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MIND Conference 2008

16th – 17th June Brunel University, Middlesex

In the red: poverty, debt and mental health

Report by Anon

The key theme of this year’s conference based itself on the research and report that MIND has done into the connections between poverty, debt and poor mental health. An executive summary of the report entitled In the red: debt and mental health is available from MIND and to read the full report you can visit: www.mind.org.uk/money .

1. 16th June: Plenary session

Poor mental health: the link between poverty, debt and mental health

This session looked at the cyclical way poverty leads to debt leads to mental health problems and vice versa. Paul Farmer, Chief Executive of MIND opened by pointing out that debt is a growing problem for the general population and that debt especially impacts upon mental health. The issue of poverty and debt was ongoing. Christopher Fitch, researcher at the Royal College of Psychiatrists and contributor to the MIND report presented some of the reports findings. Money is obviously linked to social inclusion and debt – especially every day debt – is common and useful as it helps towards a socially inclusive lifestyle. However debt problems occur and these problems especially affect the more marginalised groups in society. People with mental health problems are 3 times more likely to incur debt arrears and 1.75 million of the population live with debt problems as well as mental health problems. In the MIND survey which took a sample of 1,804 people with debts and experience of mental health problems 50% reported missing two or more consecutive payments with at least one bill and 70% had been unable to pay a bill on the final reminder. On average each individual sampled owed an average of £3,250 on credit or store cards. 78% had been threatened with court action and 51% had faced bailiffs. Half of those surveyed lived below the poverty line i.e. living on less that £200 per week. 56% had gone hungry as a result of running out of money and just over half had gone without heating for the same reason. 92% reported not being able to socialise because of poverty and debt and 71% ran out of money most weeks. The research found links between mental health problems and debt – the disabling effect of living with mental distress leads to the accumulation of debt whilst the stress that unmanageable debt causes exacerbates bad mental health. Not many of those in debt seek help e.g. from the Citizens’ Advice Bureau or mental health professional or the creditors themselves. Indeed less than one third of those surveyed even told creditors about their mental health condition – mainly because they felt the creditors would not believe them. Those who did tell creditors about their mental health condition felt they were treated unsympathetically and with lack of understanding - less than 16% felt that they were treated with sensitivity and understanding. Health professional do not generally help with advice and help with debt but as it has it had an impact on mental health they should do so. Further information: www.mhdebt.info

Teresa Perchard of the Citizens’ Advice Bureau then spoke about the work of the CAB and said that debt was the number one problem that the CAB dealt with. The next most important area was welfare advice as it was often found that people missed out on what they were entitled to through lack of knowledge. The CAB worked within general mental health services to give advice on debt, benefits and employment. She observed how those with mental health problems were often socially excluded and experienced discrimination and lack of support. Debt was extremely common amongst mental health service users who can find their personal finances difficult to manage and often have problems with the utility companies. Mental health professionals do not help enough with practical issues especially when the service user faces psychiatric hospital admission. Out of the daily bankruptcies that are declared, at least a quarter of bankrupts have a mental health problem. There is a vicious circle of debt, acute stress and mental health problems. This vicious circle was increasing and not declining especially as debt amongst the general population was also on the increase. The solution was to offer help and advice earlier on before debt became a stressful crisis. Creditors should also be more responsible and mental health professionals should be more sensitive to the service user’s practical needs.

Shaun Gastall, a service user and member of MIND Link spoke of his own experience of debt and mental health. After a period of travel during which he incurred considerable credit card debts he became mentally ill and was hospitalised. As a result of his illness he lost his job so he was unable to pay off his credit card debts. It was his experience that mental health professionals offered very little help with his debt problems and it was not until he was discharged to day services that he was given some sort of practical help. He concluded that mental health services should focus more on assistance in practical problems like debt and the service user should not be left alone to try and sort out debt problems.

3: Panel Discussion: Moving into Employment

Duncan Shrubsole of the Crisis UK (an organisation which helps the homeless) stated that a mental health service user who is single and moving back into employment was generally only £8.63 better off than being on benefit so work was not the social and health solution that it was made out to be by the Government. There should be work for those who can and support for those who cannot – above all there should be meaningful activity for everyone. For those who wanted to work their work must be worthwhile – there should not be the attitude that any job will do for them. Schemes of supported employment for mental health service users should be sustainable and worthwhile. Work is not a destination for its own sake it is a pathway to rebuilding lives after the trauma of mental illness and treatment.



Martin O’Kane, Manager of the mental health and welfare rights service for Chesterfield Community Mental Health asked what the options were for retaining benefit but also working. He said there was voluntary work, permitted work, part time work and also full time work. Whilst voluntary work did not affect benefit entitlement it could lead to work capability assessments which did affect benefit. Permitted work was still restricted to 6 hours per week with a maximum allowance of £20 per week. It also seems that the Department of Work and Pensions (DWP) do not encourage permitted work mainly because they want people off incapacity benefit and in full time work. However with full time work there are no linking rules for those who wish to return to receiving benefit if their work is not successful – this is a problematic area. Martin O’Kane asked whether people were being given the right advice about work from the Pathways to Work scheme which was now 5 years in operation. The DWP seem deliberately unclear about payment in kind – especially for payments to service users for their participation in service user involvement activities: payment in kind can be seen as income and this is a grey area. Some service users are naturally reluctant to get involved in schemes as they see that payment will entrap them with the DWP and other benefit agencies. Payment for service user involvement was still a grey area which needed clarification. Martin O’Kane pointed out that Incapacity Benefit will be replaced by the new Employment Support Allowance (ESA) in October 2008. The change cannot be seen as an altruistic move to assist people who need benefit – it is a move to get tough on people to come off benefit and go back into work. It is a political gesture to fulfil election pledges which means that there will be no real change but more of the same: the drive to force people back into work and to cut expenditure on benefit. However benefit is a right for every citizen if they need it: there is no question of whether service users are deserving or undeserving. It is of interest that more benefit goes unclaimed from those entitled to it than there is lost funds through fraudulent claims.

Alex Tambourides of Hammersmith and Fulham MIND said that out of the 600,000 new claims for incapacity benefit in 2007, one third if the claims were from mental health service users. You are twice more likely to be unemployed with a mental health disability than with a physical disability because of persistent stigma and discrimination amongst employers. There should be more support for those who wanted to return to work and many service users were not aware of the support that was already available. The rules on permitted work should change to help people back into work as at present people were either working or unemployed – there was no transition stage to help service users. Also more should be done to make work a healthier place for those with mental health problems as work can also make you ill.