Prime Minister announces review of mental health debt charges

10 January 2017, 11:42   By Samantha Smith

THE Prime Minister Theresa May has announced a review of the steep charges people with mental health issues often face in obtaining a medical certificate from their GP.

mental health
Credit: Emily frost/

This certificate - also known as the mental health debt form - can often cost as much as £150 or £300, with one in three people asking for it being charged by their GPs surgery.

In light of the close connection between debt and mental health problems, and in response to a popular campaign spearheaded by fourteen mental health charities, the PM has announced a Department of Health review into these charges. In addition, she's announced a suite of general measures to improve mental health care throughout the UK.

Of course, tackling the problematic link between debt and mental health will take more than simply removing doctor's charges for medical forms, not least because household debt has recently reached its highest level since the recession of 2008.

Rising household debt

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Increasing levels of household debt was what the Bank of England recently warned the public about in December, noting that borrowing grew in 2016 "close to the fastest growth rate since the global financial crisis".

This is a worrying development from a purely economic perspective, yet it's also worrying from a personal and social one, since it's now well-established that debt carries more than a financial cost.

As we've written before, it can cost the UK as much as £8.3 billion in terms of mental and physical health issues, breakdowns in family relationships, and work problems, at least according to the StepChange Debt Charity.

In fact, the Government's own figures state that "the economic and social cost of mental illness is £105 billion - similar to the entire annual NHS budget", something which has clearly led them and the Prime Minister to act on the issue.

Debt and mental health

On top of new mental health support for secondary schools and workplaces, new community clinics, and new digital mental health services, they're therefore launching a review into the mental health debt forms.

Research suggests that resolving debt problems for people with mental health problems could increase fourfold their chances of recovery from depression within eighteen months
Money and Mental Health Policy Institute

The review will be conducted by the Money and Mental Health Policy Institute, who were one of the groups to push the Government into acting.

On their website, they explain the urgent need for action by saying, "One in four people with a mental health problem is also in problem debt".

Given this high level of indebtedness, they go on to affirm that requiring people with pre-existing debt struggles to pay around £150 for a certificate is something of a perverse thing for a GP practice to do.

Even if this certificate proves to an individual's creditor that they have mental health issues and should therefore be treated more compassionately, the very fact that they need it suggests they're unable to afford charges for it without going into further debt.

Revealingly, the charity also add, "Research suggests that resolving debt problems for people with mental health problems could increase fourfold their chances of recovery from depression within eighteen months".

This is an important point, because it reveals how, somewhat ironically, the charges levelled by GPs can actually get in the way of people's recovery.


The review is therefore entirely to be welcomed, although it's still an open question as to what Money and Mental Health will recommend to replace the charges.

As the Royal College of GPs informed us, "GP practices, which are run as independent businesses, are forced to charge for all services which are not covered by their contracts with the NHS".

Because of this, the review will have to find a new way of covering the administrative costs of issuing the certificates, without overburdening GP surgeries or the NHS.

And even if Money and Mental Health find a model that stops the NHS' growing budget deficit from growing further while saving indebted people from unjustified expense, there will still remain the question of what to do about the UK's increasing levels of private debt.

This would involve tackling higher living costs, stagnating wages, and growing inequality, yet so far the Government have offered only tokenistic pronouncements on the "shared society" and promises from now-resigned PMs on transforming sink estates.

Without a concerted plan on what could be done to improve the fortunes of the "just about managing" families and the 32.5% of the UK population to have experienced poverty at some point between 2011-2014, problems with household debt will continue.

Worse still, they'll continue feeding into mental health issues, creating problems for people with vulnerabilities to anxiety, depression, and other conditions.

And such problems will continue to be generated, with costs to individuals, communities and the UK as a whole, no matter what the Government does to improve their symptoms.

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