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Student Debt and Its Relation to Student Mental Health

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Abstract

The present paper provides an analysis of the relationship between attitudes toward debt and mental health among university undergraduates. Data were collected from the same cohort of students across their three years of university, with responses from 2146, 1360 and 1391 first, second and third year students, respectively. Mental health was measured using the General Population version of the Clinical Outcomes in Routine Evaluation (GP-CORE). Attitudes toward debt were measured using items that tapped current financial concerns and worry about debt on leaving university. Results showed that students become more concerned about their finances as they progress through university, that there was no relationship between anticipated debt and mental health and that attitudes toward debt were related to mental health levels. Students who were identified as having high financial concerns possessed significantly worse CORE-GP scores than students with low financial concern in all three years of university. In all three years students with high financial concerns felt more ‘tense, anxious or nervous’, more ‘criticised by other people’ and found it more ‘difficult getting to sleep or staying asleep’ than students with low financial concerns. There was also evidence that students with high worry about their debt anticipated leaving university with higher amounts of debt than low debt worry students. These findings are discussed in relation to the pattern of increased student debt in UK higher education.
Journal of Further and Higher Education
Vol. 28, No. 1, February 2004
Student Debt and its Relation to
Student Mental Health
RichardCookePsychological Therapies Research CentreUniversity of LeedsUKr.cooke@shu.ac.uk
RICHARD COOKE,MICHAEL BARKHAM,KERRY AUDIN,
M
ARGARET BRADLEY
Psychological Therapies Research Centre, School of Psychology, University of Leeds,
17 Blenheim Terrace, Leeds LS2 9JT, UK. Email: richard.cooke@shu.ac.uk
JOHN DAVY
School of Computing, University of Leeds, UK
ABSTRACT The present paper provides an analysis of the relationship between attitudes
toward debt and mental health among university undergraduates. Data were collected from
the same cohort of students across their three years of university, with responses from 2146,
1360 and 1391 first, second and third year students, respectively. Mental health was
measured using the General Population version of the Clinical Outcomes in Routine
Evaluation (GP-CORE). Attitudes toward debt were measured using items that tapped
current financial concerns and worry about debt on leaving university. Results showed that
students become more concerned about their finances as they progress through university,
that there was no relationship between anticipated debt and mental health and that
attitudes toward debt were related to mental health levels. Students who were identified as
having high financial concerns possessed significantly worse CORE-GP scores than students
with low financial concern in all three years of university. In all three years students with
high financial concerns felt more ‘tense, anxious or nervous’, more ‘criticised by other
people’ and found it more ‘difficult getting to sleep or staying asleep’ than students with low
financial concerns. There was also evidence that students with high worry about their debt
anticipated leaving university with higher amounts of debt than low debt worry students.
These findings are discussed in relation to the pattern of increased student debt in UK higher
education.
Student Debt and its Impact on Student Mental Health
In the last decade students attending university have had to take on higher levels of
debt to pay for their time at university (Hesketh, 1999). This trend has coincided
with the removal of the maintenance grant which was abolished in 1998. Post-1998
a system of student loans was introduced to provide financial assistance, however
students also had to pay £1100 in tuition fees each year. So the system of student
finance shifted from the state paying for the costs of higher education to a situation
ISSN 0309-877X print; ISSN 1469-9486 online/04/010053-14 2004 NATFHE
DOI: 10.1080/0309877032000161814
54 R. Cooke et al.
where most students are reliant on borrowing money from their parents or from the
state. The recent White Paper The Future of Higher Education (HMSO, 2003)
proposes another change to the system, namely that students from low-income
backgrounds will receive a grant of £1100 to help with their costs. However, this will
not cover yearly expenditure (estimated at around £6000 per year for students living
outside London—NUS, 2002) meaning that students will still be in debt. In
addition, there is the possibility that some universities will charge higher tuition fees
(up to £3000) from 2006 onwards. It appears that student debt is here to stay.
Research has examined some of the consequences of increased student debt. For
example, Taylor et al. (1999) found that many students undertake paid work to pay
for their time at university and they argue that students find it difficult to juggle work
and study commitments, with work usually impacting on their social life. Moreover,
Humphrey (in press) reports that students who work tend to have worse grades and
join fewer university societies compared to students who don’t work. Looking at the
impact of debt on applying for university, Callender (2003) reported that there were
differences between students who intended to go to university and those that did
not. Students from lower social classes, older students, women and ethnic minorities
were all put off applying by their worries about debt accrual while at university.
Indeed, attitudes to debt were a significant predictor of decision to go to university.
The current paper focuses on attitudes toward debt as predictors of student
mental health. Work by Humphrey and McCarthy (1998) found no relationship
between debt (in expenditure terms) and stress levels among students (although see
Roberts et al., 2000). They argued that debt might now be considered an accepted
part of university life. However, other research suggests that while debt itself may
not be directly related to mental health, attitudes toward debt may be linked to
mental health. Stradling (2001) has shown that students’ perceptions of their debt
impact on mental health: students who perceived their anticipated graduate debt as
‘excessive’ were more likely to be anxious or depressed than students who viewed
their anticipated debt as ‘manageable’. Therefore, it may be that attitude toward
debt is more important than actual amount of debt. Research by Lea et al. (2001)
shows that students become more debt-tolerant as they progress through university.
Modifying attitudes to debt may be one coping strategy students use, and this may
reduce feelings of cognitive dissonance, i.e. possessing anti-debt attitudes but having
to borrow money to survive at university (Festinger, 1957).
The evidence outlined suggests that attitudes to debt are important in deciding to
attend university or not, and that these attitudes impact on mental health when
students are at university. This paper builds on earlier findings in a number of ways.
