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On the edge: What the cost-of-living crisis could mean for UK mental health

The ESRC Centre for Society and Mental Health

Our researchers and the Lived Experience Advisory Board

16 November 2022

The ESRC Centre for Society and Mental Health is launching a series of initiatives both to highlight the mental health impacts of rising costs of living and cuts to public services and to urge policy makers to make choices that mitigate these impacts.

In an effort to reassure and stabilise the markets, the Chancellor, Jeremy Hunt, has signalled that the Autumn Statement will include tax increases and substantial spending cuts. However, as the UK sees the highest inflation for 41 years, this will not reassure many people who are already struggling with and concerned about rising food, energy, and housing costs and delays in accessing critical health and other public services. Politics is always about choices. In deciding how to raise income and whether to cut – and if so how – public spending, the potential impacts need careful consideration, particularly on living standards and well-being.

In the run up to the Autumn Statement, we start by highlighting existing research – led by the Centre and others – that demonstrates the negative impacts on mental health of poverty and austerity and that points to concrete alternative policy solutions.

What do we know?

Food Insecurity and Fuel Poverty

The cost-of-living crisis is most visible in rising levels of food insecurity and fuel poverty. In recent years, there has been a sharp increase in the number of people experiencing food insecurity in the UK, with around 4.7 million adults now affected. At the same time, steep increases in energy costs now mean that many are unable to pay their bills and face stark choices between eating and heating. With rising inflation, stagnant wages, and uncertainty about whether benefits will increase in line with inflation, it is certain that the numbers affected will rise sharply in the coming months. Food insecurity and fuel poverty cause considerable anxiety and distress (1) (2). Those with disabilities and those experiencing poor mental health are more likely to be affected (3).

Several recent reports illuminate the impacts of food insecurity and fuel poverty:

Real voices

“There is a breakdown on Universal Credit - what they pay us for the rent, what we get for each child, what we’re entitled to as a couple. It goes all in one lump sum. But when you’ve paid all that and then you’ve got the bills - we had £53 to live on this month. We’ve got to get things and it’s not going to last.” 

43-year-old woman, living with her partner and two children - from Pushed to the Edge: Poverty, Food Banks and Mental Health by the Joseph Rowntree Foundation and IFAN

Illustration of a woman looking sadly out of her window.
Image courtesy Pushed to the Edge: Poverty, Food Banks and Mental Health by the Joseph Rowntree Foundation and IFAN
  • Analyses of data from Understanding Society, a longitudinal study of large numbers of households in the UK, found that fuel poverty was associated with poorer well-being on a range of indicators. This association was strongest when a composite measure of fuel poverty was used. Importantly, the researchers did not find any evidence that this was association was due to lifestyle factors (e.g., physical activity, diet). They did find evidence that it was partly accounted for by material deprivation. (Getting Warmer: Objective and Subjective health and Well-being)

  • Finally, in analyses of data from YouGov surveys of the general public and benefit claimants, CSMH researcher Professor Ben Baumberg Geiger and colleagues found that, among working-age people who are food insecure, 53% were claiming income/work-related benefits; and among people who were severely food insecure, 62% were claiming benefits. (Hunger and the welfare state: Food insecurity among benefit claimants during COVID-19)


To make ends meet, more and more people are relying on credit cards and loans to meet basic needs. This is pushing more people into debt. Debt has profound impacts on mental health (4).

Real voices

“I skip meals, I half every portion, I live very minimally, I never go shopping for anything other than bits of food, I pay minimum amounts off debts as I need to keep them happy so that I can order a new vaccume [sic] or washing machine in the future as I have no other means of affording/replacing needed items I am currently in rent arrears of £535 as I could not afford to pay the rent last month and got so sick of having empty cupboards and freezer. I am hungry"

Respondent from the GMDPP Big Disability Survey

CSMH Colc - towfiqu-barbhuiya-via-unsplash
Photo by Towfiqu barbhuiya on Unsplash

Benefits and Low Income

There is abundant evidence that those in receipt of benefits and those on low incomes are more likely to experience high levels of mental distress (5)(6)(7). This can be exacerbated or mitigated by social security and tax policy.

