Financial concerns and symptom distress among psychiatric outpatients
| Published date | 17 September 2018 |
| Date | 17 September 2018 |
| Pages | 105-113 |
| DOI | https://doi.org/10.1108/JPMH-12-2017-0041 |
| Author | David Kealy,Alicia Spidel,Sharan Sandhu,Dan Kim,Andrew Izbicki |
| Subject Matter | Health & social care,Mental health,Public mental health |
Financial concerns and symptom distress
among psychiatric outpatients
David Kealy, Alicia Spidel, Sharan Sandhu, Dan Kim and Andrew Izbicki
Abstract
Purpose –While epidemiological studies have linked economic hardship and financial difficulties with
psychological distress and suicide, investigation of financial concerns among users of public mental health
services has been limited. Moreover, empirical data regarding a relationship between financial difficulties and
mental health symptoms are lacking. The purpose of this paper is to examine the prevalence of financial
difficulties among patients attending community mental health clinics, and to examine the relationship
between such difficulties and psychological distress and suicidality.
Design/methodology/approach –Participants attending three community mental health clinics in British
Columbia, Canada provided demographic information, including annual income, and completed brief
measures of personal financial management, psychological distress and suicidal behavior.
Findings –Although more than half of participants reported good-to-excellent ability to pay their bills on time,
nearly half indicated poor long-range saving and financial planning. Lower annual income was directly related
to suicidality. Financial management difficulties were associated with psychological distress, and were
significantly related to suicidality after controlling for the effects of income and psychological distress.
Originality/value –The findings highlight the need for attention to distress and suicidality as potential
sequelae of financial management difficulties, and carry implications for further research, clinical intervention
and social policy. The findings confirm the need to address financial needs and money management abilities
among users of public mental health services.
Keywords Mental health, Financial management, Income, Psychological distress, Suicidal behaviour
Paper type Research paper
1. Introduction
1.1 Background
Financialconcerns are commonly regardedas a potential source ofpsychological distress.Indeed,
economic hardship is an important social determinant of poor mental health (Manseau, 2014).
Worries aboutnot having enough money to providefor oneself may escalate to the levelof clinically
significant anxiety, and the emotional toll of persistent poverty may involve abject depression.
The psychological distress associated with financial concerns may even involve suicidality
(Haw et al., 2015). Whileresearch using large-scale community surveys has providedevidence for
the link between financial challenges and reduced mental health, studies investigating this
issue among samples of help-seeking outpatients have been limited. The present study
sought to examine the relationship between income, financial management and psychological
distress –including suicidality –among individuals attending community mental health clinics in
British Columbia, Canada.
Epidemiological research regarding the link between socioeconomic status and mental health
difficulties has produced mixed findings (Kohn et al., 1998; Gresenz et al., 2001). Nevertheless,
many studies have indicated an inverse relationship between income and mental health, and a
meta-analysis of more than 50 studies found an increased risk for depression among individuals
with low income (Lorant et al., 2003). Indeed, individuals living in poverty have been found to
have considerably greater incidence of mental disorder (Bruce et al., 1991). More recently, in a
Received 6 December 2017
Revised 3 May 2018
25 June 2018
Accepted 30 June 2018
The authors have no conflicts to
declare.
David Kealy is Assistant
Professor at the Department of
Psychiatry, University of British
Columbia, Vancouver, Canada.
Alicia Spidel is based at the
Criminology Department,
Kwantlen Polytechnic
University, Surrey, Canada and
Mental Health & Substance
Use Services, Fraser Health
Authority, Surrey, Canada.
Sharan Sandhu, Dan Kim and
Andrew Izbicki are all based at
Mental Health & Substance
Use Services, Fraser Health
Authority, Surrey, Canada.
DOI 10.1108/JPMH-12-2017-0041 VOL. 17 NO. 3 2018, pp. 105-113, © Emerald Publishing Limited, ISSN 1746-5729
j
JOURNAL OF PUBLIC MENTALHEALTH
j
PAG E 10 5
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