First, the measures of mental health employed in earlier studies have not been
validated with student populations. In contrast, the measure employed here (GP-
CORE: Sinclair et al., submitted) has. Second, data were collected from students in
all three years of their degree course, to allow for the assessment of trends in the
data. Third, the sample sizes used (greater than 1000 at all times) are unlike any
collected before in terms of scale. In sum, we hope to provide the most comprehen-
sive analysis of the impact of attitudes to debt on mental health to date. The present
study aims to address two issues. First, to provide a description of the impact of debt
Student Debt and Mental Health 55
on student mental health for students in their final year of university. This will
provide a baseline to judge other results by. Second, to examine the impact of
attitudinal measures on student mental health, over their time at university.
Method
The findings presented here are part of the data yielded by the UNIversity Quality
of Life and Learning (UNIQoLL) project currently being conducted at a Red Brick
university in the UK (Audin et al., 2003). UNIQoLL is a longitudinal study of
student perceptions of university life that covers a variety of issues including mental
health, financial concerns, and levels of paid work. The project started in 2000 and
data have been collected for three years, with student mental health measured at
seven time-points. In this study we focus only on the measure of mental health
completed at the end of Semester 1 each year because issues relating to finance were
also collected at that time-point. In short, these data allow us to both hone in on a
particular time-point for thorough analysis (e.g. the third year) as well as examine
trends over time.
Measures
Students were asked to report their gender, age, nationality, whether they worked
during term, and in the third year they were asked to report what their anticipated
debt would be at the end of their course. Student mental health was measured using
the GP-CORE (Sinclair et al., submitted) a shortened form of the CORE-OM
(Evans et al., 2002). The GP-CORE has been validated on a student population and
yields high reliability. Students answer 14 items which are drawn from three
subscales of the CORE-OM (functioning, problems and subjective well-being). All
items are scored from 0 (not at all) to 4 (all the time). Lower scores indicate better
mental health. Sinclair et al. demonstrated the discriminant validity of the GP-
CORE for student samples by showing that students’ score significantly lower on the
scale than patients undergoing therapy. In the present study, internal consistency
was high with alpha values of 0.85 for the GP-CORE in each year.
Two attitude items were employed. In all three years, students were asked ‘Are
financial concerns a current issue?’ (1 not at all to 5 a lot). In the third year
questionnaire, students were also asked ‘To what extent does your debt worry you?’
(1 not at all to 5 a lot, 0 not applicable).
Participants
The participants in this study were all students who entered university in 2000.
Table I provides demographic data for each year. Across the three years, there were
more female students (around 50%, compared to about 40% male students, 10%
did not list their gender), more non-mature students (around 80% were aged under
21 on entry to university), and more UK students (about 80% as an average). In the
first year 23% of students were employed in paid work during term-time, and this
56 R. Cooke et al.
TABLE I. Demographic information for the three student groups
Demographics First Years Second Years Third Years
Male 841(39%) 475(35%) 522(38%)
Female 1099(51%) 622(46%) 707(51%)
Not Specified 206(10%) 263(19%) 162(11%)
Mature 113(5%) 51(4%) 79(6%)
Non-mature 1827(85%) 1046(77%) 1150(83%)
Not specified 206(10%) 263(19%) 162(11%)
UK 1793(84%) 1034(76%) 1152(84%)
International 145(6%) 63(5%) 76(6%)
Not specified 208(10%) 263(19%) 148(10%)
Work in term 492(23%) 434(32%) 442(32%)
Don’t work in term 1438(67%) 818(60%) 778(56%)
Not specified 216(10%) 108(8%) 171(12%)
rose to about 32% in the second and third years. So a majority of students were not
employed in paid work during term time.
Procedure
Students completed the questionnaires toward the end of the first semester in their
first, second, or third year. Response rates were 38% (N 2146), 23% (N 1360)
and 26% (N 1391) of the total student population at the university, for first,
second and third years, respectively.
Analysis
In the present paper, effect size differences were used to compare mean scores.
Rather than use ANOVA, which is likely to produce significant effects due to the
large samples tested, effect size differences were chosen, as they allow for differences
in the sample size. We set a level of 0.4 standard deviation units (SDUs) as being
an effect sufficiently large to have utility and therefore be worthy of comment. In
choosing this level we followed previous work (Cooke et al., submitted). In the same
way that a Z-score of 1.96 is associated with the top 5% of the values in a
distribution, a Z-score of 0.4 is associated with 34% of the values in a distribution.
We have chosen this Z-score as indicative of meaningful differences because it is
known that one standard deviation above a standardized mean is 34% of the
population of values in the distribution. Therefore a mean difference of at least 0.4
of a Z-score is about one standard deviation from the mean in the distribution of all
values and is worthy of comment. In other words, of all the possible values a variable
can take (from 0–4 in the present case) a difference between two values (e.g. the
Student Debt and Mental Health 57
average score for those who worry ‘a lot’ versus ‘not a lot’) of 0.4 is sufficiently large
to suggest that these two groups are responding differently [1].
Results
To provide a start point for the analyses, we calculated the mental health of the
student groups measured via the GP-CORE. The measure is scored so that lower
scores are indicative of better mental health. The mean score in year 1 (M 1.30)
was lower than the values for year 2 (M 1.47) and year 3 (M 1.43), which
indicates a trend for worsening mental health as students progress through univer-
sity. There were two waves of analyses. First, we examined the impact of demo-
graphic variables, debt and paid work on mental health, to compare the present data
with previous results. Second, we investigated the relationship between attitudinal
variables and mental health.
