Critics have called for more attention to be paid to the health impacts of the economic downturn and policy responses to it. Other research has reported that, without any protective measures, deprived communities will be badly hit by austerity. This article uses evidence from fifteen deprived communities to look at the changing incidence of financial difficulties among key at-risk groups, and their associations with mental health, from the pre- to the mid-recession period. High and increasing rates of affordability difficulty were found in respect of the costs of fuel, council tax and clothes, particularly among households with disabled adults, under-occupiers and families with part-time workers. Moreover, increased affordability difficulties were consistently associated with a decline in mental health, at all time periods and for all items of expenditure. The evidence supports a policy counter-narrative focussed on preserving and enhancing mental wellbeing for all rather than the current ‘austerity hegemon’.