Real voices

"In A&E, we see people who have attempted to take their own lives with the reason being 'Doctor, I don't know how to feed my family. I don't know how to heat my home'... We're seeing toddlers coming in with burns because of burst hot water bottles," 

Dr Rosena Allin-Khan, Labour MP, Shadow Minister for Mental Health, and A&E Doctor, via Sky News

CSMH CoLC - Rosena Allin-Khan

Families and Young People

Families with children are among the most affected by increasing poverty. According to recent estimates, around 1.8m children are growing up in very deep poverty (i.e., cannot meet basic needs) and, again, this will increase in the coming months. Household poverty and insecurity has direct impacts on children and young people, including on mental health and well-being (8).

  • In analyses of data from the UK birth cohorts, Centre researcher Dario Moreno-Agostino shows that pre-existing generational inequalities in mental health may well have worsened since 2020, with younger people more vulnerable to poor mental health during the pandemic. While the stresses associated with the pandemic may have lessened, the ongoing economic crisis will bear heavily on young people’s mental health.

  • The REACH study, an ongoing cohort study exploring mental health among young people led by the Centre, has shown that, during the pandemic, mental distress increased most among those adolescents in families that were directly impacted by COVID-19 and related social restrictions. Key factors negatively impacting on mental health include living in overcrowded and low-income households. These impacts are likely to be exacerbated further by the current cost-of-living crisis and the imminent recession. This is causing further anxiety and distress. A recent survey commissioned by King’s College London found that a third of parents surveyed think the rising cost of living will greatly impact on their children’s mental health. (Covid-19, Social restrictions, and mental distress among young people: a UK longitudinal, population-based study and A third of parents think the cost-of-living crisis will significantly affect their children’s mental health)

Real voices

I'm not the only one in this position. There are families all over Bristol going through situations like what we're going through. Some worse than others. And I really can't take anymore of this. This is the first time I'm actually in tears.

Single dad Samuel lives in a one bedroom flat in Bristol with his two young sons, via BBC News.

  • A review of qualitative evidence on the links between precarious employment and mental health, led by Centre researcher Dr Annie Irvine, found that financial instability had direct and indirect effects on relationships and distress. Money worries meant parents had to restrict their own and their children’s social activities. Feeling unable to meet the social or material needs of dependent children was distressing for parents and often led to feelings of guilt and failure. Increases in the cost of living for families already on low incomes will further exacerbate these impacts on the mental health of parents and children.
    Paper forthcoming

What is planned?

In response to the current economic crisis, it appears that the government is primarily focused on reducing the national debt through a mixture of tax increases and public spending cuts. There is a real danger, based on previous evidence, that this approach will worsen the impacts of the cost-of-living crisis among those on the lowest incomes and further limit access to services at a time of greatest need.

Cuts to Health and Public Services

There is extensive evidence that austerity (i.e., spending cuts to reduce government deficits) impacts negatively on health and public services and on the most vulnerable in society. In a context of rising poverty and increasing need for public support, more austerity will be devastating and people will die as a consequence. It is those at the margins who will suffer the most.

Real voices

"I work from home part-time for a disabled access review charity. I’m also a physically disabled woman, and I live in my own flat with 24 hour care...My electric wheelchair is basically my legs, and I have to make sure it’s fully charged everyday so I can live my life to the fullest and I don’t get stuck anywhere. I need to use a ventilator to help me breathe overnight whilst I’m in bed, and more recently I’ve had to start using it during the day so I have one on charge 24/7 so I know it’s always ready to use. I also rely on a hoist, hospital bed, and feed machine, all of which require electricity."

