Financial problems of people with psychosis - Experiences of patients, caregivers & professionals

Josephien Leonie JANSEN1, Vera VERHAGE2, Lydia KRABBENDAM3, Richard BRUGGEMAN1,4, Janneke KOERTS1

1Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
2Department of Health Sciences, University Medical Center Groningen, Groningen, Netherlands
3Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
4Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands

Introduction

Finances are a key challenge for people with psychosis. Yet, remarkably, literature on this topic is scarce. The few existing quantitative studies showed financial dissatisfaction and financial competence deficits in people with psychosis. To fully understand the financial problems these people experience, however, a qualitative approach is needed, focusing on the perspectives of people with psychosis and important stakeholders. Therefore, this study aims to qualitatively investigate perspectives of people with psychosis, family members and mental healthcare professionals (MHPs) on people with psychotic disorder’s financial problems and risk factors for these problems.



Methods

Fourteen people with psychosis, 15 family members and 16 MHPs were recruited using purposive sampling. Semi-structured, one-on-one interviews were conducted. The Qualitative Analysis Guide of Leuven served as an iterative guide for data-analysis. Themes are illustrated with relevant quotations.



Results

Interviews revealed five overarching themes of financial problems, namely problems with: (1) Covering expenses, (2) Financial self-management, (3) Living conditions and Housing, (4) Personal conflicts and Victimization, and (5) Regulations and Legislation. Furthermore, six overarching themes were generated as risk factors for financial problems: (1) Psychotic symptoms, (2) Indirect consequences of psychotic vulnerability, (3) Substance use and Addiction, (4) Overspending, (5) Personal contextual factors, and (6) Societal contextual factors. People with psychosis, family members and MHPs largely agreed on the wide-ranging financial problems and risk factors that people with psychosis face.



Discussion and conclusion

Financial issues and risk factors often co-occur, potentially creating a vicious cycle. These issues can have serious consequences, such as reduced engagement in social activities, society and treatment. This study is an important step towards early detection of financial difficulties and risk factors among individuals with psychosis. Collaborative efforts among stakeholders and timely recognition of these challenges are essential to breaking the vicious cycle of financial problems for individuals with psychosis.