ADVISERS (case work)
Contents
1. relatively minor action is being considered does this really require medical evidence to be collected The Consent Form The DMHEF is accompanied by a Consent Form this must be read signed and completed by the client or a third party with the authority to act on their behalf By doing this the client is giving their explicit consent for a health or social care professional to complete the DMHEF This is explained in more detail on P6 P9 If the Consent Form is not a completed and signed by the client and b shown to the health or social care professional they are highly likely to refuse to complete the DMHEF 2 1b Why was the DMHEF created The DMHEF has been created in response to reports from adviser and creditor organisations about difficulties in collecting relevant and high quality medical evidence from health or social care professionals e which could help the adviser or creditor organisation identify better and fairer decisions on what action to take when an individual reports that a mental health problem is affecting their ability to manage their money The current version of the DMHEF is Version 3 It was launched on the 28 of November 2012 Previous versions of the DMHEF should no longer be used ic What evidence does the DMHEF collect The DMHEF asks eight basic questions BOX 1 When completed by a health or social care professional who knows the individual the DMHEF can provide relevant informatio2. debt 1a Whatis the DMHEF The DMHEF is a standardised form that can help creditors or debt advisers collect high quality and relevant medical evidence It is used most effectively when A an individual reports a mental health problem to a creditor or debt adviser I B and the individual says that the mental health problem has impacted on their ability to manage their money C a debt adviser or collector has spoken in detail with the individual to establish how their ability to manage money has been impacted aE D but where despite this conversation unanswered questions concerns or doubts remain or the individual s situation is complex and needs further exploration E and additional information therefore needs to be collected from a health or social care professional who knows the individual in order to help creditors decide what action they should take D F and where the client has given their explicit consent for such an approach to be made The DMHEF should not automatically be used every time an individual reports a mental health problem Instead before making the decision to use the DMHEF creditors and advisers should stop and consider whether a they could collect the information they need simply by talking in more detail with the individual about the reported situation b the time and resources it will take for the information to be collected is proportionate to the potential action being considered e g if a
3. with their responsibilities under the Data Protection Act 1998 These include but are not limited to obtaining explicit consent from the individual to collect evidence e ensuring that record management is compliant with the Act before using medical evidence that has been previously stored the adviser must check this evidence is still accurate relevant and timely destroying any medical evidence that is no longer accurate relevant or timely 3b Explicit consent A key responsibility for advisers under the Data Protection Act 1998 is ensuring that a client has received an explanation of how their information will be processed and that they have given their explicit consent for this processing to take place Explanations given by advisers to clients about how their information will be processed should cover why their data is being collected and how and when their data will be recorded used shared stored and deleted To confirm that they a understand this explanation and b agree to their data being processed in this way the adviser should ask the client to give their explicit consent There are numerous ways in which your organisation may wish to record this explicit consent for your own internal purposes see below However the client should always be asked to read complete and sign the Consent Form and the adviser must ensure it accompanies the DMHEF when the documents are submitted to the health or social care prof
4. 2005 In Scotland the Adults with Incapacity Scotland Act 2000 applies Northern Ireland does not have specific legislation relating to mental capacity and common law applies 4c Why doesn t the DMHEF contain a question asking the health or social care professional to estimate when an individual is likely to recover return to work We understand that information about when a client is likely to recover from their mental health problem return to work would be valuable to some advisers and creditors However estimates or prognoses of such recovery return to work are extremely difficult for health and social care professionals to provide 1 Making a useful and accurate prognosis can be very difficult consequently health and social care professionals may be reluctant to make a statement about the likely progression of a person s mental health problem This may particularly be the case if they do not know the patient or their wider medical or social circumstances well 12 2 Individuals often experience mental health problems in different ways for example even though clinical guidelines might indicate that depression usually lasts up to a certain number of months with the chance of repeated episodes afterwards there will be large numbers of people who do not have this experience 3 the inter relationship between mental and physical health can complicate reaching an accurate prognosis this adds an additional fa
