They can't just have a light bulb moment as we'd expect them to, says Maxwell. "We get a bit pious," she says. "But people are captured in their debt. It affects their long-term planning."
If that's not bad enough indebtedness was cited as an "important risk factor for mental disorder" by the UK Government's Foresight Review of Mental Capital and Wellbeing. As well as mental health problems there are also conditions such as borderline personality disorder that can wreak havoc on finances.
And the researchers in the Royal College's review of literature about mental health and personal finances found that the more debts people are burdened with, the more likely they may be to have a mental disorder.
It can be a chicken and egg situation. Sometimes financial stress leads to depression or mental health problems or at least has an effect, and at other times the reverse is true.
The UK's National Association for Mental Health says that for people whose mental health fluctuates, being in debt can bring on a bad episode. It's not uncommon for people in this situation to become too afraid to open official-looking envelopes or even answer the phone.
People with low self-esteem or who are feeling down can find talking to bank staff, lenders and other officials particularly difficult.
Some of the relationship between money and mental health is a no-brainer. If someone's anxiety, depression, bi-polar disorder or schizophrenia, for example, affects their ability to work, there will be a reduction in income, which can lead to financial problems. What's more, work doesn't just provide income. It is often associated closely with a person's identity. Lose their job and their self-worth can be affected, which can in turn have an impact on mental health.
Up to 80 per cent of people with mortgage payment problems can experience mental health problems, the research reviewed by the Royal College found. And household heads with consumer debt had lower than average levels of psychological well-being than those without consumer debt.
Researchers behind the Royal College report found that large-scale housing recessions had a negative effect on mental health for people who had no experience of coping with hardship. One moment your financial future is secure. The next your property is in negative equity and the lender is calling the mortgage up. It's easy to see a big black tunnel in that situation instead of a future.
On the other hand, it's not all intuitive. Researchers Howard Kaplan and Kelly Damphousse suggested that children with lower psychological well-being may be less likely to borrow for higher education and to take out mortgages, which then has a negative impact on their financial future.
In a review of research, the Royal College found that debt can make you anxious and/or depressed. But it's not only depression that has a symbiotic relationship with debt.
The human cost of debt can negatively affect personal identity, the study found. It makes sense — some people feel negative about being in debt and it can induce feelings of stigma and shame — especially when unexpected, such as by the erstwhile successful businessman who has fallen on hard times.
Some types of mental illness such as bi-polar disorder can lead to spending sprees. United States research cited by the Royal College found that compulsive buyers were more likely to make minimum credit card payments than others.
In his autobiographical series The Secret Life of the Manic Depressive, Stephen Fry described how he would go off while in a manic state and do something like buy six cameras in one afternoon. He was wealthy enough to do so.
Financial adviser Steve Morris of SW Morris Associates says that clients with bi-polar disorders have got themselves into significant debt and sometimes can't hold down regular jobs. "Often, the key is to get family members and partners involved to provide support in creating a plan to rebuild their financial position."
Mental ill-health is stigmatised in our society, which means people with debt and mental health problems often don't seek help to solve their financial problems and customers with debt won't admit to mental health problems believing that the information may be used against them.
The British research found that there was a lack of training of budget advisers, who didn't necessarily know how to deal with mental health problems, and mental health professionals who didn't have the time, knowledge and confidence to ask about patients' finances.
That lack of financial success might all be down to mental health problems, large or small. The signs to watch out for, according to the Ministry of Health, are experiencing the following for two weeks or more:
• Feeling down, depressed or hopeless often
• Feeling angry, frustrated or irritable more than usual
• Having little interest or pleasure in doing things you used to enjoy
• Feeling worried or anxious often. This anxiety can cause physical symptoms such as pain, a pounding heart or stomach cramps
• Feeling restless
• Low self-esteem
• Loss of energy or feeling tired
• Difficulty concentrating or making decisions
• Feelings of emptiness or loneliness
• Thinking about death
• Sleeping too much or too little
• Loss of interest in sex
• A change in appetite or weight loss or gain
People who do feel financially stressed need to take steps to manage the problem. As a society, our first reaction to someone's financial problem is to send people to a budget adviser. Sometimes the best step can be to seek help from a mental health professional.
If you are connected with the mental health services then seek help there, says Mental Health Foundation spokeswoman Paula Taylor. That will give you access to social workers, counsellors, care workers and others. Services vary according to which district health board they come under. If not available from your DHB, see your general practitioner (GP). GPs can organise counselling sessions.
It can be hard, says Taylor, to open up to friends, family and colleagues. However, it's best not to go through a mental health problem alone. If you suspect that someone around you might have a problem, then start a conversation. "The first step is to let the person know you are there for them and ask the person if there is anything you can do."
You might be able to be an advocate for the person.
Taylor says both the Mental Health Foundation and the Ministry of Health have information and resources that will be of help to people who have mental health issues related to their financial situation or are in financial difficulty thanks to mental health issues.
The Ministry of Health's Coping with Financial Stress leaflet has good advice. It suggests:
• Talk openly about what's going on with people you can trust and work out how to deal with it.
• Work together to set goals with whanau.
• Get physically active.
• Take time to think through hard decisions.
• Look for community support.
Contact the depression helpline: 0800 111 757 or text 5626.
Download the workbook from depression.org.nz that outlines steps to overcome the problem.
Talk to your doctor or other health professional.
Choosing to ignore the financial problems related to mental health often leads to those problems getting worse.
