Mental health and financial capability are intricately intertwined, each affecting the other in a complex relationship. While financial difficulties can be a source of stress and anxiety, poor mental health can, in turn, impact one's financial stability. In this article, I look at how bipolar mental health, which I suffer from, is likely to influence one’s financial capability.

The interplay between mental health and financial capability is multifaceted. Thus, the impact on one’s financial well-being can vary according to the nature and severity of one’s mental illness. The adverse financial consequences stemming from bipolar illness often reinforce one another.

A few of the impacts include:

Reduced earnings: A bipolar illness, treated or untreated, will likely impact one’s work productivity at certain intervals. This can result in absenteeism, decreased work hours or difficulty maintaining employment. The consequences of a bipolar illness on one’s financial stability can be profound. There exists a high risk of losing one’s job due to erratic behaviour or reduced earnings if, for example, you are self-employed as you need to take time out or work fewer hours to handle the depressive cycles or medication side effects. Thus, a person can easily find himself/herself in poverty. The symbiosis between a mental health condition and poverty is a vicious cycle challenging to break.

Impaired decision-making: Impulsive, grandiose thinking, euphoria or heightened risk-taking during the manic phase of bipolar disorder is likely to occur, resulting in significant consequences to one’s financial well-being. The manic phase is marked by elevated mood, increased energy and heightened impulsivity. During this phase, I can testify from first-hand experience, one acquires a sense of invincibility and will engage in reckless and excessive spending without fully considering the consequences. Reality and the aftermath of the decisions will be hard-hitting and pervasive as you face the harsh reality of your suddenly worsened financial situation post-mania.

Debt accumulation: The risk of accumulating debt in the mania phase of a bipolar disorder heightens significantly – whether this results from neglecting financial responsibilities such as paying your home loan, overspending or maxing out on your credit card.

Medical expenses: We have a social welfare system that recognises mental health as an illness today. I can attest that generic medication for the treatment of bipolar is readily available, including more advanced treatments such as transcranial magnetic stimulation for persons with chronic, medication-resistant depression. Yet, at times, medication is out of stock. Psychotherapy is essential to managing a bipolar illness, as is psychiatrist treatment. Government-free treatment in such services may not be forthcoming on demand. Thus, a person may be compelled to seek treatment in the private sector. It does not come cheap. Low-income people may struggle to meet such expenses, tapering off the frequency of such important treatment and ultimately giving up because they cannot afford it. The financial well-being and poverty symbiosis sparked by the bipolar condition will kick off again.

Having experienced how my bipolar illness impacted my financial well-being when I was involved in Gemma, within the Ministry for Social Policy and Children’s Rights, the government’s financial capability education platform, I believed that one important contribution was that of introducing a programme directed to equip persons with a mental health illness with a “financial well-being toolbox”. In designing this toolbox and a training programme on how to apply it, we teamed up with the occupational therapy services at Mental Health Services within the Ministry for Health. This programme's objective was to ensure that a person with a mental health illness achieves a solid foundation to manage their income and expenditure, plan for the rainy day and use proactive financial management strategies in managing the mania phase of bipolar, the importance of speaking one’s employer or human resources, etc.

It was a programme that the Gemma team could not have carried out without the support of the HSBC Malta Foundation. In support of this initiative, we issued the Mental Health and Financial Capability Guidebook – which can be accessed at https://gemma.gov.mt/wp-content/uploads/2021/05/Mental-Health-and-Financial-Capability-Guidebook.pdf