Financial interventions have a “sustainable effect” among adults with mental illness and substance use disorders

Recent reviews published in Psychological services sheds light on how financial interventions can help improve behavioral health outcomes for adults with mental illness and substance use disorders. The study reviewed more than a century of literature and found that financial-based interventions, such as money management programs and paying agent services, not only help people manage their finances but also can reduce drug use and improve overall performance.

Researchers conducted this study to address a critical treatment gap for adults with mental illness, substance use disorders, or both. Many people with these conditions struggle to manage their finances, which can make their health problems worse.

Psychological problems that accompany these problems—such as impulsive spending, difficulty budgeting, or falling prey to fraud—can exacerbate financial insecurity, which can lead to depression. and worsening mental health. Financial constraints can also hinder adherence to treatment and increase the likelihood of hospitalization.

Previous studies have shown that people with serious mental illnesses who receive help with money management tend to have better health outcomes, such as improved health and hospital stays. However, these studies have been scattered, and no comprehensive review of the evidence has been conducted to date.

“Money is an important part of life and many Americans are reluctant to talk about money,” said study author Jack Tsai, district director and professor of public health at the University of Texas Health Science Center in Houston. “A large percentage of Americans also have consumer debt and there is low financial literacy across economic and social groups but especially among low-income adults with and mental illness. I wanted to explore what steps are available to help adults with mental illness become more aware of their finances and manage their money.”

The study was a systematic review of peer-reviewed literature published between 1900 and 2022. The researchers searched several databases, including PubMed and Google Scholar, for studies related to human elders with mental illness or substance abuse problems who are involved in financial matters. Their search produced more than 2,000 articles, which they narrowed down to 18 studies that met specific criteria. Selected studies focused on repeatable financial interventions for adults with behavioral health conditions and reported quantitative outcomes related to money management or behavioral health.

“I’m surprised that there hasn’t been much activity in this area,” Tsai told PsyPost. “I knew most of the researchers in the studies I included in the review, and I was hoping to find new measures that I didn’t know about, but I was surprised to find very little that was new. That gives with the view that this is an area that needs further growth and development.”

These studies included many types of financial transactions. Others were voluntary, such as financial literacy programs designed to teach budgeting and saving skills. Others were more structured, such as paid agent programs, where someone manages one’s finances. In some cases, these arrangements were legally binding, and a third party controlled how disability funds or other benefits were distributed.

Researchers have found that financial transactions can have a positive effect on behavioral health outcomes. One of the most important findings is that funding-based interventions can reduce drug use among people with mental illness and substance use disorders. In particular, the review highlighted the benefits of paid affiliate programs. These programs were found to help individuals manage their money in ways that led to reduced drug use, particularly among people with severe mental illness.

In addition to drug use, financial transactions have also improved money management skills in several studies. The researchers found that people who participated in structured financial programs, whether through financial services or educational programs, reported better management of their finances. These programs not only helped individuals keep track of their spending but also led to improved budgeting and financial planning over time.

Interestingly, researchers have noted that the benefits of financial partnerships go beyond financial stability. Better money management appears to have a lasting effect, leading to better mental health and overall functioning.

For example, several studies have found that participants in financial programs had fewer hospitals and used outpatient health care services. Improved financial management also appears to strengthen participants’ self-efficacy, or their belief in their ability to control their lives, which is an important factor for long-term recovery from mental illness or substance use disorders. drugs.

“There are many financial strategies available that can help people with mental illness and alcoholism better manage their money and improve their performance,” explains Tsai. “The main thing that has been realized is that managing money does not only improve financial conditions but can also improve health problems. Improving structure and discipline in one area of ​​life (eg finances) can help improve other areas of life (eg addiction).

However, the researchers also found some negative results. In particular, they noted that when doctors act as an expert and a paying agent, the therapeutic relationship can be damaged. Clients in these two-part settings often felt pressured, which negatively affected their overall experience with the intervention. This proposal highlights the need to carefully consider who should act as a financial manager and under what circumstances.

Although the analysis provides important information, it also has some limitations. One of the main issues is the small number of high-quality courses available through financial partnerships for people with behavioral health conditions. Only four studies were randomized controlled trials, which are considered the gold standard for determining the effectiveness of interventions. Based on the promising findings, the researchers emphasized the need for more intensive research in this area.

“We need randomized controlled trials of cost-based interventions,” Tsai said. “The most researched intervention was paid through agents, but there is also a lot of interest in money management that needs more study.”

“I would like to promote a range of evidence-based interventions from highly structured, expert-led service models to self-directed learning models to serve diverse populations with diverse educational needs. finances. I also like to study how finances and behavioral health are related in ways to determine cause and effect, and how to improve life in both areas for Americans. In this country, there is a problem of moral health and one of consumer debt and misuse of funds which motivates me to continue to pursue this area of ​​research. ”

“For others who are interested in this matter, please feel free to contact them if you want to cooperate with the financial system,” added Tsai. “We are also always looking for donors to support our work.”

The study, “Evaluation of Financial Cost Management for Adults with Behavioral Health Conditions,” was written by Jack Tsai, Rebecca L. Kinney, Eric B. Elbogen, and Jeffrey Gluff.