not otherwise have taken out. Three in ten people with mental health problems (29%) reported that they would only be able to make ends meet for less than a month if their household lost its main source of income. This was double the rate of people who had never experienced a mental health problem (14%). HAVING A MENTAL HEALTH PROBLEM CAN AFFECT YOUR ABILITY TO ACCESS ESSENTIAL SERVICES AND MANAGE YOUR FINANCES Mental health problems can also make it harder to engage with essential services, such as banks and energy companies. People can struggle to understand bills and remember account details, leading to financial difficulties and distress. More than one in three (37%) people who have experienced mental health problems experience significant anxiety levels when dealing with essential services, including symptoms such as a racing heart or trouble breathing. Communicating with essential service providers can be particularly challenging. In national polling, three quarters (76%) of people with mental health problems found at least one communication channel difficult, with four in ten people (41%) saying they find it difficult or distressing to make phone calls. When alternative communication channels are not offered, this can prevent people from accessing support and addressing financial problems early. SUPPORT SERVICES HAVE A KEY ROLE IN TACKLING FINANCIAL DIFFICULTIES FOR PEOPLE WITH MENTAL HEALTH PROBLEMS Health and social care services can play an important part in identifying people with mental health problems who are also experiencing financial difficulties, but opportunities to spot people who would benefit from support are often missed. Only one in five (22%) of people with mental health problems had spoken to a GP, social worker or mental health nurse about how their finances affect their mental health, with less than three in ten (28%) reporting that they had been proactively asked about their finances. Debt advice services can also serve as a lifeline to people with problem debt, but many people with mental health problems struggle to access debt advice and need greater flexibility in the system to support them to get the vital help they need. •