Intended for healthcare professionals


The cost of living crisis is harming mental health, partly because of previous cuts to social security

BMJ 2022; 377 doi: (Published 27 May 2022) Cite this as: BMJ 2022;377:o1336
  1. Kate Andersen, research associate1,
  2. Aaron Reeves, associate professor of evidence-based social intervention and policy evaluation2
  1. 1Department of Social Policy and Social Work at the University of York
  2. 2University of Oxford
  1. Twitter: @KateAndersen_ @aaronreeves

As the government announces measures to help the cost of living crisis, Kate Andersen and Aaron Reeves discuss the impact of financial insecurity on people’s mental health

The surge in prices over recent months has created a cost of living crisis that is exacerbating insecurity and harming people’s mental health. The Food Foundation warned recently that more than two million adults in the UK have gone without food for a day because of the rising cost of living. This is not inevitable. Yes, when prices rise faster than earnings, this puts additional financial and emotional strain on households. But in contexts where social security is more generous, this strain is minimised. Indeed, in some places, this strain has been entirely removed.1

The problem in the UK is that a decade of austerity means this particular cost of living crisis will be especially acute for families in receipt of social security. Reforms to Universal Credit over the past few years have entailed direct cuts to the generosity of social security payments and the failure to uprate the value of those payments in line with inflation. Social security benefits have therefore fallen considerably behind the rising cost of living. Out-of-work benefit rates are, adjusting for inflation, currently at their lowest for 30 years.2

A recent report from the Joseph Rowntree Foundation outlined how changes to the social security system have actually increased poverty since 2012.3 One of those reforms pushing people into hardship is the benefit cap, which limits the total amount of social security a household can receive. When the policy was first introduced in 2013, the cap was set at £26 000 per year for families. In 2016, the cap was lowered to £23 000 in London and £20 000 elsewhere. The policy applies to households with earnings below £617 a month.

This policy is the focus of a large-scale mixed-methods research project funded by the Nuffield Foundation.4 So far, the findings show that the benefit cap not only causes considerable financial hardship, but also has adverse mental health impacts.5 For example, in 2016, when the government introduced the lower (and therefore less generous) cap, the number of people affected by the cap more than tripled (rising from ~20 000 households to more than 70 000 households every month). Thousands of households were subsequently left with less money to meet their basic needs and this also had a knock-on effect on their mental health. In the months following the reform to the cap, the proportion of capped households experiencing mental health difficulties increased from around 21% to 30%, a relative increase of around 50%. This lack of support may push people further away from the labour market precisely because such cuts are affecting their mental health and making it more difficult for them to work. This suggests the benefit cap may undermine efforts to move people into paid work despite this being a central aim of this policy.

The research interviews show how the adverse mental health impacts of the benefit cap can hinder attempts to obtain paid work. “Jessica,” a mother to three children, explained she was:

“…worry about every bill, worrying about people knocking on the door, I’m constantly ringing my worker for a food bank [voucher] and constantly trying to get bills down and looking for bargains online and it’s quite exhausting actually…hopefully I’ll manage to get back to work. But, you know, that’s kind of been dragged out because the more stressed and the worse my mental health gets, the longer I’m gonna be off work for.”

Currently, the cost of living crisis is deepening severe financial hardship and the social security system is not adequate to withstand this. Worse still, some policies are increasing poverty and in doing so are harming mental health and making it more difficult for people to obtain paid work. While the government has taken some action to offset the rise in energy prices (including those who are subject to the cap), more profound reforms are needed; reforms which not only increase the generosity of social security benefits, but also remove the benefit cap going forward due to its longterm adverse impacts.


  • Competing interests: none declared.

  • The project has been funded by the Nuffield Foundation, but the views expressed are those of the authors and not necessarily the Foundation. Visit