Feasibility and potential effects of a combined money advice and psychological therapy intervention within National Health Service Talking Therapies services.

Abstract

Background: It is now accepted that social factors affect not only onset but also mental health treatment outcomes. One such factor is financial difficulty. Within National Health Service (NHS) Talking Therapies, problem debt has been shown to interfere significantly with recovery from mental health problems, estimated as 22% versus 50% recovered with no problem debt. One solution is a combined money advice and psychological therapy intervention to improve treatment outcomes.

Aims: The aim of the current study was to trial a combined money advice and psychological therapy service within NHS Talking Therapies, to ascertain its feasibility and acceptability.

Methods: This study employed a mixed methods case series of individuals attending high-intensity cognitive-behavioural treatment who were provided with a combined intervention (money advice service plus NHS Talking Therapies). Acceptability and feasibility were evaluated through interviews, and benefit was assessed from comparisons of routinely collected symptom measures and compared to historical recovery estimates.

Results: Some 32 participants, with similar gender distribution but more representation from ethnic minorities, were recruited from NHS Talking Therapies. One-third demonstrated complete recovery on both depression and anxiety, while half showed symptom improvement and modest improvements on the financial outcomes measure. Our interviews with patients, therapists and money advisors suggested the combined intervention was acceptable and beneficial, but that money worries should be identified earlier.

Conclusions: The combined service is acceptable, accessible and could deliver benefit, even in the short term, to those with mental health and debt problems.