Demographic Variables
Students supplied us with information about their gender, age and nationality. To
control for the possibility that different groups respond differently, and that this may
affect their attitude scores, we first compared the scores on the GP-CORE items for
these three variables. A number of differences emerged from the analyses. In all
three years, women scored lower (i.e. better) on the measure ‘I have felt warmth and
affection for someone’ than men. In year 1 and year 2 women scored lower on the
measure ‘I have felt I have someone to turn to for support when needed’. There were
no other differences. Also, in all three years international students scored higher (i.e.
worse) on the two measures mentioned above, compared to UK students. Finally,
mature students (classed as those who were 21 or older on entering university) had
worse scores in year 1 and year 2 for the measure ‘I have felt I have someone to turn
to for support when needed’, than younger students. Thus, although there were
some differences due to demographic variables, the majority of items were scored
similarly regardless of differences in gender, age or nationality.
Debt and Paid Work
We used effect size differences to ascertain if there were any differences in mental
health levels between students who worked in term and those who did not. Although
there was a trend for worsened mental health among students who worked, in each
year, none of these differences were significant. Therefore, paid work does not result
in significantly worse mental health.
Third-year students were asked to report how much debt they anticipated they
would have by the time they completed university. The average amount of antici-
pated debt on leaving university was £9082.78, with a standard deviation of
£5081.61. Because there was very little correlation between mental health and debt
(r 0.03, ns), further analyses were not conducted.
58 R. Cooke et al.
Debt Worry
The correlation between mental health and debt worry was 0.28 (p .001) among
third-year students, indicating as GP-CORE scores decreased (i.e. mental health
improved) debt worry lessened. Effect sizes were computed between those students
who answered ‘a lot’ (high worry) versus those who answered ‘not a lot’ (low worry)
and students who answered ‘a lot’ versus ‘not applicable’. It was assumed that
students who answered ‘not applicable’ had no debt, and examining the data on
anticipated debt this was found to be the case. Therefore, this group was assumed
to have no debt worry and were classed as the ‘no worry’ group. The effect sizes are
displayed in Table II.
Table II shows that students categorised as high worry (N 292) had significantly
higher GP-CORE scores (M 1.64) compared to low debt worry students
(N 130, M 1.19). To provide further insight into this difference we decided to
compare the mean scores for each group on the 14 items that make up the
GP-CORE. High debt worry students felt more tense, anxious, or nervous, more
criticised by other people, more unhappy, and more irritable with other people. In
addition, high debt worry students also felt less OK about themselves, less able to
cope when things go wrong, less happy with things they have done, less able to do
things they have needed to, and less optimistic about the future, than students low
on debt worry. This analysis shows that differences in how students perceive their
debt are reflected in their mental health levels. In addition, there is a significant
difference between the high worry and low worry groups in their anticipated amount
of debt on leaving university. High worry students expect to leave university with
more debt (M £11667, SD 4034) than low worry students (M £7631,
SD 4812).
A second analysis, comparing students with high debt worry with students who
had no debt (N 89) worry was conducted. This was done to see if there were
differences in GP-CORE scores between students who were very worried about their
debt and students who had no debt to worry them. GP-CORE scores were
substantially higher for those with high debt worry (M 1.64) compared to students
with no debt worry (M 1.28). Moreover, high debt worry students felt more tense,
anxious or nervous, felt less able to cope when things go wrong and felt that they had
not achieved the things they wanted to. However, there were fewer substantial
differences between students classed as high worry and those with no worry than
between high worry and low worry students.
There was only one substantial difference in mental health measures between
students with low debt worry and those with no debt worry: Students with low debt
worry had less feeling that they had achieved things they wanted to compared to
students with no debt.
Financial Concerns a Current Issue
This question was asked in all three years, so it was possible to plot how students’
financial concerns differ over time. Figure 1 illustrates the results. There is a trend
Student Debt and Mental Health 59
TABLE II. Means, standard deviations and effect size differences for students with high worry, low worry, or no worry
High Worry (N 292) Low Worry (N 130) No Worry (N 89)
Variable Mean Sd Mean Sd ES Mean SD ES
I have felt tense, anxious or nervous 2.56 1.03 1.58 1.14 0.92* 1.99 1.12 0.54*
I have felt that I have someone to turn 1.06 1.03 0.95 1.15 0.10 1.10 1.16 0.04
to for support
I have felt OK about myself 1.43 0.99 0.93 0.95 0.51* 1.08 0.89 0.36
I have felt able to cope when things go wrong 1.53 1.02 0.91 0.91 0.63* 1.08 0.82 0.46*
I have been troubled by aches, pains or other 1.62 1.34 1.3 1.26 0.24 1.23 1.22 0.30
physical problems
I have been happy with the things I have done 1.63 0.94 1.1 0.84 0.58* 1.34 0.97 0.31
I have had difficulty getting to sleep or staying 1.97 1.38 1.5 1.34 0.34 1.53 1.35 0.32
asleep
I have felt warmth and affection for someone 1.01 1.03 1.29 1.33 0.25 1.03 1.20 0.02
I have been able to do most things I needed to 1.61 0.96 1.2 0.87 0.44* 1.24 0.99 0.38
I have felt criticised by other people 1.37 0.99 0.88 0.98 0.50* 1.05 0.90 0.33
I have felt unhappy 1.66 1.01 1.02 0.9 0.66* 1.31 0.89 0.36
I have been irritable when with other people 1.70 1 1.18 0.94 0.53* 1.31 1.03 0.39
I have felt optimistic about the future 1.92 1.03 1.41 1 0.50* 1.53 1.05 0.38
I have achieved the things I wanted to 1.93 0.97 2.18 0.87 0.27 1.49 0.88 0.46*
GP-CORE 1.64 0.6 1.19 0.6 0.75* 1.31 0.58 0.56*
*Effect size difference of 0.4 or above
60 R. Cooke et al.
FIG.1. Financial concerns over time at university.
for students to be more concerned about their finances as they progress through
university, with more students indicating that concerns are ‘a lot’ of a problem in the
third year than in the first or second year.