5. THE DEBT AND MENTAL HEALTH EVIDENCE FORM V3 DMHEF USER GUIDE ADVISERS case work It is strongly recommended that this guide is read before the DMHEF is used for the first time It has been written for debt advisers who are involved in case work A separate guide exists for advisers who provide assisted self help to clients Summary This guide introduces debt advisers who are involved in case work to the Debt and Mental Health Evidence Form DMHEF Version 3 and the Consent Form that is used with it A separate guide exists for advisers who provide assisted self help to clients In Section 1 the guide covers the following questions 1a What is the DMHEF 1e How should the DMHEF be used 1b Why was the DMHEF created 1f Who developed the DMHEF 1c What evidence does it collect 1g Which creditors recognise the DMHEF 1d Who can use the DMHEF th Is the DMHEF copyrighted In Section 2 the guide describes in detail the ten steps that advisers should take when using the DMHEF and its accompanying Consent Form In Section 3 the guide considers advisers responsibilities under the Data Protection Act 1998 when using the DMHEF to collect medical evidence In Section 4 the guide provides answers to a series of other Frequently Asked Questions Resources The DMHEF V3 the accompanying Consent Form this User Guide and a one page user flowchart can all be downloaded at www malg org uk www rcpsych ac uk
6. al the health or social care professional completes the DMHEF and returns this and the Consent Form signed by the client in the stamped addressed envelope to the adviser the adviser receives the completed DMHEF and client Consent Form and decides what action to take in light of this the adviser gives a copy of the completed DMHEF to the client and discusses the options with them the adviser sends copies of the DMHEF and Consent Form to creditors 2b The ten steps detailed description Step 1 Step 2 a mental health problem is identified The client tells the adviser that they have a mental health problem that is affecting their ability to manage their money the adviser finds out more about this The adviser discusses with the client how the mental health problem affects their ability to manage money how the mental health problem affects their ability to Communicate with their creditors e whether anyone helps the client manage their finances Such as a family member By asking a range of questions not just limited to the above the creditor should aim to develop a good understanding of the client s situation Step 3 Step 4 Step 5 the adviser decides whether medical evidence is needed By this point the adviser should have spoken with the individual to establish how their ability to manage money has been impacted by the reported mental health problem If collecting medical evidence is likely t
7. and NHS 111 is the non urgent number for out of hours care and information www nhsdirect nhs uk Wales NHS Direct 0845 46 47 www nhsdirect wales nhs uk Northern Ireland web based information service http www nidirect gov uk check ups appointments and emergencies Payplan Provides a free debt management service to people with debt problems 0800 280 2816 www payplan com Rethink National Advice Service Advice for people with mental health problems 0300 5000 927 www rethink org advice Royal College of Psychiatrists The Royal College of Psychiatrists delivers programmes which make a difference to the everyday lives of people with mental health problems and those working with them Since 2006 we have run a research and intervention programme addressing the relationship between financial difficulties and mental health including information for creditors and debt advisers www rcosych ac uk debt Samaritans Support 24 hours a day www samaritans org UK08457 90 90 90 Republic of Ireland 1850 60 90 90 16 SANELINE National out of hours mental health helpline providing support and information 0845 767 8000 www sane org uk StepChange Debt Charity formerly The Consumer Credit Counselling Service Charity helping people who are over indebted through free independent and realistic support 0800 138 1111 www stepchange org 17
8. client assess whether that information still needs to be held e assess the likelihood that the information is still relevant and accurate If information is no longer relevant or accurate it should be either updated or securely destroyed or archived for future destruction We strongly recommend that you proactively notify creditors or their agents of any changes in the nature of their customer s mental health as promptly as possible since lenders are permitted to use relevant and accurate existing information on file to assess applications for further credit We recommend to advisers that rather than using the DMHEF to routinely or automatically update their information about the client s mental health problem they should ideally ask the client to provide this information However if there is a need to obtain medical evidence e g the client incurs a new debt and the client s situation has changed then the DMHEF may be used to collect this medical evidence Due regard should be given to the Financial Conduct Authority FCA s Consumer Credit Sourcebook on Mental Capacity CONC Rule 2 10 see also P12 We strongly recommend that advisers refer to The MALG Royal College of Psychiatrists Briefing Note 4 that covers the issue of explicit consent under The Data Protection Act in depth It was issued on 3 April 2013 and is entitled Appropriately processing data from individuals with mental health problems under the Data Prote
