The unresolved advice problems that are straining our mental health services
The link between those seeking advice services and people with mental health problems is one the advice sector has long experienced, now mental health services are feeling the impact of their patient's advice needs not being met. A report by citizens advice demonstrates the extent of practitioner concern.
In July 2018, Citizens Advice published a report; ‘The roadblock to recovery: How mental health practitioners deal with people’s practical problems in England’, that explored the link between mental health and the practical problems that individuals manage on a daily basis including debt, unemployment, homelessness and health problems.
One in four adults experience a diagnosable mental health condition in any one year, representing the largest single cause of disability in the UK. In 2017, over 100,000 people with mental health problems sought help from Citizens Advice, making it the largest health issue amongst their clients.
The correlation between practical problems leading to conditions such as stress, anxiety and depression is evident with the report indicating the most common issues leading to mental health problems as financial difficulties (91%), employment (84%) and housing (81%). The strain placed upon mental health practitioners is also evident with 53% finding it stressful to deal with patient’s practical problems, staying late or working unpaid hours.
87% of practitioners say that issues relating to debt, housing and unemployment force clients to cancel or miss their mental health appointments, making completion of treatment rare.
This creates a vicious cycle, missing appointments and receiving no support for practical problems will further exacerbate any pre-existing mental health condition and does not help to resolve the practical problem
A greater integration of health, social and practical advice services would be a necessary and welcome step so that mental health practitioners can refer patient’s suffering from practical problems to adequate pathways. The report highlights that only 11% of mental health practitioners feel able to advise clients adequately by themselves without further practical support.
The report calls for the government to place greater funds into the National Health Service as to include practical support services alongside current mental health programmes such as IAPT (Improving Access to Psychological Therapies). Instead of referring client’s directly to IAPT, a range of test models designed to offer support and advice for practical problems should be incorporated into the NHS. An example of this would be to identify a clients’ wider practical problems at an early stage by utilising GP referrals to practical support services or having GPs offer information on different practical services so that self-referral becomes an option. Another example highlighted by the report would be for practical support advisers to offer briefing sessions to mental health practitioners as to advise them on the different routes they can offer their patients.
Over 1 million people were referred to IAPT services last year and with funding for mental health services already considered to be at breaking point, it is important the government recognise the role advice problems have to play in affecting mental health and act now to address the strain both on the people and public resources involved.