We calculated the correlation between financial concerns and mental health in
year 1 (r .19, p .001), year 2 (r .22, p .001) and year 3 (r .24, p .001).
These correlations suggest that there is some relationship between financial concern
and mental health. We decided to compare the mental health responses of the
participants who answered that financial concerns where ‘not a lot’ of a current issue
(low concern group) with those who indicated ‘a lot’ of concern (high concern
group). In all three years, GP-CORE scores were greater for the high concern group
than for the low concern group (see Table III). Therefore, the individual items were
examined in each year as well. The results show that the high concern group scored
significantly higher on more items as they progressed through university.
For year 1 students, high concern students felt more tense, anxious or nervous,
troubled by physical problems and aches and pains, criticised, irritable with people
and had greater difficulty getting to sleep than low concern students. In year 2,
students who were more concerned reported feeling more tense, anxious or nervous,
more criticised, less OK, less able to do things they needed to, less optimistic, less
able to achieve things they wanted to, and more difficulty getting to sleep compared
to those who were little troubled by financial concerns. However, the biggest
differences occur for year 3 students, with all but four of the 14 GP-CORE items
showing significant differences (see Table III).
It is interesting to examine which variables were consistently rated differently by
high and low concern groups. Three variables were rated significantly worse by high
concern students in all three years—feeling tense, anxious or nervous, feeling
criticised by other people and having difficulty getting to sleep or staying asleep.
Also, two of the 14 GP-CORE items did not significantly differ between the two
groups in any year—‘felt I have someone to turn to for support’ and ‘felt warmth and
Student Debt and Mental Health 61
TABLE III. Means, standard deviations and effect sizes for comparisons on financial concerns as a current issue.
Year 1 Year 2 Year 3
High concern Low concern High concern Low concern High concern Low concern
N 395 N 175 N 334 N 113 N 369 N 105
Variable M SD M SD ES M SD M SD ES M SD M SD ES
I have felt tense, anxious 1.84 1.14 1.20 1.11 0.57* 2.4 1.08 1.85 1.24 0.49* 2.55 1.05 1.65 1.14 0.85*
or nervous
I have felt that I have 1.39 1.17 1.16 1.12 0.20 1.30 1.08 1.00 1.12 0.28 1.11 1.06 1.05 1.15 0.05
someone to turn to for
support
I have felt OK about myself 1.30 1.03 1.09 0.94 0.21 1.55 1.05 1.10 1.02 0.43* 1.41 0.97 0.97 0.92 0.46*
I have felt able to cope 1.29 1.03 1.03 0.88 0.26 1.53 1.07 1.14 0.99 0.37 1.53 1.03 1.02 0.87 0.52*
when things go wrong
I have been troubled by 1.52 1.33 0.93 1.09 0.47* 1.69 1.29 1.27 1.30 0.32 1.59 1.34 1.22 1.31 0.28
aches, pains or other
physical problems
I have been happy with the 1.53 0.97 1.24 0.96 0.30 1.72 0.96 1.35 0.96 0.39 1.65 0.94 1.21 0.95 0.46*
things I have done
I have had difficulty getting 1.94 1.37 1.19 1.19 0.57* 1.99 1.39 1.31 1.27 0.50* 1.92 1.40 1.29 1.27 0.46*
to sleep or staying asleep
I have felt warmth and 1.12 1.11 1.26 1.17 0.12 1.06 1.12 1.13 1.15 0.06 0.99 1.05 1.21 1.33 0.20
affection for someone
I have been able to do most 1.39 0.97 1.04 0.90 0.37 1.76 1.05 1.24 0.92 0.51* 1.63 0.95 1.23 0.93 0.43*
things I needed to
I have felt criticised by other 1.34 1.06 0.87 0.94 0.46* 1.52 1.06 1.04 0.97 0.46* 1.34 1.07 0.82 0.91 0.50*
people
I have felt unhappy 1.45 1.11 1.05 1.03 0.37 1.71 1.03 1.41 1.12 0.28 1.67 1.00 1.16 0.92 0.52*
I have been irritable when 1.48 1.01 1.07 0.94 0.41* 1.77 1.03 1.35 1.08 0.40* 1.66 1.04 1.14 0.88 0.51*
with other people
I have felt optimistic about 1.69 1.11 1.35 1.03 0.31 1.94 1.09 1.46 1.17 0.43* 1.90 1.01 1.53 1.11 0.35
the future
I have achieved the things 1.71 1.00 1.35 1.01 0.36 1.93 0.97 1.48 1.01 0.46* 1.93 0.93 1.50 0.98 0.47*
I wanted to
GP-CORE 1.5 0.65 1.13 0.59 0.59* 1.7 0.61 1.31 0.65 0.63* 1.63 0.61 1.21 0.63 0.69*
*Effect size difference of 0.4 or above
62 R. Cooke et al.
affection for someone’. The implications of these findings will be covered in detail
in the discussion.
One final point to make is the relationship between the two attitude items. The
correlation between debt worry and financial concerns in the third year was high
(r .66, p .001) suggesting that current concerns are linked to worries about final
debt, though this may reflect the fact that students are in their final year. In addition,
comparing the effect sizes between the high worry versus low worry groups and
between the high concern and low concern groups there were similar findings, e.g.
variables that were different in one analysis being different in the other analysis.
However, there were three variables that differed. Difficulty sleeping was
significantly different in the high versus low concern comparison, but not in the high
versus low worry comparison as was achieved the things I wanted to. In contrast,
there was a significant difference between high and low worry students for the item
‘I have felt optimistic about the future’, while there was no difference between the
high concern and low concern groups. These findings will be further discussed
below.
Discussion
In summary, demographic and economic measures do not appear to predict differ-
ences in mental health among students. In contrast, students’ perceptions of their
finances and debt differentiated mental health scores. Students’ concerns about their
finances appear to be associated with better and worse mental health. All students
face debt and financial concerns but how they perceive these difficulties seems to
impact on their mental health.
