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Mental health in an age of austerity
  1. Martin Knapp
  1. Correspondence to Martin Knapp, London School of Economics and Political Science; and Institute of Psychiatry, King's College London, PSSRU, LSE, Houghton St, London WC2A 2AE, UK; m.knapp{at}lse.ac.uk

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Given the current economic climate, it might well be assumed that it is a poor time to advocate greater expenditure on people with mental health needs. With the push to reduce government spending, a strong light is being directed to every corner where cuts might be made and mental health services are not likely to prove exempt. But might there be a case for quite the opposite course. Research shows that some expenditure on selected interventions may actually reduce public spending in the short or longer term, in addition to improving the well-being of individuals, families and local communities.

Links between mental illness and financial problems

The links between financial problems and mental illness are quite well known to those working in the mental health field. Unemployment, a drop in income, unmanageable debt, housing problems and social deprivation can lead to lower well-being and resilience, more mental health needs and alcohol misuse, higher suicide rates, greater social isolation and worsened physical health. To give one example, 45% of people who are in debt have mental health problems, compared with only 14% of those who are not in debt.1 Moreover, the effects of a macroeconomic downturn affect the mental health not only of some adults but also of their children.2 Numerous studies have also shown the effect of general economic recession and unemployment on the rate of suicides and suicide ideation.3

Of course, there are also causal links in the other direction. People with mental health problems are at elevated risk of economic hardship, with a higher risk of unemployment, early retirement, rent arrears and other debt, lower personal and household income and social isolation. Care must therefore be taken in interpreting associations and building an evidence base for action.

There is no question that current economic problems are very real. There are more than …

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