Financial Tools Access and Navigation (FinTAN) for Supported Financial Decision Making

Financial Tools Access and Navigation (FinTAN) for Supported Financial Decision Making – Project Summary Financial hardship and mental illness intersect in ways that have devastating consequences for millions of Americans. People with serious mental illness (SMI) are more likely to run out of money, fall behind on rent and bills, be indebted, and experience financial stress, all of which impact mental health outcomes; people from low socioeconomic status backgrounds, particularly people of color, are more likely to experience financial hardship, given historical and ongoing structural discrimination. Financial hardship among people with SMI arises partly from meagre disability benefits and/or low wages but is exacerbated when people have difficulty managing money due to their illness. Currently, money management support is limited to ad hoc budgeting advice or, more commonly, removal of financial control through a representative payee or conservator; currently, 26% of people receiving disability benefits – mostly those with SMI - have a payee. Having a payee can reduce hospitalization, homelessness and substance use and increase likelihood of treatment adherence and paying essential bills. However, there is little evidence of positive impact on mental health outcomes, and some significant downsides; some people have their autonomy unnecessarily curtailed, the arrangement can damage important relationships and hinder recovery, and others do not get needed assistance due to the understandable reluctance of some people to relinquish financial control, and shortage of payees. This raises the risk of eviction, utility disconnection, hunger, and financial abuse among people with SMI. Work is underway to develop more person-centered models and to explore guidance that does not involve removal of financial control. An area that remains underexplored is the potential for financial tools and services such as bank accounts, payment cards, and digital apps to expand and improve money management support options for people with SMI; there is compelling evidence that these are crucial in shaping people’s financial management. This project will test an intervention that will guide people to use of financial tools and services that may allow people to more effectively manage their own finances, receive assistance from another person in a way that maximizes the autonomy of the owner of the funds, and that offer pathways towards greater autonomy over time, so improving mental health and quality of life. The specific aims of this study are to: i) collaboratively create a Financial Tools Access and Navigation (FinTAN) guide to assist persons and care providers to identify the potential utility of relevant financial products, and guide them in their use; ii) pilot test the feasibility and impact of using the FinTAN guide and the associated financial tools and services among 15 people with SMI and those who assist them with their money management; iii) prepare for a future full-scale clinical trial of the FinTAN guide and relevant financial tools and services. We will use a Community Based Participatory Research approach, deploying primarily qualitative methods to assess feasibility and impact of the intervention, as well as testing various quantitative measures to be used in a future larger clinical trial. Project Number: 1R34MH140874-01 | Fiscal Year: 2026 | NIH Institute/Center: National Institute of Mental Health (NIMH) | Principal Investigator: ANNIE HARPER | Institution: YALE UNIVERSITY, NEW HAVEN, CT | Award Amount: $757,250 | Activity Code: R34 | Study Section: Special Emphasis Panel[ZMH1 ERB-K (02)] View on NIH RePORTER: https://reporter.nih.gov/project-details/11212133