Analysis of demographic data suggests that younger (under 21 on entry to
university), female and UK students develop better social support networks than
other student groups. Further work is needed to explore the reasons for this.
Nevertheless, the results also suggest that any differences in mental health levels
are not primarily due to demographic information, as the majority of GP-CORE
items remained the same regardless of which group the participant belonged
to.
The fact that there was little relationship between GP-CORE scores and antici-
pated debt was probably because there was limited variation in the amount of debt
students anticipate facing. The amount students expect to owe is higher than the
figure reported in the most recent UNITE poll (M £9082 compared to
M £8816, UNITE, 2003). It is unclear whether this reflects an effect of averaging
across universities in the MORI survey, or university life is more expensive at certain
universities. What the current figure shows is that the cost of student life is
continuing to rise.
The increase in the cost of university appears to have impacted on students’ debt
tolerance. Work by Lea et al. (2001) indicates that students become more debt-tol-
erant as they progress through higher education. In contrast, the current data show
that students become more concerned with finances as they progress through
university. Apart from the fact that the two studies used different measures, another
Student Debt and Mental Health 63
reason for the difference is the situation students were in during the period in which
the studies were completed. The Lea et al. study was based on data from 1995, when
there was less necessity in taking loans because grants still existed. This is obviously
a different situation to that facing the students in the present study, with most
students having to take loans to pay for higher education, and these loans being
much larger than in 1995. This may be the main reason for the differences in the
two studies.
Looking at the psychological data, financial concerns become more prevalent over
time, affecting more mental health variables in the third year than in either the
second or first years. Since the mental health averages are almost equivalent for the
second and third years, it seems that financial concerns are heightened as students
complete their degrees. This is unsurprising as students will have accumulated more
debt by their third year and may have very real concerns about paying these debts
off when they complete their degree.
It was found that students who had high financial concern possessed higher scores
on measures of feeling tense, anxious or nervous, difficulty getting to sleep and
feeling criticised by other people. Humphrey and McCarthy (1998) argue that
students have higher stress levels than individuals who do not attend university and
Stradling (2001) reported high levels of anxiety among students in his research. This
finding suggests that while most students find university stressful, those who are
worried about financial issues are particularly anxious.
There is evidence that shows that greater anxiety is associated with sleep problems
such as insomnia (e.g., Moul et al., 2003; Morin et al., 2003; Viens et al., 2003), so
it may be that high concern/high worry students have more trouble sleeping because
of their anxiety. The other item that appeared to be different for high and low groups
was ‘I have felt criticised by other people’. It is difficult to explain this finding
without further research. It is necessary to find out who these people are. For
example, do students with more debt worry get more criticised by lecturers, friends,
family, etc? It could also be the case that high worry students may be sensitive to
criticism that less worried students would ignore.
There were no differences between high and low concern/worry groups on the
following two items: ‘I have felt I have someone to turn to for support’ and ‘I have
felt warmth and affection for someone’. These two items are concerned with
friendships and social support, and the lack of difference suggests that the high
worry students may have in place coping strategies for dealing with their worries that
are as effective as the low worry students. This seems to rule out the suggestion that
low worry students are people who simply cope better with university than high
worry students, but it also begs the question of why the high worry students have
worse GP-CORE scores. Research examining risks and buffers to mental health in
students is needed to try and untangle the various effects of university life on student
mental health (Cooke et al., submitted).
There were a number of limitations in the present research. One weakness is that
it fails to account for the possibility that students in the high concern/worry groups
are just generally more anxious. Debt is clearly a contributing factor but not
necessarily the sole factor accounting for their distress. Although this explanation is
64 R. Cooke et al.
possible, we argue that debt and financial concerns are an extra psychological
burden on top of the other pressures of university life.
Examining the pattern of results for the comparisons between the high, low and
no debt worry groups suggests that the high worry group are not necessarily more
worried about things in general. First, there were fewer differences between the high
and no worry groups, than between the high and low worry groups, suggesting that
finances do impact on mental health measures as the both high and low worry
groups have debt. Second, there was only one difference between the low and no
worry groups which suggests that these two groups give similar responses. Put
together, these findings suggest that the high worry group are similar to the no worry
group, who in turn are similar to the low worry group, and this argues against the
likelihood that the high worry group are just generally more worried about a number
of issues. However, until research has been conducted to compare these explana-
tions it is not possible to be certain at present.
The one difference between students with low and no debt worry was that
students with low debt worry had less feeling that they had achieved things they
wanted to compared to students with no debt worry. This interesting finding
suggests that although the low debt worry students are not suffering worsened
mental health due to their debt, they may be prevented from doing desired activities
by their debt. This finding is consistent with Humphrey’s (submitted) study that
demonstrated that students who work join fewer university societies. These results
show that debt can have a detrimental impact on students’ experience of university.
Another concern is the use of two attitude measures which correlate highly, as it
could be suggested that the two measures were tapping similar responses. However
the differences in the comparisons noted above suggest that the financial concern
item taps present concerns whereas the worry item taps future concerns. For example,
comparing someone with high current financial concerns and someone with low
current financial concerns on the item ‘I feel optimistic about the future’ is unlikely
to produce a difference, because the question is about the future, whereas thinking
about expected final debt may differentiate responses to feeling optimistic about the
future.
