Futures Recovery Healthcare

Wealth and Wellness

While the concept of wealth may be subjective, A widely-cited 2018 Purdue University study substantiated the old saw that money cannot buy happiness. Researchers found that for individuals earning between $75,000 and $95,000 per year (somewhat higher for families), “…further increases in income tended to be associated with reduced life satisfaction and a lower level of well-being.” The study suggests that once people earn enough to meet basic needs and afford some conveniences, making more stokes their desire to attain more wealth and compare themselves to others. While a host of factors influence how much money people need to be comfortable, the study’s central theme is consistent with the observations of many mental healthcare professionals — the pursuit of wealth can sometimes negatively affect individuals and family systems. In, “The funds, friends, and faith of happy people,” psychologist David G. Myers refers to this problem as “The American Paradox,” and suggests that “the more people strive for extrinsic goals such as money, the more numerous their problems and the less robust their well being.” 

The mental health risks posed by wealth do not discriminate between those in the top one percent of earners and those in the top tenth of one percent, nor between entrepreneurs bootstrapping their way to the top, or the scions of wealthy families. Certainly, not all wealthy people are negatively affected by their financial status, just as wealthy people who are impacted are affected differently. While many variables influence whether any person will develop a behavioral health condition, common risk factors for wealthy people include problematic ethos, cultural assimilation, loss of purpose, stigma, and enabling. These risks increase the potential for the development of mental health problems and make it less likely that wealthy people will acknowledge their problems and seek treatment. 

Prioritizing material gain over physical and mental health can lead to a dangerous inability to recognize and address serious health risks. Entrepreneurs and people who are driven to succeed in competitive careers can wear mental and physical battle scars like badges of honor. The belief that anxiety, sleeplessness, depression, and poor physical health are the necessary side-effects of getting ahead can lead people to rationalize the use of alcohol and drugs to self-medicate or enhance performance. It is common to find business leaders, celebrities, and other career luminaries who operate at the highest levels at work while other aspects of their lives are in a state of disarray. It can be easy for these people to think that as long as they meet the financial needs of their family members and fulfill the obligations of employees, fans, or shareholders, they may continue being singularly focused by any means necessary. Adopting this ideology can make it extremely difficult for them to acknowledge that their mental health problems and substance use are putting themselves and their dependents in jeopardy. This way of thinking makes it very hard for influencers in their lives to persuade them that they have a serious problem and get them to seek treatment.

Striving to succeed can mean assimilating to health-averse business environments. Regardless of an individual’s level of self-agency or experience, we all remain susceptible to pressures that can lead us to make unhealthy choices. Professional environments in which social drinking, over-working, or other damaging behaviors are commonplace can lead to the development or deepening of problematic substance use. The pressure to excel in elite professional environments and to meet the expectations of boards, patients, peers, and others can lead to long hours, frequent travel, constant performance pressure, and the prioritization of business needs over family life, personal aspirations, and self-care. The very process of becoming wealthy and successful can diminish one’s ability to benefit from or enjoy their success. 

The loss or lack of perceived purpose is a common and profound problem for some wealthy people, especially when transitioning from work life to retirement. However, this problem can also affect wealthy people who do not work as well as family members and dependents. Orenda primary therapist Terry Macho finds that older, financially successful patients who drank without problems while working could develop problematic drinking in retirement. “Some people can drink in moderation throughout their careers, but the drinking may pick up considerably when they enter retirement. The cause is often boredom. Many successful people have lived every day with a deep sense of purpose and commitment to meeting career objectives and accomplishing lofty goals. Retirement can be a double-edged sword — a chance to relax, but also an immediate loss of direction and meaning. Without scheduled activities and a sense of purpose in their lives, they begin drinking to fill the hours without realizing that they are essentially anesthetizing themselves. Career provided the organizing principle for their lives. When that stops, it can feel like staring into a void and not knowing what to do with themselves. Eventually, the drinking becomes problematic, but dependents and friends can pass it off as a right of retirement without recognizing the underlying problem. This is one reason that it is essential to plan one’s transition into retirement and to pay close attention to the mental health of people in early retirement.”

Wealthy people, like any cultural subset, are subjected to stigma. The fear of being shamed keeps many wealthy people from asking for help. People who believe that money buys happiness cannot readily empathize with a wealthy person’s problems. Entire tabloids and websites are dedicated to the schadenfreude of the wealthy and well-known. The wide-spread fall-out from the media coverage of the 2013 Ethan Couch “affluenza” defense, is a recent example of this stigma playing out in the public square. The problem of wealth-related stigma doesn’t just affect celebrities and socialites. Many wealthy people can be ridiculed — even by family members — if it is perceived that they are complaining about their problems despite having access to expensive healthcare and not having to worry about many of the problems of everyday life. This issue highlights the misperception that wealthy people have easy lives, while the opposite is often true. The need to manage or preserve wealth, consistently meet business demands, uphold status, and share or distribute wealth with equanimity can be intensely stressful. Paradoxically, the fact that wealthy people have more resources to seek help makes it harder for them to do so. 

