Tending to Patients' 'Financial Mental Health'

By Garrick, Jacqueline | Clinical Psychiatry News, December 2016 | Go to article overview

Tending to Patients' 'Financial Mental Health'


Garrick, Jacqueline, Clinical Psychiatry News


The following opinions are my own and not those of the U.S. Department of Defense.

Job insecurity can have a powerful impact on health, particularly mental health.

A recent study of almost 17,500 U.S. working adults found that 33% of the workers thought that their jobs were insecure, and those who reported job insecurity were more likely to be obese, sleep less than 6 hours a day, report pain conditions, and smoke every day. When it came to mental health, those who were job insecure had a likelihood of serious mental illness within the last 30 days almost five times higher than those who were not job insecure (J Community Health. 2016 Sep 10. doi: 10.1007/ S10900-016-0249-8). This study is one of many that highlights the importance of what I call "financial mental health."

The notion of financial mental health merges two distinct, yet interrelated aspects of patients' lives into a single construct that can be used to inform resiliency-building behaviors and identify gaps in institutional approaches to supportive services. Patients with strong financial mental health are able to build, maintain, sustain, and revitalize their resiliency across several domains, which include mind, body, spirit, and social indicators.

Financial mental health should be considered a construct in its own right, because the impacts are great. It acknowledges that socioeconomic status and mental health are interdependent. This does not imply, however, that wealth is a protector from depression or that poverty ensures it. Rather, the construct recognizes the interplay between those factors, which often are managed in silos.

Financial mental health and mortality

According to the World Bank, "Mental health issues impose an enormous disease burden on societies across the world. Depression alone affects 350 million people globally and is the leading cause of disability worldwide. Despite its enormous social burden, mental disorders continue to be driven into the shadows by stigma, prejudice, and fear. The issue is becoming ever more urgent in light of the forced migration and sustained conflict we are seeing in many countries around the world." (1) In the United States alone, the Consumer Financial Protection Bureau (CFPB) reports that almost one-third of Americans are touched by poverty and advocates for financial literacy and empowerment for our most vulnerable citizens.

Unfortunately, mental health clinicians rarely discuss a depressed patient's financial planning aside from occasional referrals for housing, disability benefits, or subsistence allowances. Based on observations from the World Health Organization, mental health is tied to satisfaction with quality of life. Furthermore, it relates to the ability to cope with life's stressors, to engage in meaningful and productive activities, and to have a sense of community belonging.

When Abraham Maslow, PhD, described psychological health through the lens of human motivation, he constructed a "hierarchy of needs" (2) that at the base lies the physiological requirements for food, shelter, and clothing. Those items represent our most physical necessities, protect us from harm, and determine our survival. They also are related to our need for safety (i.e., job security), which is the second rung on Dr. Maslow's hierarchy of needs. In many ways, our ability to feel safe is predicated on our ability to secure our environment with proper housing, healthy nutrition, and appropriate wardrobe (and the accouterments thereof), which, in turn, align us and our families to our culture, community, and socioeconomic status. But it costs money to stay healthy and protected. The CFPB recognized the intersection of these issues and developed a toolkit (3) for social service and related agencies aimed at enhancing financial literacy and education within the populations they serve so that those individuals can become more skilled and empowered. …

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