Further research examining the impact of paid work on mental health, such as
investigating the number of hours a student works, is needed, as it seems likely that
student employment is becoming an unavoidable aspect of university life for many
students. Also, research examining students’ experiences after graduation is re-
quired. Callender (2003) notes that certain students are put off university by the
debt associated with attending, while the present paper indicates that debt only
appears to impact on the mental health of certain students (i.e. those with high debt
worry). It is unknown how graduates experience full-time employment and pay for
their university debts. It would be interesting to see if graduates earn enough money
to pay off their ever-increasing debts, and see if they view university as a good
investment. Other areas for future research include examining why females develop
better social support networks than males and seeing if better networks can protect
students from the effects of debt, to further examine the causes of higher GP-CORE
scores and to conduct similar research at other institutions. This latter research is
Student Debt and Mental Health 65
important because the majority of students attending red-brick universities tend to
come from wealthy backgrounds, so the effects reported here may be even stronger
in newer universities.
The results presented have implications for professional action. First, it is import-
ant to make professionals aware of the actual financial situation facing students, and
to let students know that they are aware of their financial burden. This should foster
better understanding between staff and students. Second, departments could assign
a member of staff to oversee the impact of debt on studying. It would be this
person’s responsibility to encourage students to approach them for help when they
need it and to suggest ways to reduce conflict between students’ need to study and
the need to work to support themselves. For example, submitting work via email
may be a way to allow students to work when they have the time available, rather
than limiting the submission of work to office hours which may be a problem for
certain students. Finally, universities could run workshops on coping with financial
hardship after graduating. If students are reminded that their current financial
situation is temporary and that they will be in a better position after graduation, this
may reduce some of the concerns students have and, potentially, lead to better
mental health.
In conclusion, the results presented highlight the utility of attitude items in
describing issues related to student debt and mental health. Attitude measures have
allowed us to discover subtle differences in students’ mental health that would have
been missed by other measures. It is important to include such measures in future
studies as they have been shown to usefully add to our understanding of the impact
of debt on the stresses and strains students face at university.
Acknowledgements
UNIQoLL is funded by the University of Leeds. We thank members of the Steering
Group, Departmental Representatives and successive Union Executive members for
their encouragement and constructive criticism. Authors affiliated to PTRC were
also funded byR&Dlevy from Leeds Community and Mental Health Teaching
Trust.
Note
[1] It is worth noting that analyses were run using ANOVA to check the findings. Post-hoc
analyses using Tukey’s HSD reinforce the results from the effect size analyses. These data
are available from the first author.
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... Lange and Byrd (1998) find that chronic financial strain negatively affects New Zealand students' psychological well-being and stress differentiating immediate or ongoing financial situation to explain distress. Considering the actual student's debt and ongoing concern with paying that debt and other financing concerns, Cooke et al. (2004) find that it is how they perceive these difficulties rather than their anticipated debt that seems to impact their mental health significantly. This finding is also supported by Richardson et al. (2017) who find that it is the degree of distress about debt rather than the size of the debt itself which exacerbates anxiety, depression, and stress. ...
... Khawaja and Duncanson (2008) note that students enrolled part-time have a higher tendency to be depressed. On the other hand, Cooke et al. (2004) find an insignificant relationship of paid work during the student's college years and mental health. The survey's sample are all full-time students and the polychoric correlation between this variable and concern for college financing is +0.384 (see Appendix A, Table A.2). ...
... Although both variables have a negative polychoric correlation of -0.28 (see Appendix C), the results, show that either variable can be a weak instrument of the other, where the correlation coefficients between residuals of the two probits are insignificant. This supports the hypothesis that factors other than income can affect concern over financing ( Cooke et al. 2004). The factors underlying such a concern deserve further study. ...
Preprint
Do financial capacity and financing concerns affect the frequency of students’ feeling depressed? Data from a sample of Philippine college and university students between 2015 and 2018 show that students from income brackets immediately above the poorest ones are less prone to feeling depressed although we do not find similar results from other higher income brackets in our sample. This suggests that partial needs-based financial assistance can alleviate depressive feelings among students. We also find that the perceived financial burden of college financing is positively associated with such feelings of depression. This implicitly recommends that mental health support should be more integrated in the University’s health services.
... Estimates suggest that the average debtor leaves school with more than $30,000 in student debt (Reed & Cochrane, 2012;Student Borrower Protection Center, 2020). Given these trends in rising education costs, researchers have recently begun examining the social and health consequences for indebted students, including how debt is associated with engagement in college activities (Quadlin & Rudel, 2015), and the relationship between debt and mental health among university undergraduates (Cooke et al., 2004;Walsemann et al., 2015). A key emphasis of this research is that student loan debt is a stratifying mechanism for students' time use, the foundation of campus life, and their mental health. ...
... A growing body of research documents a strong and persistent link between financial strain and mental health (Drentea & Reynolds, 2012;Kahn & Pearlin, 2006), including personal indebtedness and psychological functioning (Selenko & Batinic, 2011), anxiety (Cooke et al., 2004), mental disorders (Jenkins et al., 2008), and depressive symptoms in later life (Aranda & Lincoln, 2011). ...
... Stradling (2001), for example, found that students who perceived their anticipated graduate debt as 'excessive' were more likely to be anxious or depressed than students who viewed their anticipated debt as 'manageable'. Furthermore, among college-enrolled students, those classified as "high debt worry" report feeling more "tense, anxious, and nervous" (Cooke et al., 2004) and have more difficulty getting sleep (also Richardson et al., 2017;Walsemann et al., 2015). Beyond negative impacts to borrower's health, student perceptions and loan borrowing experiences have been associated with credit card debt, decreased capacity to plan financially, and extended years to homeownership (Cho et al., 2015;Fox et al., 2017;Henager & Wilmarth, 2018). ...
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... Studies investigating debt and mental wellbeing have been conducted in numerous country contexts, for example, in the UK , Malaysia (Cai, Yusof et al. 2021), China (Gong, Zhang et al. 2014), Sweden (Rojas 2021) and the US (Berger, Collins et al. 2016). Within countries, evidence exists among general and specific population groups, for example, in children (Berger and Houle 2016, Berger and Houle 2019), military personnel (Bell, Nelson et al. 2014, Bryan andBryan 2019), university students (Cooke, Barkham et al. 2004) and cancer survivors (Dean, Schmitz et al. 2018), all of which report some associations, but most of these are based on crosssectional comparisons. Some studies have attempted to investigate whether the association is stronger among some subgroups than others. ...
