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Understanding the Relationship between Financial Difficulties and Mental Health Problems
I hope to provide some insight into my research on the potential vicious circle between financial difficulties and mental health problems, and emphasising the importance of psychological mechanisms. I hope this research will inform policy makers in demonstrating the impact that financial difficulties have on mental health, but also demonstrating that mental health problems can impair financial decisions.
Student Debt
Back in 2010, at the height of the debate on increased tuition fees, I was amazed that nobody mentioned the potential impact on mental health. I set to investigate the impact of the tuition fee increase from £3.5k to up to £9k on student’s mental health. My research has shown that it has only had a minor impact until now. This got me wondering: perhaps it is not the amount of debt per se which is important, but rather how you view it.
People with mental health problems are more than three times as likely to be in debt. My student data set has shown that struggling to pay the bills has an impact on students’ mental health, and importantly there is a vicious circle between financial difficulties and eating disorder symptoms, general mental health and alcohol dependence. Finances impact mental health and vice versa.
Bipolar Disorder and Psychological Factors
An important gap in the literature is the lack of knowledge on whether financial difficulties are important in Bipolar Disorder. Impulsive spending is in the diagnostic criteria for mania, and as a sufferer myself I have experienced strong urges to impulse buy when I am unwell. My ongoing research on the area has shown that financial difficulties exacerbate anxiety and depression and vice versa in Bipolar Disorder. There are some interesting processes at play here: anxiety and stress predict later compulsive buying suggesting that ‘comfort spending’ may be important. A strong need for achievement, which is often seen in Bipolar Disorder, also appears to drive compulsive spending. This suggests that psychological therapies such as Cognitive Behaviour Therapy (CBT) might help break this cycle.
Impact of Findings
My research with students has received media attention, and has been used to inform a training package for Universities to increase awareness of the relationship. A key development is that Martin Lewis of Money Saving Expert has set up the Money and Mental Health Policy Institute after realising the extent to which this is an unrecognised problem, and his involvement in this has received considerable media attention. A key issue they are interested in is impulse spending in bipolar disorder. I am therefore linking with them about my research and was invited to their launch at the Houses of Parliament. I am offering a psychological viewpoint on the issue and considering how psychological therapy may help reduce impulsive spending when unwell. It is great to see celebrities, politicians, charities and banks involved in this discussion. They have some great ideas for policy such as having a family member as a ‘guarantor’ before credit limits can be extended, and encouraging mental health professionals to consider finances as a contributing factor to difficulties. I hope my research can play a part in informing these policies. A national charity The Children’s Society saw my meta-analysis on debt and mental health in adults and asked me to advise them for their report ‘The Damage of Debt’ about the impact on children’s mental health. There is already draft legislation in parliament as a result of their work.
My hopes for the next few years is to increase the scale of my research by applying for larger research grants and focus on developing specific psychological models of this relationship. This in turn could be used to develop targeted, evidence based interventions which are truly integrative and can be tested in the NHS. I am continuing to work with the Money and Mental Health Policy Institute to offer a psychological view and I hope my research can be used to help other NGO’s and charities. My research has shown a vicious circle between finances and mental health: we therefore need to tackle both simultaneously as if they were one problem.
Dr Thomas Richardson
Tom is a Clinical Psychologist working in Community Adult Mental Health Services for Solent NHS Trust and a Visiting Academic at the School of Psychology University of Southampton. You can follow him on Twitter @DrTomRichardson
Partnering for policy change
Find out how Dr Richardson's work with Money & Mental Health Policy Institute has influenced government policy
Read here
Resources
Conference Presentations on Debt in Bipolar Disorder Research, here and here
Talk on the Science and Psychology of Debt and Mental Health.
References
• Richardson, T., Elliott, P.A., Roberts, R. & Jansen, M. A Longitudinal Study of Financial Difficulties and Mental Health in a National Sample of British Undergraduate Students. Community Mental Health Journal, FirstOnline.
• Richardson, T., Elliott, P.A. & Roberts, R. (2015a). The Impact of Tuition Fees Amount on Mental Health over Time in British Students. Journal of Public Health, Epub ahead of print.
• Richardson, T., Elliott, P., Waller, G. & Bell, L. (2015b). Longitudinal Relationships between Financial Stress and Eating Disorder Features in Undergraduate Students. International Journal of Eating Disorders, 517-21.
• Richardson, T., Elliott, P.A. & Roberts, R. (2013). The Relationship between Debt and Mental and Physical Health: A Systematic Review and Meta-Analysis. Clinical Psychology Review, 33, 1148-1162.
• Pinter, I., Ayre, D. & Emmott, E. (2016). The Damage of Debt: The impact of money worries on children’s mental health and well-being. London: The Children’s Society.