“Evidence of the link between mental ill-health and poverty is compelling,” he continued, spotlighting high levels of both poverty and mental ill-health compounded by austerity measures and cuts to public services.
“This in turn can increase demand for support with mental ill-health, with much of this pressure being felt by GPs and other primary care colleagues, who are often the first port of call for people struggling to cope.”
Late in 2016, the Social Publishing Project (SPP) published the results of its Quids In Readers Survey of social tenants across the UK and its findings echoed those in Liverpool and elsewhere in the UK. Our report called for more linkages to be forged between healthcare services and money advice. So what might those partnerships look like? And what is already underway? And rather than adding pressure on GPs, could advice services carry some of the load?
SPP has been sharing its research findings with financial capability networks around the UK. Our presentation reveals 47 per cent of respondents said money worries made them anxious, frightened or depressed. Around a third (35%) were skipping meals and 42% were switching off heating despite being cold. A fifth (22%) blamed their finances for falling physically ill.
Worse, working age people likely to be on benefits were suffering most. Among those not in full-time employment the statistics rose further: 58 per cent felt anxious, frightened or depressed; 44 per cent skipped meals; 51 per cent went cold; and 28 per cent felt physically ill.
The research found most people turned to friends and family for advice (37%), followed by GPs (31.3%) and then Citizens Advice (30.6%).
“Locally in County Durham these issues are also true,” Lewis Kirkbride told QIPN. He is the Healthier and Wealthier Network & Development Officer at County Durham Citizens Advice and recognises many people tend to start with their GP when it’s advice they need. “Work and money are still relatively scarce here, and you can plot health issues onto a map of the county in exactly the same places as deprivation.”
He reckons tackling financial issues will go a long way towards easing pressure on health services and, he says, local GPs have been become willing partners once advice agencies approached them with a clear offer. “Clinicians understand the links between stress and financial problems and physical health, so they’re extremely interested. It’s not just the effects of stress and anxiety – living in fuel poverty and having poor heating, for example, can increase your risks of stroke, heart attack and breathing problems. GPs are under immense pressure, so it’s not always easy to get your message heard, but once they understand what you’re offering they’ll be glad to have you if you can make your referral process easy.”
In February 2016, South Liverpool Citizens Advice was awarded the £2.5m contract to deliver the Advice on Prescription service over five years. GPs had noted a rise in patients presenting with problems with a practical rather than medical cause often linked to poverty and money worries. Expert financial advice was made available at surgeries across Liverpool, helping to prevent mental ill-health and promote recovery from mental illness. Doctors refer patients to advisors on a range of issues including housing, job loss, debt issues and benefit advice.
In a 2-year pilot prior to the five year programme, 80% of those referred to the scheme suffered from a long-term health condition and 75% had an annual income of less than £12,000. In that time, the Citizens Advice team dealt with over 13,000 referrals and increased income for local people by a total of £12 million through accessing tax credits and housing benefit, helping with prescription charges, unclaimed wages and other health-related benefits.
So what does it take to get a robust partnership between health services and money advice? “There are 3 main things,” says Lewis Kirkbride. “One is the willingness of a Public Health department to invest and keep the faith that good advice services will ultimately lead to better health in the population. Another is if you can offer doctors a lightning-fast referral into services. They don’t have much time with each patient so they can’t always treat the immediate health problem and tackle the underlying money issues, so show you can help reduce pressure on their consultation time. Finally, invest in a networking officer – it takes a lot of work and time.”