Enabling can be a problem for some members of wealthy families. When people have more discretionary spending money, they can sometimes more easily obtain medications from a private doctor or buy illicit drugs without others knowing. Having the money to mount a significant defense against legal problems like intoxicated driving and other problems can reduce the severity of adverse consequences of substance use disorders. Enabling is not just a problem that affects the children of wealthy people, but any member of a family system. Adult family members can also become unwitting supporters who facilitate the ongoing substance use and mental health problems of spouses and partners. Attempts to insulate family members from negative consequences can allow these problems to persist and worsen. Orenda family therapist, Amy Effman, helps families understand how to set appropriate boundaries to address this problem. “Enabling is a problem for many families, regardless of financial status. It’s normal for us to try to protect our loved ones from experiencing pain. But sometimes, protecting them at all costs makes the underlying problem much worse. This creates the perception that no harm will come from continued drug misuse, drinking, or hiding the symptoms of mental health problems. We need to help these families understand that setting and enforcing boundaries is the healthiest thing they can do to improve long-term health and well-being.” Orenda integrates family therapy into its treatment programming to educate family members and provide them with their own treatment. 

Many more factors influence how families are affected by mental health and substance use disorders. However, knowing the risks afforded by wealth helps treatment providers better understand the challenges these patients face and what strategies may offer the best solutions. Because Orenda specializes in meeting the needs of individuals and families dealing with problems related to the generation and maintenance of wealth, its treatment team is well-versed in understanding and addressing their needs. 

Recognizing the role of wealth managers in promoting wellness

Wealth managers who understand the mental health challenges that wealthy families face can educate patients and help them put defensive strategies in place.

John Egan, BA, CADC, Orenda Clinical Outreach Professional

One way Orenda addresses the needs of wealthy families is to partner with and train financial planning professionals. Financial planners and wealth managers play a unique role in the lives of many wealthy individuals and families. They are among the family’s most trusted and objective advisors, are privy to intimate details related to family finance and dynamics, and are considered partners in fulfilling family needs and pursuing goals.  

By identifying anomalous or problematic spending behaviors, wealth managers may be among the first people outside of the family unit to see the signs of a problem. Unusual and frequent debits for unnamed purchases could be a sign of illicit drug buys. Erratic decision-making or choices that seem to counter previously established goals could signal a problem within the family or a mental health issue. In some cases, patients may tell their advisors about a problem and the need to adjust their finances to address it. Financial advisors who become aware of a problem can intervene to reduce the potential severity of financial losses, and even save a patient’s life by getting the appropriate help. 

John Egan, BA, CADC, is an Orenda clinical outreach professional whose financial services background gives him a unique perspective into the connections between wealth and wellness. John and his Orenda colleagues provide insights and training to wealth managers so that they can proactively address the prevalent problems of substance use and mental health conditions among wealthy families, and know-how to offer help if they see issues arise. 

“Wealth managers who understand the mental health challenges that wealthy families face can educate patients and help them put defensive strategies in place. Money is something most families keep to themselves. We know our own finances, but not those of our friends and neighbors. We don’t know what other families may be dealing with or how to avoid potential pitfalls that others have experienced. Wealth managers offer the advantage of experience and perspective. They do see what other families come up against and can use this knowledge to help patients better plan,” says Egan. By training financial advisors in behavioral health issues, Orenda hopes to give planners the knowledge and resources to initiate interventions. “Advisors have a great deal of power to help families get ahead of mental health and substance use problems and to stop them from depleting the family’s resources if they do occur. They can also directly save someone’s life by referring them to treatment.” 

Egan and his colleagues can share insights into the use of financial and legal instruments that financial planners, trust managers, and family lawyers can use to help affected families. “An informed planner can significantly reduce the severity of a problem by knowing the signs of a problem and how to help. Assigning a power of attorney, for example, can immediately reduce someone’s ability to fund a substance use problem. It can also mitigate the effects of contentious separations or custodial issues that can cause legal entanglements and incapacitating stress. Helping a trustee set up a drug testing protocol for a dependent with a history of substance misuse can increase their chances of lasting recovery.”

Protecting privacy is another critical aspect of helping families. Maintaining confidentiality is of the utmost importance in the management of wealth as it is in healthcare. Orenda prioritizes the privacy of its patients and partners with financial advisors, lawyers, and other family service providers to maintain an open and productive flow of information while maintaining patient and family privacy. 

“Mental health problems are now more common for people of every walk of life. We’re also seeing a broader acceptance of seeking care — which is a very positive development. Every professional service, including wealth managers, will need to understand how their patients could be affected by these issues and how they can play a meaningful, helpful role. Financial advisors who can help families navigate and identify these issues can be even more valuable to their patients. I believe that advisors who take the initiative to become well-versed in protecting patients from substance use and mental health problems will deepen and prolong their patient relationships even more. Everyone wants to be able to do more for their patients. Understanding the linkage between wealth and well-being can save and improve lives and protect and grow assets.”

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