9. ction Act 1998 http www malg org uk briefing htm 1 In such cases relevant information about the mental health of the individual should be retained throughout the period of the debt only 11 Frequently Asked Questions FAQs 4a What should happen if the client refuses to give their explicit consent If a client is unwilling to give their explicit consent including explicit consent to complete the Consent Form then the process cannot continue The only exception may be if a third party is legally authorised to give consent on the behalf of a client for example in cases where the client lacks the mental Capacity to make such a decision Health and social care professionals should not complete the DMHEF unless the consumer has given their explicit and written consent for this to happen The Information Commissioners Office has made it clear that the responsibility rests with the health professional who should not complete the DMHEF without the consent of their patient 4b What if any bearing does the Financial Conduct Authority FCA s Consumer Credit Sourcebook CONC Rule 2 10 Mental Capacity have on the processing of the DMHEF Much of the Office of Fair Trading s Guidance Mental Capacity Guidance for Creditors has been transferred to the FCA Credit Sourcebook The law relating to mental capacity differs across the UK In England and Wales advisers should be familiar with the Mental Capacity Act
10. ctor to the consideration It also could involve an examination of the patient which would require time resources and possibly payment 4 there will be other social and economic factors often unknown to the health or social care professional that will impact on a person s recovery from a mental health condition and which are difficult to incorporate into a prognosis Overall making an accurate and useful prognosis can be very challenging for health and social care professionals Furthermore there is the probability that such a prognosis could be inaccurate which would not help the creditor recover the debt or the individual get on top of their financial and mental health situation Consequently the DMHEF does not include a prognosis question 4d What about people with debt and mental health problems who are not in contact with a health or social care professional The DMHEF relies on information being collected from a health or social care professional However not every client may be in contact with such a professional In these situations an adviser may wish to recommend that an individual either registers or re establishes contact with a General Practitioner It is important to remember that although an individual does not have contact with a health or social care professional they may still have a mental health problem If a client needs urgent assistance or is in crisis as a direct result of the current stat
11. e of their mental health they or the person working with them should contact the Samaritans Saneline or the Rethink Advice Line numbers under Part 5 If they or anyone else are in immediate danger of harm the police emergency number 999 should be called If the need is less urgent the individual concerned or the person working with them can still call the above organisations or call NHS Direct Alternatively the person can visit their General Practitioner Advisers should also consult and become familiar with their own internal policies on dealing with such emergencies 13 4e What happens if the client having sight of the completed DMHEF from their health or social care professional wishes to make a personal comment or statement about the information given The client can either write or if the adviser can support this dictate a personal comment or statement This should be passed on to the individual s creditors There is no longer any actual space allowed for such comments on the DMHEF but this should not discourage individuals to comment if they wish 4f Should a Common Financial Statement be submitted at the same time as the DMHEF This is not a mandatory part of the DMHEF process the decision therefore rests with the adviser 14 5 Useful Sources ofInformation Useful resources Advice UK UK network of advice and information agencies 020 7469 5700 www adviceuk org uk Advice NI Leadership
12. er psychiatrist nurse psychologist occupational therapist social worker or another member of the health and social care team the adviser sends a DMHEF pack to the health or social care professional The adviser will need to prepare the following DMHEF pack ablank DMHEF version 3 the Consent Form that was completed and signed by the client a stamped addressed envelope with the advice service s contact address on it You may wish to draft your own covering letter to accompany these materials You should write your client s contact details the name of your organisation and any reference number on the front of the DMHEF You should then send the DMHEF pack to the nominated health or social care professional the professional completes and returns the DMHEF and signed Consent Form to the adviser The health and social care professional completes signs and stamps the DMHEF and then returns this to the adviser in the stamped addressed envelope along with a copy of the Consent Form signed by the client the adviser receives the completed DMHEF and client Consent Form and decides what action to take in light of this On its receipt the adviser should read and check the DMHEF ensuring it is signed and stamped by the health or social care professional to authenticate its completion and combat fraud 8 Step 9 Step 10 The DMHEF will contain information that should not only be shared with credi
13. essional This Consent Form is always sent with the DMHEF to the health and social care professional and indicates to the professional that the client has given their explicit consent for the professional to complete the DMHEF Unless the Consent Form is completed and signed the health or social care professional should not complete the DMHEF As noted above your organisation needs to record the client s explicit consent for internal purposes Provided you receive it from the client you may indeed do this Sometimes this is obtained by telephone sometimes during a face to face interview sometimes it is received in writing Whatever the method organisations should have evidence to demonstrate that explicit consent was given and that this was acquired in a fair and lawful manner 10 Finally once explicit consent has been obtained this will authorise you to store information about the individual on the basis that a this information will be securely stored and b it will be destroyed when no longer relevant 3c Record management To comply with the Data Protection Act 1998 information should be kept on file for no longer than is necessary In practice you must judge each case individually For some individuals episodes of poor mental health which affect their ability to manage their money may last for several months while for others this could be longer Consequently you need to e review the information you hold about a
