PurposeThe purpose of this paper is to evaluate the evidence on the extent to which personal debt impacts on mental health, and mental health on personal debt.Design/methodology/approachThe paper systematically reviews the English‐language, peer‐reviewed literature, 1980‐2009, drawing on 14 databases across the medical, business, legal, and social science fields.FindingsFrom 39,333 potential papers identified, 39,283 were excluded, and 50 were reviewed using a narrative analysis approach. Among nine longitudinal studies, three controlled for psychiatric morbidity or psychological wellbeing at baseline, income/wealth, and other socio‐economic variables. From these, two reported indebtedness or an increase in debt levels associated with subsequently poorer mental health, while one study found no such relationship. While methodological limitations make it difficult to definitively demonstrate whether indebtedness causes poorer mental health, plausible data exist which indicate that indebtedness may contribute to the development of mental health problems, and mediate accepted relationships between poverty, low income, and mental disorder.Research limitations/implicationsExisting research either uses definitions of “debt” which lack specificity, or definitions of “mental health” which are too broad‐brushed. A more sensitive set of core questions is needed. Further longitudinal research is also a key priority.Practical implicationsThose working with people with debt problems need to be aware of the potential risk of reduced mental wellbeing or mental disorder.Originality/valueThe mental health of individuals living with indebtedness has become a recent concern for the health and financial services sectors. However, no systematic reviews have so far been conducted.
An understanding of the social and economic contexts mediating HIV spread is a prerequiste to identifying the environmental "pre-conditions" of epidemic outbreaks, and thus also, for predicting and preventing HIV transmission. The "risk environment" may influence the efficacy of individual and community-level HIV prevention and highlights the concomitant urgency for interventions targeting social and environmental change.
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.
RARs, which require relatively little external funding, appear to be effective in linking assessment to development of appropriate interventions. The present results add to the evidence that rapid assessment is an important public health tool.
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