Wealth & Mental Health: Reflections on the Intersections of Class & Mental Health

The impact that someone's wealth and class has on their experiences with their mental health is, I feel, underacknowledged. When it is acknowledged it is often done so dismissively in a "they've got money; how bad can they really have it?" kind of way and I believe this is one possible reason why many people can get a bit defensive discussing this subject. Obviously it is not acceptable to dismiss or diminish anyone's pain or distress. The experience of, for example, depression is no less awful for someone when they themselves or their family have wealth, but we have to acknowledge the impact that poverty has on people's mental health and the safety net that having wealth provides.

So, I thought I would write a short blog highlighting some of the ways that class and mental health intersect, as well as how this factored into our thinking when setting up LPG Counselling.

I am always a bit surprised that this isn’t talked about more given how much research data there is linking class and mental health. Both poverty and financial stress have been linked to worsening mental health and a higher prevalence of common issues such as depression and anxiety, with the poorest fifth of the UK population being twice as likely to experience issues with their mental health than those on average incomes. We often hear that employment is generally beneficial for mental health. However, these benefits depend on the quality of work: work that is unfulfilling, low paid, insecure or poses health risks can be actively damaging to mental health.

People who hear voices and/or experience visual hallucinations are also represented more in lower social classes, but there is conflicting evidence over whether social class is a factor in the likelihood of developing these experiences. Struggling with our mental health can easily cause us to fall into poverty. In the UK 300,000 people a year are put out of work due to struggling with their mental health. Where individuals need to take time off, this can come with a significant financial penalty. Statutory sick pay is only £95.85 a week for up to 28 weeks, less than a third of what someone working full time receiving the minimum wage would take home each week. And, whether employers offer their own sickness schemes on top of this is entirely at employers’ discretion: with lower paid, less secure work also less likely to offer these. Those who lose their jobs have to apply for Universal Credit through the DWP an experience which has itself been shown to increase psychological distress. All of this financial stress only serves to make recovery harder and we can see how having a financial safety net or family who can support us, while not making the experience of struggling with our mental health any easier, can prevent further burdens and sources of stress being heaped upon us while we try to heal.

To an extent, our class determines the treatment options available to us. NHS mental health services are very often underfunded and oversubscribed, with waiting times of up to and well over a year being common. This does very little to help people in the present. Often what is eventually offered is short term CBT therapy and continued medication, neither of which are intended to get to the root of what is actually causing the problem.

This means many people are faced with the prospect of having to go private in seeking support with their mental health. With private therapists fees often ranging from £45 to £100+, this is simply unaffordable for a huge number of people. For those who cannot go private, in some areas there are charity mental health services however these charities also often have long waiting lists meaning they too are limited in what they can offer. In the case of counselling charities it is likely that your counsellor will be a student. Not to disparage student counsellors, we all need to gain experience, but it does mean that clients are likely to have a counsellor who is less experienced. Further to this, it is jobs that are better paying that are more likely to be flexible in allowing people time off to actually attend things like therapy and support groups.

People often react defensively in discussions about wealth, class and their relation to mental health, but it need not dismiss or diminish anyone's experience of mental illness to acknowledge the many ways that class and mental health intersect in our society. By doing this we are better able to identify systemic factors within our society that have a negative impact on people's mental wellbeing.

How do we at LPG see ourselves fitting in to this? Well, acknowledging these issues has been fundamental to LPG from our inception. All of us at LPG have experience of and/or continue to offer free-to-the-client counselling and mental health services through charities and the NHS. We are real believers in the importance of these services. However, we are also fully convinced of the efficacy of the Person Centred approach in helping people who are struggling and, due to the pressure to offer short term therapies because of long waiting lists, it is relatively rare to find existing services where it is possible to fully work in this way. Added to this, in the charity sector "free-to-the-client" or counselling in exchange for a small donation more often than not means the counsellor is going unpaid. We don't feel that it is right for people who cant afford £45 per session to be priced out of accessing counselling or for counsellors to have to work for no pay.

This is why, when setting up LPG, we had as our aim creating a service that offered Person Centred counselling that is more affordable. All three of us have extensive experience working minimum wage jobs and when setting our fees we tried to think about what we could afford on those wages, while also providing us enough to live on in the present. We appreciate that £30 is still a lot of money to be paying regularly and this is why we emphasize that we do not require clients to attend weekly or even fortnightly. We give clients’ control of scheduling their sessions as and when they can and need them. Regular sessions are the ideal, but due to financial constraints or shift work this is not possible for many and we have tried to create a service that caters for that as much as possible. We also encourage any existing clients who are experiencing financial difficulties to speak to us in order to prevent them having to end counselling prematurely and have some capacity to offer them further reduced rates for sessions.

We are not under any illusions that this makes us a social enterprise or that there will not still be people priced out of accessing counselling with us. However, we hope that by considering this and offering flexible therapy at as low a price as we can that we can broaden access to Person Centred counselling and perhaps take a tiny amount of pressure off of the overburdened counselling charities.

Sources:

https://www.mentalhealth.org.uk/statistics/mental-health-statistics-poverty

https://www.mentalhealth.org.uk/sites/default/files/Poverty%20and%20Mental%20Health.pdf

https://pubmed.ncbi.nlm.nih.gov/25897057/

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30026-8/fulltext