14. he Information Commissioner s Office has reviewed the DMHEF and has approved it as keeping to the Data Protection Act 1998 BOX 2 BOX 2 Information Commissioner s Office statement The following statement has been provided by the Information Commissioner s Office about the DMHEF It is important that creditor organisations and debt advisers have up to date relevant and accurate information about consumers who have mental health problems It is equally important that users of such information remain aware of the sensitivity of the data they are collecting keep it secure and use it only for the stated purpose The DMHEF version 3 is a tool that enables the collection of this information and it is clear that careful thought has gone into its design We welcome the opportunity to have reviewed the form and accompanying Guidelines and we are sure that the form can be used in a manner consistent with the principles of good data handling as set out in the Data Protection Act 1998 1f Who developed the DMHEF The DMHEF has been developed by the Royal College of Psychiatrists and the Money Advice Liaison Group in collaboration with creditors debt advice agencies mental health and social care professionals organisations people with experience of mental health and debt problems and carers 1g Which creditors recognise the DMHEF The DMHEF is recognised in the Lending Code sponsored by the British Bankers Association B
15. n and allow them to ask questions if necessary to clarify any points Thirdly after doing this the adviser should ask the client for their explicit consent to process their information in this way There may be additional steps or actions that your organisation requires you to take to record this explicit consent see P10 However you should always ask _ the client to read complete and sign the Consent Form that accompanies the DMHEF Step 5 the client reads signs and returns the Consent Form By reading signing and returning the Consent Form to the adviser the client is giving their explicit consent for the health or social care professional to complete the DMHEF Step 6 Step 7 Step 8 Unless the Consent Form is completed and signed the health or social care professional should not complete the DMHEF The adviser should be aware that before signing the Consent Form the client may want to ask the adviser further questions about the DMHEF including what will happen to their information or with whom it might be shared It is important for the adviser to remember that the Consent Form can also be completed and signed by a third party authorised to act on their behalf When completing the Consent Form the client is asked to nominate a health or social care professional to approach for evidence This person should be someone who knows the client in a professional capacity This professional could be a general practition
16. n about how an individual s mental health problem affects their ability to manage their money e any communication support or other relevant needs that the debt adviser and creditor should take into account BOX 1 The eight DMHEF questions The DMHEF invites the health or social care professional to answer eight questions Q1 what is your relationship with the person reporting the mental health problem Q2 does the person have a mental health problem Q3 whatis this mental health problem If it has a name or diagnosis what is it Q4 does the person have a mental health problem that affects their ability to manage their money Q5 if the person is receiving treatment or support for this mental health problem does the treatment or support affect their ability to manage their money Q6 when communicating with the person are there any special circumstances that a creditor needs to take into account Q7 what was the approximate date when a this mental health problem first started b the first treatment was given c the most recent episode took place and d is the episode on going is there anything else we should know about the person 1d Who can use the DMHEF The DMHEF can be used by debt advisers a in situations where the adviser is working on behalf of a client Case work or b where the adviser is guiding an individual who is managing their own debt situation including the communication and negotiatio
17. n with creditors assisted self help The DMHEF can be used by creditors in situations where their customer agrees to collect medical evidence from a health or social care professional and to then share this with the creditor The DMHEF is usually always given to a client by a debt adviser or a customer by a creditor However members of the public may become independently aware of the DMHEF and may arrange for a completed DMHEF to be submitted If this happens the adviser or creditor should a check that the DMHEF is correctly completed by a health or social care professional including a service stamp or equivalent to verify its authenticity and b use the completed DMHEF to start a conversation with that individual about their situation The DMHEF has not been designed for independent use by individuals who are either not receiving the assistance of a debt adviser or who have not been issued a DMHEF by their creditor We would recommend that individuals in this situation should always get the help of a debt adviser see P16 P17 for contact details 1e How should the DMHEF be used There are ten steps that need to be taken when a debt adviser involved in case work uses the DMHEF These are described in detail on P6 P9 When using the DMHEF advisers also need to be aware of their responsibilities under the Data Protection Act 1998 in regards to processing health data These are discussed in detail on P10 P11 However t