An interview with Claire, via Cost of living crisis: young scots share their stories from BBC The Social

Woman in a wheelchair reading.
  • The impacts of any health and social care funding cuts are likely to be the most pronounced, given the extent of rising need. Research exploring the relationship between austerity and mental health service provision shows that austerity and associated policies have contributed to an overall increase in the burden of mental distress and marginalisation within the UK. Prior to the Coronavirus pandemic, healthcare funding increased at a rate below the long-term average and did not keep pace with the rising demand for healthcare as the population ages. Mental healthcare services have been feeling this pressure, as evidenced by high demands for inpatient beds and the increased use of the Mental Health Act.
    The Impact of Austerity on Mental Health Service Provision: a UK perspective

  • Prior research has explored options to reduce psychological distress linked to social disadvantage, including co-location of welfare advice services (for example, debt and access to welfare benefits) in healthcare settings. Research led by Centre lecturer Dr Charlotte Woodhead examined the effects of co-located welfare benefits and debt advice on mental health and GP consultation frequency. The study found that such co-located welfare advice improved short-term mental health and well-being, reduces financial strain and generates considerable financial returns. This research is ongoing via the UCL Health Justice Partnerships team. (Impact of co-located welfare advice in healthcare settings: prospective quasi-experimental controlled study)

Real Voices

“When people ask what I will do with the rising costs this winter, my answer is simple,” says Richard*, a 59-year-old disabled man: “I will die”.

from Fighting Back Against ‘Life or Death’ Energy Prices, via Novara

A man sitting in a wheelchair with a woman walking beside him

What needs to change?

Policy reform

The combined effects on mental health of increasing poverty and debt, decreasing – in real terms – benefits and wages, and cuts to public services will be profound. Those who are most disadvantaged, marginalised, and vulnerable will be impacted the most.

Based on the above research, we select 10 broad and specific policies, both short and medium term, that can mitigate these impacts:

  1. Continuation of the energy price cap, with measures to prevent ‘self-disconnection’ among the most vulnerable

  2. More targeted support for with food, energy, and housing costs for those most in need

  3. Increase in welfare benefits in line with inflation, as a minimum

  4. Reforms to current welfare systems to simplify claims procedures and to ensure they are accessible and non-stigmatising

  5. Provision of services to support and advise people facing sanctions or changes in benefit entitlements to mitigate distress and to prevent them falling into debt

  6. Investment in health and public services that address waiting times, low capacity, and inconsistency in services by region, and

  7. Investment, in particular, in public services that improve access to employment, decent housing, legal advice, community supports, and social engagement

  8. For families and young people, implementation of our young-person-led six-point plan to enable young people to thrive post-pandemic

  9. Free school meals for all to mitigate the effects of household poverty and food insecurity

  10. Develop and implement, within health services, a ‘poverty aware paradigm’ which recognises the impact of poverty on individuals and communities accessing services. Integrating screening for poverty into health settings may increase our ability to identify those at particular risk and allow for better referral pathways from health to social services, including housing and employment. (see Should we screen for poverty in primary care?)

Austerity has failed. It has failed to reduce public debt or stimulate economic growth and has caused considerable distress for many people. Further cuts to core public services will only exacerbate the suffering caused by rising poverty and inequality. 

Work by the Centre

The Centre continues to lead research on the complex relationships between society and mental health, currently in our three research programmes: Young people and social change; Marginalised communities; and Work and welfare reform.

You can read about Centre related work via the links below:



Our Sick Society podcast

In addition, CSMH is about to launch a project, funded by the Maudsley Charity, to develop packages of social interventions that can be fully integrated into mental health services to address the social needs of those with severe mental health problems.

Get in touch

For more information about our work, you can visit our website or email

Work by The Policy Institute

The Policy Institute is carrying out an innovative mixed-methods research project to understand the impact of the increased cost of living. From this, we will co-design local and national solutions to mitigate that impact with those most affected.

Find out more here:

DPO Forum England

The DPO Forum England comprised of over 40 Disabled People's Organisations have coordinated an emergency communique to tell the government that Austerity Kills.

Press Release


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