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Dr Fiona Pienaar, Senior Clinical Advisor at Mental Health Innovations, which powers the Shout 85258 text support service, explores the impact of the cost of living crisis on mental health and wellbeing, exploring what we're seeing in the anonymised data from our text service.

We are all aware of the impact the pandemic had, and continues to have, on the public’s mental health. This has put enormous stress on the system; for example this August there was a backlog of 1.6 million people waiting for referral to NHS mental health services, with an 80% rise in referrals for children and young people since the start of the pandemic.

Earlier this year two articles in the British Medical Journal (BMJ) highlighted the growing cost-of-living crisis. ‘Food bank use is a canary in the coal mine for mental health services’ served as a warning regarding the increasing need for food support amongst the public, with a concerning new trend of demographics beyond the unemployed needing help. ’Food aid charities fear the worst as the cost of living crisis takes hold’, reported on feedback from the Independent Food Aid Network that both donations and volunteer capacity had reduced, with people who used to donate food to food banks now seeking support themselves. The Network reported their teams struggling with both mental and physical exhaustion after the pandemic, noting that the level of distress volunteers are witnessing was more than should be expected of them.

The connection between income and mental health has been established for decades . In June 2022 the President of the Royal College of Psychiatrists, Dr Adrian James, warned that ‘the cost-of-living crisis poses a threat of pandemic proportions to the nation’s mental health’, citing ‘food insecurity, fuel poverty, debt and the loneliness and isolation that come with it, as ‘a hard reality for millions of people’.

What the data is telling us

Increasing media coverage on the ‘cost of living crisis’, including the impact on the public, reports from food banks and charities in general, and the government's focus on the challenges, would suggest to us that data collected from usage of our Shout service will increasingly reveal the impact on our texters and their families, exacerbated by the approach of winter.

We have been tracking this issue for some time and are constantly adjusting our understanding of the language our texters use to describe their distress related to issues connected to the economic situation. Our data team reported in mid-September that mention of the phrase ‘cost of living’ had begun to grow, with almost all related conversations concerning texters struggling to cope with soaring energy prices and rising food bills. In around a third of cases, these concerns were exacerbating existing mental health struggles. Other insight that emerged included:

Following this analysis, Shout’s Director of Data Insights, Dr Mark Ungless, commented: “We perhaps find ourselves at the foothills of this crisis and its impact on mental health, much in the same way that we saw early mentions of coronavirus in Shout conversations, in the early days of the pandemic.”

Supporting people with their mental health around the cost of living crisis

While many of the people who text Shout may be of an age when they are not directly responsible for finances, witnessing the anxiety and stress others in their home might be experiencing could result in young people holding back from seeking support for themselves from their parents and primary caregivers. They may respond by withdrawing and remaining watchful or they could act out their fears and concerns through more obvious changes in their behaviour. There may also be situations where they are directly impacted by the curbing of household finances, for example by a lack of food and heating in the home. Much like the public messaging that gave many people hope and information during the pandemic, awareness about supportive charities such as Shout, where they can reach out and talk through their fears and anxieties with compassionate people who are mindful of the broader picture of what is going on in society, is critical for the mental health of the public.

Let’s also not forget that many of our texters will be responsible for finances but may not articulate their struggles. It’s not easy to talk about financial difficulties and people could feel ashamed and embarrassed. This is a time for us to be sensitive to what might be lying underneath someone’s anxiety, worry, panic, depression, isolation and loneliness. We must hold an awareness about the increasing financial and other national and global challenges and how this may impact on people’s mental health.

As we continue to monitor this situation, each conversation widens our understanding about the language people are using to describe their distress; what challenges are affecting which demographics; how homelessness is changing and who is being impacted; where are people finding support; and the exacerbation of existing mental health challenges and signs of the emergence of new ones.

Our data will provide us, our partners and funders, academics, charities and statutory services with information that will be critical in informing responses to the cost-of-living challenges we are currently facing. Simultaneously our data insight will increase our volunteers’ and clinicians' understanding of the unfolding situation and ability to support our texters with updated resources and specialised support.

Importantly, as an organisation that deals constantly with demanding issues, we remain cognisant of the fact that we are all, collectively, living through these challenging times and we need to both look after our own mental health and be there in support of each other.