The Role of Psychiatrists

Chris Fitch, Robert Chaplin, Colin Trend and Sharon
Collard
Chris Fitch is a research fellow at the Royal College
of Psychiatrists’ Research and Training Unit (CRTU).
He is a sociologist with an interest in finance and
mental health, and the challenges of living with a
mental health problem in the community. Robert Chaplin
is a research fellow at the CRTU and a consultant in
general adult psychiatry for Oxfordshire Mental
Healthcare NHS Trust. He has interests in audit, the
therapeutic alliance and mental capacity. Colin Trend
is project manager at Money Advice Plymouth, and
provides advice and guidance to people in debt,
including those with mental health problems. Sharon
Collard is a research fellow at the Personal Finance
Research Centre at the University of Bristol. She has
research interests in the use of credit and other
financial services by low-income consumers, and is a
member of the Department for Trade and Industry
advisory group on over-indebtedness.

One in four people with mental health problems in
Britain report debt or arrears, which is nearly three
times the rate among individuals without similar
conditions. Although health professionals commonly
encounter debt among patients, some report that they
lack basic knowledge to effectively intervene and that
patient debt is often not acted on until a crisis
emerges. Our aim in this article is to improve
psychiatrists’ knowledge and confidence in dealing
with patient debt. We provide basic definitions of
debt and problem debt; outline the impact that debt
can have on patients’ health, social and financial
well-being; identify the stages and signs that a
patient may be accruing problem debt; describe how
psychiatrists should respond; and review the
instruments available to assess patients’ mental
capacity to make financial decisions. We do not expect
psychiatrists to become ‘debt experts’, but provide
working knowledge for engaging more effectively with
this problem.

http://apt.rcpsych.org/cgi/content/abstract/13/3/194

Copyright © 2007 The Royal College of Psychiatrists.