Thesis
This thesis is concerned with the relationship between household debt and the mental wellbeing of people aged 50 years and older in England, elsewhere in Europe, and the US. This topic is prompted by the substantial levels of household indebtedness seen today in western countries, which have increased more rapidly than average incomes. Concurrently, the over-50 population has grown substantially, making it likely that there will be more older adults holding some form of debt in the future. For these reasons, the mental wellbeing implications of debt among older adults should be taken seriously. However, in current research, household debts are rarely considered to be socioeconomic determinants of the mental health of ageing populations. This thesis investigates the links between debt and mental wellbeing in three distinct but connected papers. The three papers all focus on people aged 50 years and older, all analyse mental wellbeing outcomes, and all use forms of household debt as main predictors. But each paper provides additional and novel evidence from different viewpoints. The thesis took a quantitative approach and used regression and sample weighting methods throughout. The first paper analyses the English Longitudinal Study of Ageing (ELSA). The paper explores the extent to which different household mortgage and non-mortgage debt measures predict depressive symptoms and quality of life scores in England. Non-mortgage debt, particularly when substantial considering the available assets of the household, has a robust link to both mental wellbeing outcomes. Mortgage debt is linked to lower quality of life, whereas no association is observed between this debt type and depressive symptoms. Similar associations, albeit smaller in magnitude, are observed in longitudinal settings; people had lower mental wellbeing after they acquired non-mortgage debts and better mental wellbeing after they got rid of their debts. The second paper uses the same dataset and focused on non-mortgage debt. The paper investigates the moderation of an individual level contextual factor – employment status – in the link between debt and mental wellbeing. This paper looks at moderation from population inference and intervention-focused perspectives. Population inference analysis shows that, while people in England with debts have lower mental wellbeing 4 (more depressive symptoms and lower quality of life) in all employment status categories, the mental pain linked to debts is stronger for people who are jobless (retired or not working). In the analysis, from an intervention perspective, observational data is analysed within the framework of a target trial. This type of analysis suggests that an intervention of getting rid of debts may reduce depressive symptoms only among people who are jobless. Getting rid of debts may improve the quality of life of all subgroups examined. The third paper analyses three harmonized longitudinal surveys, consisting of adults aged 50 and older from 21 European countries and the US. It investigates whether the link between non-mortgage debt and depression is observed across time and space, and whether this association is moderated by country-level factors. People with household non-mortgage debt have higher odds of depression – net of differences in other socioeconomic variables – in all countries. But this association is particularly strong in countries with poor personal discharge legislation and low levels of indebtedness, both of which indicate stronger social stigma related to debt. Within countries, there is also some weak indication that debts become more depressing in poor economic times, measured by the country-level unemployment rate. In almost all countries, the link between debt and depression is also observed when comparing people’s odds of depression in times when they were in debt to the times when they were debt-free. Altogether, these results stress that household debt is an important while nuanced socioeconomic determinant of poor mental wellbeing among adults aged 50 and older. Policy measures, such as integrated debt and mental health services, are needed to alleviate the mental health burden in older adults with non-mortgage debts, particularly among people in disadvantageous labour market situations and with few available assets. Subsequent intervention studies that aim to assess the mental health effects of debt relief may benefit from targeting people who are out of the labour market.
... The impact of debt on anxiety appears to be moderated by stress about debt (24). Greater subjective concern and stress about finances is linked to poorer mental health (7,25), and worries about debt predicts greater symptoms of depression over time, better than other financial variables such as income and employment status (26). One study showed differences in subjective financial wellbeing between individuals and found that this impacted overall wellbeing (27). ...
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Background: Previous research has shown a strong relationship between financial difficulties and mental health problems. Psychological factors such as hope and worry about finances appear to be an important factor in this relationship. Objective: To develop an online based psychological intervention (Space from Money Worries) to tackle the psychological mechanisms underlying the relationship between poor mental health and financial difficulties, and to conduct an initial evaluation of the acceptability and preliminary efficacy of the intervention. Materials and Methods: 30 participants accessing Increasing Access to Psychological Therapies (IAPT) services completed GAD-7 to measure anxiety and PHQ-9 to measure depression upon signing up to the online intervention and again 4 to 8 weeks after this. Participants also completed a measure of perceived financial distress/wellbeing and a “Money and Mental Health Scale” constructed for the evaluation. Results: Overall, 77% (n = 23) completed the intervention and follow-up assessments. Intent to Treat Analysis showed that there were statistically significant improvements in symptoms of depression, anxiety, improved perceived financial wellbeing and reduced scores on the money and mental health scale. The vast majority of participants rated each module positively. Conclusions: Space from Money Worries appears to be acceptable and may lead to improvements in mental health, perceived financial wellbeing and a reduced relationship between financial difficulties and poor mental health. However, future research with a larger sample and a control group are needed to confirm that these changes are due to the intervention.
... The few sources that have examined these issues outside of medicine demonstrate debt's negative impact (7,11,18). Limited research indicates prioritizing salary over elements of job satisfaction or preferred practice setting may contribute to burnout and decreased professional development and higher debt loads are consistently associated with lower levels of personal wellbeing (24,(27)(28)(29)(30)(31)(32)(33)(34). Importantly, most existing research has explored these effects within a narrow timeframe. ...
