Wealth, Wellbeing and the Importance of Connection

Last week, I took part in a panel at the SIP Global Health Conference at The Langham in London, discussing the mental health pressures facing wealthy families. Alongside me were psychiatrist and psychotherapist Dr Konrad Hitz and Bryony Cove of Farrer & Co, with Léa Wagenaar from SIP moderating.

I was invited because we have considerable experience supporting high-net-worth families. In this work, collaboration with lawyers, wealth managers, trustees and family offices is often a necessary part of case management. Understanding the structures around a person can be essential to understanding both the difficulties they face and how best to help.

It is nevertheless a subject I tend to approach cautiously. I have never wanted Portobello Behavioural Health to feel exclusive. We try to make our services accessible to as many people as we can reach, and we charge the same prices for the same services regardless of a client’s wealth. Sadly, that consistency is not universal in our industry.

Part of the reason Liz and I established PBH was that we had both seen vulnerable families of means being taken advantage of when seeking help. Exploiting someone’s distress is appalling whatever their financial circumstances. When substantial wealth is involved, the scale can be frightening.

Against that background, our panel explored some of the less visible difficulties that can accompany wealth, including isolation and loneliness. Someone with considerable resources may understandably choose treatment that promises complete privacy and exclusivity. But if isolation is already part of their difficulty, a setting in which they never meet anyone else who is struggling may reinforce it. Privacy matters, but so do connection, shared experience and the opportunity to discover that you are not alone.

We also discussed the importance of bringing psychoeducation and financial education together within estate and trust planning. Decisions about money can carry enormous emotional meaning: questions of independence, responsibility, belonging and trust often sit beneath the technical arrangements. Making room for a family’s values and moral commitments can help those arrangements reflect more than the preservation and transfer of assets.

Another theme was cooperation across the family system and the professionals supporting it. Lawyers, trustees, wealth managers and clinicians may each hold a different part of the picture. Their responsibilities can be difficult to navigate, particularly when family relationships are strained or someone is unwell.

Clearly defined roles help everyone understand where to turn and for what. Equally, confidentiality and privacy need to be explained explicitly: what can be shared, with whom, with whose consent, and for what purpose. Families and advisers should not have to discover those boundaries in the middle of a crisis.

The wider conference considered how families can protect their health and plan for longer lives. Our panel brought attention to the relationships and emotional foundations that also need care. Wealth can open doors to support, but a person still needs to feel understood, connected and able to trust the people around them. Back to meaning and purpose, if you don't need to work. If you don't need to do anything in particular then finding meaning and purpose can be harder and yet all the more important.