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Standing on the edge
With debt playing a major role in feelings of despair that lead to suicide, lenders and advisers are being encouraged to play a role in offering support to consumers.
People in debt usually have problems with more than money. Occasionally their personal tragedy spills over into newspaper headlines, with lenders dragged into the limelight. Last month, the Foresight Review of Mental Capital and Wellbeing, organised for BIS, featured an analysis by Howard Meltzer, professor of mental health and disability at the University of Leicester, examining links between debt and suicide.
Previous research included coroners' reports of suicides, information from the case notes of psychiatric patients admitted because of a suicide attempt, and data from national surveys of psychiatric morbidity. Not surprisingly, all showed indebtedness to be a risk factor for suicidal thoughts, and successful and unsuccessful suicide attempts.
Professor Meltzer found that being in debt doubled the likelihood of having suicidal thoughts, even after taking into account personal factors and traumatic experiences. Looking at the relationship between sources of debt and suicidal thoughts in general, he said that debts which result from a matter of individual choice – such as overspending on credit cards or buying goods on hire purchase – in contrast to getting behind with payments for basic utilities, are more associated with suicidal tendencies.
He concluded that people experiencing difficulties in repaying such debts due to having recently been made unemployed, having had a relationship break down or coping with caring responsibilities may need psychiatric evaluation as well as debt counselling.
Professor Meltzer's paper was presented at an event which included a presentation from Professor Rachel Jenkins, whose latest study found that there is a lack of coordinated activity across health, money advice, and creditor organisations. Her paper, Recession, Debt and Mental Health: Challenges and Solutions, published in Mental Health in Family Medicine, proposes solutions identified in workshops held during the UK government's Foresight Review.
It found that, as a minimum, all UK financial sector codes of practice should recognise the existence of customers with mental health problems. All codes should also define best practice in working with such customers. Creditors should ensure that their practices comply with the statutory requirements for disability discrimination.
It recommends that health and social care professionals should ask patients about financial difficulties in routine assessments and, to enable action to be taken, they should ensure good referral links exist with the money advice sector. Where debt is reported, primary care professionals should routinely assess for depression and other common mental disorders. Low levels of customer disclosure of mental health problems may be an important obstacle to creditors taking appropriate account of them. Creditors should work to encourage customer disclosure, and money advice agencies should update creditors (with the client's consent) about any changes in circumstances.
Money advisers should not be expected to become mental health experts, but when a client discloses a problem for which they require, but are not receiving, therapeutic support, advisers should be able to direct them to information and/or referral services. Health and social care professionals should receive basic training in debt first aid – learning how to talk to patients about debt and how to refer to, and support, debt advisers.
The Jenkins study also recommends a renewed emphasis on coordinated debt care pathways between local health and advice services – that is, the routes by which individuals with debt and mental health problems get the support they need.
These measures would be a first step towards addressing the relationship between debt and mental health, but it is a complex issue that requires far more examination.
The Consumer Credit Counselling Service is taking practical steps to bring help to people in debt who could be depressed or even suicidal. Our online counselling Debt Remedy will help people to find advice, referrals or online treatment through cognitive behavioural therapy. Professor Jenkins' view has been that at least half of those in debt are clinically depressed – so a pathway for tens of thousands of people a year is the ideal.
The work of Professors Jenkins and Meltzer shows how great the need is. We can help with the treatment, and lenders must learn how best to deal with a population in desperate need of being treated fairly.
Original article, by Malcolm Hurlston, Chairman of CCCS, courtesy of Credit Today.