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... Other necessary changes such as the transition from school and home to the independence required of university have been identified as exacerbating the impact of academic factors as students navigate new identities and environments (Mann, 2001;Perry & Allard, 2003;Scanlon, Rowling, & Weber, 2007). For some students, even before the changes in fee regimes in England in 2012, financial independence brought difficulty managing and paying bills, long working hours, and debtall of which have been associated with poorer student mental health (Cooke, Barkham, Audin, Bradley, & Davy, 2004;Roberts et al., 2000). ...
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... These include the challenges of acute periods of intensive learning, living away from home for the first time and lacking access to key support networks, exposure to drink and drug-related activities, and student debt-and many of these factors have been shown to contribute to poorer psychological functioning (e.g. Brown, 2016;Cooke et al., 2004). As a result of these demands, longitudinal studies have indicated that student distress rises on entry to college and does not return to pre-college levels until the end of their course (Bewick et al., 2010), up to one in three students reports clinical levels of psychological distress (Bewick et al., 2008), and it appears to be an international phenomenon that affects students in many different countries (Rückert, 2015). ...
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... The financial strain associated with student life constitutes a source of stress for an increasing proportion of the student population (Dundes & Marx, 2006). A substantial group of students faces financial pressures (Cooke et al., 2004), which can have a significant long-term impact on their mental health (Richardson et al., 2017). While most countries have financial aids systems or government-sponsored student loan schemes, there is considerable variation in the size of the repayment and recovery ratios across schemes (Shen & Ziderman, 2009). ...
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Institutional self-evaluation is becoming increasingly pertinent as the student population becomes more diverse and higher education institutions become more customer focused. This paper describes the philosophy and early stages of a large-scale institutional self-evaluation project, based at and funded by the University of Leeds. UNIQoLL (UNIversity Quality of Life and Learning) aims to monitor student well-being over time, on a university-wide basis. It explores students' perceptions of strengths and weaknesses in the university's academic and service infrastructure and the relationship of these perceptions to student well-being. It aims to 'close the loop' by facilitating change in academic and service infrastructure in the light of emerging findings in order to enhance the student experience. The focus on student psychological well-being in addition to satisfaction, the longitudinal approach and the university- wide scope make UNIQoLL unique as a system of institutional self-evaluation. A pilot study in which 23 departments ( n =3667 students) participated is described to illustrate the procedures and underlying philosophy of UNIQoLL. Selected findings from two pilot surveys are presented to illustrate the potential of the project in providing relevant and useful information for academic departments, university support services and university managers. Illustrative data relating to academic issues, accommodation, student finances and student well-being are presented. Long-term success of an institutional self-evaluation project like UNIQoLL depends on the active cooperation of and ownership of findings by departments, students and university agencies. It also needs procedures to be sufficiently rigorous to generate robust findings and yet be sufficiently manageable to be feasible and sustainable.
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This paper reports on an ongoing research project exploring the perceptions of finance held by undergraduate students and how these perceptions modify over time. It examines changing government policy on student finance in an historical context before moving on to provide a critique of contributions made to the sociology of the student experience thus far. The rationale underpinning the case for a new economic sociology of the undergraduate financial experience of higher education is presented and then augmented by way of empirical data. The final section then examines some of the implications of the research findings for the new and arguably still evolving government policy on student finance.
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Objectives: This study was initially designed to test the notion that generalized anxiety is a predominant factor in the maintenance of psychologically determined sleep-onset insomnia and that a trait anxiety reducing technique can provide significant therapeutic gains. Methods: Twenty participants (age 19–63) with moderate to severe sleep-onset chronic insomnia were first asked to monitor their sleep-onset latency (SOL) for a 3-week baseline period at home using a SOL clock device. Then, 10 received anxiety management training (AMT) for 9 weeks, while the remaining 10 were trained in the use of progressive relaxation (PR). All participants were measured before and after therapy using sleep laboratory recordings (three nights each), the Spielberger Trait Anxiety Inventory and the Beck Depression Inventory. Daily home sleep-onset measures with the SOL clock device were also taken during therapy. Results: There was no change in SOL over the 3-week baseline period. However, both groups experienced a significant improvement in SOL from pretreatment (end of baseline) to posttreatment periods. In the laboratory, both groups experienced a reduction in Stage 1 sleep as well as an increase in slow wave sleep (SWS) and sleep satisfaction. On the personality measures, both groups experienced a significant reduction in trait anxiety and a decrease in depression. Overall, there was no indication that one of the therapies was significantly better than the other in effecting changes. Conclusion: These results suggest that both PR and AMT are efficient therapies for sleep onset insomnia and overall sleep quality. Improvements in the application of the AMT technique are proposed to maximize its usefulness.
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Is contemporary student life stressful? And if so, what factors are associated with stress among students? This paper attempts to provide answers to these questions in reporting a research project that explored physical and mental health among students studying at Newcastle University in 1995. Forty-nine per cent of a stratified random sample of students (956 students) completed a postal questionnaire which, as well as addressing questions of health, covered numerous aspects of student living conditions and lifestyle. Stress was measured by the 12-item General Health Questionnaire, which was converted into a 36-point scale. The analysis identifies various factors that were associated with stress, and culminates in the construction of a multi-variate model that explains 25 per cent of the variance in student stress. The findings are discussed within the context of the changing nature of higher education in Britain
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This paper explores the social and academic effects of term-time working on undergraduate students at an English university. Data initially collected via a survey of student social relationships were enhanced by the inclusion of end-of-year academic performance. Various inferential statistical techniques were used to identify these effects. Path analysis was employed to disentangle significant variables and to show that term-time working had direct and significant effects on the two factors shown to be affected most significantly by term-time working: end-of-year average grade and participation in university societies. A major finding was that almost all students who worked came from state schools rather than from independent privately financed schools. The findings are discussed within the context of the recent history of funding policy regarding higher education in England. A key conclusion is that structured inequality, an inherent feature of a divided secondary education system, is being pulled firmly into higher education.