Evaluation Scotland Wales
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No one left behind

Evidence type: Insight i


Governments and authorities across the UK are striving to improve economic and health outcomes for those who are struggling or ‘left behind’, including as part of the UK Government’s so-called ‘levelling up’ agenda. A quarter of people experience mental health problems in any given year, and a half of people over their lifetimes. Financial difficulties and mental health problems often go hand-in-hand, yet people with mental health problems are a key group who have been left behind. Reducing the large ‘disadvantage gap’ that people with mental health problems face in some inequality hotspots needs to be an important part of the levelling up agenda.

The study

This study was undertaken by the Money and Mental Health Policy Institute (MMHPI) to understand what factors shape the disproportionate economic and health disadvantage that people with mental health problems face in some places in the UK and how a locality can help or harm people’s mental health and finances. This mixed-methods study included a review of existing academic and grey literature and involved analysis of four types of data sources:

  • National surveys: the Financial Lives Survey 2020, Family Resources Survey 2019-20, the Labour Force Survey 2021 and an MMHPI online survey of adults aged 18-65 across the UK from 2021.
  • Two bespoke surveys from the MMHPI’s Research Community panel of 4,000 people with experience of having a mental health problem or of caring for someone who does: one in February 2022 (432 respondents) and one in March 2022 (268 respondents).
  • A follow-up online focus group with eight MMHPI survey respondents in April 2022.
  • An online roundtable in May 2022 with representatives from the charity sector, local government, health service, civil service and government officials.

The analysis focusses on regional and national variations only (rather than variation at a more granular geographic level) and it focusses on outcomes for people experiencing mental health problems. The quantitative analysis draws on seven main measures: the burden of keeping up with domestic bills and credit commitments; the employment rate; housing costs that exceed 33% of household income; the economically inactive where mental health is a main health problem; being behind on household payments; and being within 1km of banking services.

Key findings

  • Drivers of the ‘disadvantage gap’: three main themes emerged:
    • Employment: Some places appear more successful in supporting people with mental health problems to find and stay in work. The disadvantage gap for people with mental health problems was especially large in Northern Ireland and Wales.
    • Living costs: The cost of key services (such as public transport) in an area could aggravate to or mitigate problems. People with mental health problems in London were highly likely to have fallen behind on housing payments in 2020-21.
    • Access to services: Accessible mental health, banking and advice services can be critical to people with money and mental health problems. Waiting times for primary mental health services and living within 1km of banking services ranged considerably.
  • Recommendations: Recommendation for UK Government include publishing levelling up metrics for people with mental health problems, introducing specialist mental health Work Coaches at Jobcentres and reducing the discrepancy between private rent and housing support. Other recommendations are made for local authorities, social landlords and the health sector.

Points to consider

  • Methodological strengths/weaknesses: Despite reasonably large sample numbers, the bespoke surveys of the MMHPI Research Community achieved comparatively low response rates, which might have skewed the results in unobservable ways.
    • Survey sample sizes at national and regional levels are likely to be small and the error associated with the statistical estimates large.
    • The qualitative evidence is based on only one focus group and is unlikely to have provided an exhaustive picture of the issues facing individuals.
  • Generalisability/transferability: The report does not provide any information about the likely representativeness of the bespoke survey samples, which may be limited in their generalisability to the wider population of people with mental health problems.

Key info

Year of publication
United Kingdom, England, Scotland, Northern Ireland, Wales
Contact information

Stacey B and D’Arcy C, The Money and Mental Health Policy Institute (MMHPI), 22 Kingsway, London, WC2B 6LE, www.moneyandmentalhealth.org