Around 100 food banks across the UK will test whether offering money advice to people drowning in debt can measurably improve their mental health. Unmanageable debt—unpaid rent, credit cards, or council tax—is a known source of chronic stress that hits people already using food banks hardest. Many of these individuals also have mental health problems, disabilities, or unstable housing. A smaller pilot by the same team suggested that food bank advice services (FBAS) could reduce that stress and narrow health inequalities, but the evidence was too limited to guide policy. This larger trial will compare mental health outcomes—stress, wellbeing, self-efficacy, and healthcare use—between food bank users who receive advice and those who do not. Researchers will also track costs and benefits to the NHS and social care. If the results are positive, the case for investing in advice services within food banks strengthens. That could shift how local authorities and charities tackle the health consequences of poverty, potentially reducing pressure on GPs and emergency services while giving people a practical route out of financial crisis.
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Research question: What is the overall and differential impact of food bank advice services (FBAS) on mental health-related outcomes for people in or near destitution who experience unmanageable debt? Background: A person has ‘unmanageable’ debt if they are unable to repay money they have borrowed (such as loans, credit cards) or pay other bills and commitments (such as rent, Council Tax). Unmanageable debt is a significant source of stress and can seriously affect health. People on low or insecure incomes, people with mental health problems, those with housing problems and disabled people – who are all over-represented in the food bank population – are more likely to experience unmanageable debt. Food banks provide emergency food and support to people in or near destitution. Evidence from a previous evaluation conducted by the study team shows money advice services delivered by food banks, which support people to manage their finances and deal with debt, could improve health and reduce inequalities. This proposed larger-scale evaluation involving c. 100 food banks, designed with public contributor input, extends the previous work by examining the impact of food bank advice services (FBAS) on validated mental health-related outcomes and health inequalities. Aims and objectives: We aim to (a) understand the impact of food bank advice services on the mental health and wellbeing of people with unmanageable debt; (b) explore what helps to improve health-related outcomes for different groups, and why these work; and (c) find out the costs, economic benefits and equity impacts of food bank advice services. Methods: We will: (1) Quantitatively evaluate the impact of food bank advice services on validated measures of perceived stress (PSS-4), mental wellbeing (WEMWBS), self-efficacy (GSE-6) and healthcare service use (simplified MODRUM), using a before-and-after design (baseline and 8-week follow-up) and comparator group of food banks that do not operate an advice service. (2) Conduct case studies with 10 food banks to qualitatively evaluate the impact of advice services for different groups and understand the contexts and mechanisms that influence differential impacts. The case studies comprise observations in food banks; interviews with staff and stakeholders; and longitudinal interviews at three time points (baseline, 3 and 9 months) with people who use food bank advice services and those who do not. (3) Use the quantitative data to assess the cost-effectiveness and equity impact of food bank advice services, accounting for health and non-health costs and benefits. Timelines for delivery: 36 months, 1 November 2025 to 31 October 2028. Anticipated impact and dissemination: If the study shows that food bank advice services have positive health-related impacts and reduce health inequalities, this strengthens the case for investment in similar services. Such investment could reduce pressures and costs to health, care and wider public services. To influence change, we will: (1) develop research and policy briefs with public contributor input to engage policymakers and advice funders; (2) communicate results to local communities and the public via food banks and create video summaries to share findings in an accessible way; (3) disseminate the study results to the academic community through peer reviewed journal articles and conferences.
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