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The relationship between personal debt and mental health: a systematic review

Chris Fitch (Research Fellow at the College Centre for Quality Improvement, Royal College of Psychiatrists, London, UK)
Sarah Hamilton (Senior Research Officer at Rethink Mental Illness, London, UK)
Paul Bassett (Stats Consultancy, Amersham, UK)
Ryan Davey (University of Cambridge, Cambridge, UK)

Mental Health Review Journal

ISSN: 1361-9322

Article publication date: 9 December 2011




The purpose of this paper is to evaluate the evidence on the extent to which personal debt impacts on mental health, and mental health on personal debt.


The paper systematically reviews the English‐language, peer‐reviewed literature, 1980‐2009, drawing on 14 databases across the medical, business, legal, and social science fields.


From 39,333 potential papers identified, 39,283 were excluded, and 50 were reviewed using a narrative analysis approach. Among nine longitudinal studies, three controlled for psychiatric morbidity or psychological wellbeing at baseline, income/wealth, and other socio‐economic variables. From these, two reported indebtedness or an increase in debt levels associated with subsequently poorer mental health, while one study found no such relationship. While methodological limitations make it difficult to definitively demonstrate whether indebtedness causes poorer mental health, plausible data exist which indicate that indebtedness may contribute to the development of mental health problems, and mediate accepted relationships between poverty, low income, and mental disorder.

Research limitations/implications

Existing research either uses definitions of “debt” which lack specificity, or definitions of “mental health” which are too broad‐brushed. A more sensitive set of core questions is needed. Further longitudinal research is also a key priority.

Practical implications

Those working with people with debt problems need to be aware of the potential risk of reduced mental wellbeing or mental disorder.


The mental health of individuals living with indebtedness has become a recent concern for the health and financial services sectors. However, no systematic reviews have so far been conducted.



Fitch, C., Hamilton, S., Bassett, P. and Davey, R. (2011), "The relationship between personal debt and mental health: a systematic review", Mental Health Review Journal, Vol. 16 No. 4, pp. 153-166.



Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited

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