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How to Be There for Clients with Mental Illness

June 8, 2018

This time we hear from Lori (Embrey) Eisel, president of Canal Winchester, Ohio-based Arcadia Financial Partners. She tells the story of learning to work with a client with bipolar disorder.

A few years ago I met with a new client who had found me through family members in the area. During the course of our getting-to-know-each-other conversation, she told me she was "crazy." She had a big, fun personality, and I assumed she was joking.

As we worked together over the following months and I got to know her better, I came to understand that she truly was dealing with mental health issues. We developed a good connection and talked about her illness openly. It can be tempting for advisors to avoid these kinds of conversations because they’re uncomfortable, or because they don’t seem directly relevant to financial planning. I could tell, though, that navigating this situation was an important part of my client’s life, and one I needed to understand in order to understand her.

She told me she’d been on medication for bipolar disorder but she didn't like the way it made her feel and was experimenting with different medications. To better understand what she was going through I read up on her condition and how I could best support her. There wasn't much out there on how financial advisors should deal with clients with mental illness, but I did find quite a bit of information directed toward friends and family members.

Then one day I got a call from her in the midst of what was clearly a manic episode. She gave me a string of rapid-fire instructions. She told me she wanted to sell off her whole portfolio, go to Europe, buy a new house — basically upend her entire life.

I thought back to a time many years previously when I had worked with a client who had made similar demands. When a client tells you to do something with their money, it's your responsibility as an advisor to do it. If you don't act, you could face serious legal consequences. With this previous client I had erred on the side of caution, telling him in writing that it seemed best if I refrained from advising him. Later I learned he'd completely wrecked his finances.

I didn't want this woman to meet the same outcome. In my research I'd read that the best way to deal with people cycling through a manic episode was to simply to give them time. So I stalled. I asked her a lot of questions and gave her what I thought of as homework assignments to look into certain financial products and strategies. I told her I'd do more research as well, and we agreed to talk a few weeks later.

The next time we talked, she had abandoned all her ideas from our previous conversation. We had a very frank discussion about her mental illness. I asked her if there was someone I could reach out to if a similar situation occurred in the future. I was worried that she'd be offended or feel like I didn't trust her but she told me she appreciated that I'd asked and gave me the name and contact information of a lifelong friend.

Lori (Embrey) Eisel

Working with mentally ill clients is tricky. On the one hand you have an obligation to follow their instructions. On the other hand you don't want to enable decisions that could have disastrous consequences. What I've found is that a little knowledge about the client's condition goes a long way. If you have a sense of what a client is going through, you can work with them in a more compassionate and responsible manner.

I've also found that this lesson applies to aging clients who are losing some of their mental capacity. As clients get older, for example, they can become forgetful and fail to implement recommendations the first time you discuss them. If you know that a client suffers from dementia, you can be prepared for situations like this and respond to them strategically. It can be hard to have conversations about mental illness and cognitive decline, but if that information is on the table, both you and your client will be better off.