People using mental health services have dramatically higher rates of unemployment, housing insecurity and personal debt than the general population and these difficulties can worsen their health. This research highlights the link between poor mental health and a frequent experience of welfare problems such as unmanageable debt and difficulties with housing and benefits and finds that specialist welfare advice is likely to save mental health services money by improving people’s health and reducing hospital admissions.
The report looks at Sheffield Mental Health Citizens Advice Bureau (SMHCAB), which offers a real world example of how specialist welfare advice can cut the cost of mental health care in three main ways: reductions in inpatient lengths of stay; prevention of homelessness; prevention of relapse. The average cost of an inpatient stay is £330 per day nationally. Specialist advice located in a mental health service can help patients to resolve complex problems, including issues around housing, such as eviction or repossession, which may enable them to be discharged from hospital more quickly than would otherwise be possible. This also means that the risk of homelessness can be diminished, as those with severe mental illness are at much higher risk of homelessness than average. Homelessness costs the public sector, including the NHS, up to £30,000 a year as well as causing great distress to the person affected. Welfare advice can also help to prevent relapse of mental illness. A relapse of schizophrenia costs the NHS over £18,000. Specialist welfare advice can act directly on an immediate cause of acute stress which threatens to trigger relapse. The report calls for every mental health service to secure specialist welfare advice to help to support recovery and to intervene early when difficulties emerge. Health and social care commissioners should ensure that their plans include welfare advice provision. And the government should consider including welfare advice in its outcomes frameworks for the NHS, social care and public health.