18. o assist the individual s situation the adviser may decide that medical evidence needs to be collected It may not be necessary to collect medical evidence to achieve some actions For example most creditors are obliged to offer a breathing space consider reasonable offers and not harass a client regardless of whether or not the client has a mental health condition When taking this decision the adviser should check whether the client has recently collected any medical evidence about their mental health problem e g in response to a previous request from another creditor either using the DMHEF or another method If so there may not be a need to collect fresh medical evidence the adviser explains to the client how the evidence will be used and gets their explicit consent to collect evidence for this purpose Firstly the adviser will need to explain to the client how the medical evidence collected from the health and social care professional will be used This includes an explanation of why the adviser wishes to collect this data what the data will be used for who the evidence might be shared with e g the creditor and possibly the creditor s agent how it will be securely stored and how long it will be stored for Without this explanation the client cannot know what they are consenting to and consent therefore cannot be properly obtained Secondly the adviser will need to ask the client if they understand this explanatio
19. representation and support to independent advice organisations in Northern Ireland 028 9064 5919 www adviceni net Citizens Advice Independent charities providing advice and information across the UK Details of individual bureaux are available at England and Wales www citizensadvice org uk Scotland www cas org uk Northern Ireland www citizensadvice co uk Money Advice Service Telephone advice for clients eligible for Legal Aid and hosts national directory of advice providers 0845 345 4 345 hittp moneyadviceservice org uk StepChange Debt Charity formerly The Consumer Credit Counselling Service Charity helping people who are over indebted through free independent and realistic support 0800 138 1111 www stepchange org Law Centres Independent organisations that employ lawyers and specialist advisers to assist clients in court www lawcentres org uk Money Advice Scotland Can provide details of advice agencies in Scotland providing free independent confidential advice 0141 572 0237 www moneyadvicescotland org uk 15 National Debtline Free confidential and independent telephone advice on how to deal with debt problems 0808 808 4000 www nationaldebtline co uk NHS information helplines 24 hour nurse advice and health information service providing confidential information on what to do if you or your family are feeling unwell particular health conditions local healthcare services England amp Scotl
20. tors but which could help improve your understanding of the client s situation and your relationship with them The adviser should take into account the information in the DMHEF to help make a decision on what action to take next For credible information on a range of mental health problems please visit www rcpsych ac uk debt the adviser gives a copy of the completed DMHEF to the client The creditor should give a photocopy of the completed DMHEF to the client as soon as possible as they will want to see what has been written about their mental health problem the adviser gives copies of the DMHEF and Consent Form to creditors If the completed DMHEF contains relevant and useful information you should send a photocopy of the completed DMHEF to all appropriate creditors of your client If the completed DMHEF does not contain any relevant information but an organisation specifically requested that a DMHEF was completed you should a inform the organisation that requested this information that the client will not be providing evidence and give a reason for this and b discuss this decision with the client You should supply your client with a list of all the creditors to whom the completed DMHEF has been sent These actions will ensure that the client has full knowledge of what information has been provided about them and to whom TheDataProtectionAct1998 3a Overview adviser responsibilities Advisers should be familiar
21. uilding Societies Association and The UK Cards Association the Finance and Leasing Associations Lending Code the Credit Services Association s Code of Practice It is recognised in The Financial Conduct Authority s Occasional Paper No 8 on Consumer Vulnerability No agency or individual from the advice creditor or health social care sectors is obliged to use the DMHEF It has been designed as a voluntary tool to improve the collection of information 1h Is the DMHEF copyrighted MALG and the Royal College of Psychiatrists hold the copyright to the DMHEF However you are encouraged to use photocopy or disseminate the DMHEF in its entirety as long as this is for non profit making purposes only If you wish to revise alter or reproduce questions from the DMHEF for any purpose you will need to obtain the permission of MALG and the Royal College of Psychiatrists How should debt advisers use the DMHEF 2a Overview the ten steps There are ten steps involved in a debt adviser using the DMHEF when conducting case work on behalf of a client a mental health problem is identified the adviser finds out more about this the adviser decides whether medical evidence is needed the adviser explains to the client how the evidence will be used and gets their explicit consent to collect evidence for this purpose the client reads and signs the Consent Form the adviser sends a DMHEF pack to the health or social care profession
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