Debt, common mental disorders and mental health service use

Abstract

Background: Uncertainty remains as to whether the effects of debt on common mental disorder (CMD) are persistent over time and what impact it has on mental health service use (MHSU).

Aims: To determine the distribution of debt across sociodemographic and socioeconomic statuses; to examine whether debt influences CMD recovery over time; and to determine the effects of episodic and/or long-term debt and CMD on MHSU outcomes.

Methods: Data were collected from phase 1 (N = 1698) and phase 2 (N = 1052) of the South East London Community Health (SELCoH) study, a population-based survey.

Results: 37.2% of participants who reported debt at SELCoH 1 and 46.6% at SELCoH 2 experienced concurrent CMD. Those with concurrent exposure to debt and CMD at SELCoH 1 were at greater risk of CMD at SELCoH 2. Debt accumulation was strongly associated with CMD cross-sectionally; however, this somewhat dissipated over time. Reporting any debt at SELCoH 2 or debt at both time-points were strongly associated with MHSU in the past year in the fully adjusted model adjusting for prior mental health.

Conclusions: More focus is needed on concurrent exposure to debt and CMD with regards to subsequent psychological impact and consequences for MHSU.

Keywords:

• debt
• common mental disorders
• mental health
• help-seeking
• service use

Declaration of interest

No potential conflict of interest was reported by the authors.

The funders did not have a role in the study design; collection, analysis or interpretation of data; the writing of the manuscript; or in the decision to submit the manuscript for publication. These data can be accessed through the corresponding author. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

This paper represents independent research partly funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. This work was also supported by the Economic and Social Research Council [Grant number RES-177-25-0015].