Your mental health can be undermined by worrying about debt

Struggling with debts is making us ill. Just over two-thirds (67 per cent) of people taking debt advice from CAP (Christians Against Poverty) are also seeing their GP "due to the negative effects of debt".

Many of the health problems relate to depression and anxiety but the charity says that nutrition issues are also looming large.

To the small number of experts who specialise in the field, the CAP research – given exclusively to Your Money – does not come as a shock.

Speaking of the last few years, a spokeswoman for the British Nutrition Foundation says: "People in low-income households are spending more of their household income on food, yet the nutritional quality of their food purchases is declining."

Chris Fitch, research fellow at the Royal College of Psychiatrists, who specialises in the debt-mental health relationship, has assisted in proving the link. His work has helped demonstrate that people with debt problems are twice as likely to get major depression as those without.

The CAP data also shows that 42 per cent of their clients are being prescribed medication by GPs "due to the negative effects of debt".

The link works both ways. Debt can cause poor health; and poor health can cause debt. Some 11 per cent of CAP clients got into debt because of a long-term illness and another 2 per cent say that they got into debt as a result of mental health issues.

National Debtline, another advice charity, has come to similar conclusions, with 14 per cent of its callers saying their debt problems were caused by health issues.

National Debtline also surveys clients after they have resolved their pressing money issues. At this stage, some 90 per cent say "their general health and wellbeing improves as a result of getting advice", according to spokesman Paul Crayston. However, these links are poorly understood outside expert groups. For instance, many photographs of indebted people who have featured in newspapers show they are clearly overweight.

Some comments from readers have been so harsh that at least one debt-advice charity has asked papers to turn off the comment facility in these cases. Those readers do not, perhaps, understand that, as the British Nutrition Foundation spokeswoman says, "child obesity rises as household income falls."

But even the medical profession appears to have a way to go before linking health and debt problems. The Royal College of GPs, for instance, was unable to provide comments to The Independent on the CAP findings. And many GPs will charge far more than indebted patients can afford to write a letter that can be sent to creditors, saying that the person has health issues.

But the economic downturn has helped some GPs get a better understanding of how debt and depression can be related.

Dr Richard McClean, practising in Larne, country Antrim, says the trend in debt-linked cases of depression "has certainly been upwards over the past three to four years". In the "last couple of years", he has come to see the importance of encouraging patients to deal with debt itself.

"It is essential," he says. "Unless you are dealing with the root cause you are just popping a plaster on." But encouraging people to see a debt-advice charity can produce transformations. "Many mild-to-moderate cases can be dealt with without medication," he says.

Encouraging people to talk to family, friends or advisers helps another symptom of this kind of depression.

"Debt and social isolation usually go hand in hand," says Dr McClean. "One of the things I put to people is that it is not just about getting your debt cleared but about getting you speaking to people again and getting your coping mechanisms working again."

In some cases medication will be needed – and some people also ask for counselling. But there is concern that too little is being done with counselling in general.

Chris Fitch of the Royal College of Psychiatrists says: "Good progress has been made to deliver high-quality talking treatments in the NHS. However, further progress is needed to make sure that all people with anxiety and depression are able to access effective psychological therapies."

GPs are being encouraged to charge less for letters to creditors in cases where patients cannot afford the extra fees.

David Sinclair of the International Longevity Centre says: "If GPs know debt is a problem and having a negative impact on health, them charging to write a letter could actually be counter productive and make the situation worse."

His organisation published research this week which showed that older people struggling with debt have "eight times the odds of having reduced levels of mental wellbeing".

Citizens Advice says that three out of four of its debt clients have worries that are "impacting their mental health", and it wants to see regulators do more.

Gillian Guy, chief executive of Citizens Advice, says: "As part of its new duty to consumers the Financial Conduct Authority must give a clear and authoritative steer to lenders and debt collectors to make sure that people with mental-health issues are not being treated unfairly and suffering in isolation."

Chris Fitch thinks that there is potential. He says: "The problem is getting worse where creditors and the NHS see only one side of the situation. If creditors treat a customer with mental-health problems unfairly, their health could be affected, and the debt could go unpaid."

Jon King, a member of CAP's mental-health team, sees an improvement in attitudes by banks and other creditors. "The vast majority of creditors do care," he says.

If advisers such as Mr King can get a doctor's letter to a creditor, they will often stop interest and charges piling up, accept a compromise repayment arrangement and direct all letters to the adviser, rather than the debtor.

The average consumer debt for UK adults is £3,167, according to the Money Charity. That amount is tiny for a millionaire but may be insurmountable for someone on a low income. If we can help people repay debts without ruining their health we will create a society that is easier to live in for us all.

Case studies: spirals into sickness

Danielle and her husband got into financial difficulties after they moved house and he then lost his job. What made the issue worse was that Danielle was diabetic. "I was finding it harder and harder to regulate my blood-sugar levels," she says, recalling the stressful weekly shop when she had to decide between "what I needed to stay healthy and what we could afford". She explains: "All the cheap food was full of fat and sugar and so bad for my health, but I had no choice if we wanted to keep some kind of financial control. My health really suffered as I put on weight and my blood-sugar rocketed." They took out a loan, only to realise that they ended up worse off after they had used up the capital and were having to make hefty interest payments. They finally met a CAP adviser, who "never criticised us or made us feel stupid for the mess we'd gotten into" and helped them turn their finances around. Danielle no longer takes insulin, has lost more than four stones and says: "I could well not be a diabetic anymore."

Like Danielle, Jane and her husband were unable to cope with their debts. "I ended up on anti-depressants," she says. "Sometimes I would drink to sleep. My husband phoned the doctor who referred me to a counsellor. It helped but it didn't get the situation sorted." After six sessions, the counsellor suggested debt advice, and Danielle went to CAP. A budget and an arrangement with creditors turned the situation around both financially and in terms of Jane's health. She stopped taking the anti-depressants.