This story was supported by the journalism nonprofit the Economic Hardship Reporting Project.
As the first person in her family to go college, Catherine fought hard to get her bachelor’s. After transferring from community college to a four-year university, she worked as a barista and a line cook, trapped in a cycle where she’d take on extra hours to cover her bills, then feel too tired to study. But it still wasn’t enough. She regularly felt desperate for money. She put books and necessities, like hygiene supplies and food, on credit cards, accumulating debt she's yet to be able to pay off. By the time she graduated in 2018, she also had about $14,000 in student loan debt, which she described as causing “a lot of mental strain.”
“I have three main problems with my mental health,” Catherine, now 30 and using a pseudonym to protect her privacy, told Teen Vogue. “One is family issues, one is myself, and one is debt. Because it's a trap. And there's no out.”
After she graduated, Catherine was working the night shift in a psychiatric hospital, about 7 p.m. to 7 a.m. Monday through Thursday, picking up weekend shifts at the coffee shop for extra cash. She even leaned on friends who made more money. Her credit card debt from college has only grown due to car problems and other emergency costs; it’s now somewhere between $6,000 to $8,000 a year, she told Teen Vogue, and came from paying those college expenses. Thanks to issues like her car breaking down and other emergency costs, she hasn’t had enough money to catch up. Whereas the initial pandemic student loan payment pause meant Catherine could pay off medical bills she’d incurred, the end of the pause spelled the end of relief. She had to stop seeing her therapist before payments resumed because she couldn’t afford the $90 per week and budget for eventual payments. She’s supposed to be on antidepressants, she said, but couldn’t continue paying an additional $90 a month for telehealth appointments with a psychiatrist on top of the therapy payments, and decided not to fill the prescription since she wouldn’t have access to a doctor.
After the end of the three and a half year-long payment pause, borrowers have discussed cutting back on “essential purchases” in an effort to make ends meet, or how the loss of financial breathing room was impacting their lives. For some, the pressure of student debt and resumption of payments meant delaying or forgoing mental health care — even if debt was contributing to their mental distress.
“Student loan debt is absolutely exacerbating the mental health crisis,” Aissa Canchola Bañez, policy director at the Student Borrower Protection Center, told Teen Vogue. “We have also heard from borrowers who report delaying routine medical and dental care and putting off buying necessary medication because of the way that their student debt is straining their budgets.”
Maya Chavis, 21, a first-generation student who graduated early, told Teen Vogue that many of her family members didn’t go to college because of the cost. When Maya was in college, she waived the fee that would’ve afforded her on-campus physical and mental health care so she could put those funds toward bills. “I put my mental health on the back burner, and my [physical] health on the back burner, for the fact that I didn't want to have to pay for it later,” she said.
By the time she was out of college and payments resumed, “I remember getting that first bill and I'm like, Mom, I can't pay this,” Maya recounted. At that time, she was working three jobs, and she says there was no way she could afford rent, her phone bill, and her car payment with another $175 bill on top. Her loan payments were temporarily paused under economic hardship deferment when she was on Medicaid, but the number still loomed over her. “It’s kind of like a terror type thing,” she said. “It's always in the back of my mind.”
Kristen Lindgren, the professor and clinical psychologist at the University of Washington School of Medicine whose study found a relationship between student debt and stress, said, “When you have the larger financial uncertainty that's just happening demographically to this age group, then you throw in student debt, then you throw in uncertainty about if and when and how much your payments are going to be, that's really, really challenging to navigate.”
In addition to the “psychological toll” of student debt, the stress of payments can make forgoing care or support feel like the only feasible option. Arielle Kuperberg, professor of sociology at University of North Carolina Greensboro, conducted research alongside Joan Maya Mazelis, associate professor of sociology at Rutgers University, that found students who took out loans reported being more likely to delay medical, dental, and mental health care to save money. Six and a half years after graduation, 46% of graduates who had loans reported delaying mental health care in order to make ends, Kuperberg told Teen Vogue. (About 30% of graduates without loans reported delaying mental health care.)
Maya now works as a campus organizer for RISE, a nonprofit focused on making higher education more accessible and affordable, and receives benefits through work. But she said she doesn’t want to see a doctor because she doesn’t want to accumulate another bill. That includes counseling, which Maya noted can be expensive. “It's a lot to say, okay, like, I'm gonna go talk to somebody about my issues, but to pay $200 for it–that could have been my groceries for the month or I could have paid for my student loans for that month.”
In her work with RISE, Maya connects with students who say they don’t have time to talk to a therapist or even decompress. Like Maya, many of the students she talks to are working while in school, and in some cases, just trying to afford to finish.
The expense could also exacerbate existing disparities in access to mental health care and who is most profoundly impacted by the student debt crisis. As reported by The Education Trust, Black borrowers are among those most negatively impacted by student loans, and 64% of survey participants reported that student debt negatively impacted their mental health. Other research outlines that people of color, those with low incomes, and students who are parents are all among those who might be impacted by student debt and also face barriers to receiving healthcare.
Aissa Canchola Bañez, of the Student Borrower Protection Center, noted that the student debt crisis shouldn’t be seen in a silo. “It is a crisis that is impacting workers and families across their financial and personal lives—impacting their financial stability as well as their mental, emotional, and physical wellbeing,” she said.
In Catherine’s case, she said you work hard to get to the point where you can talk to a doctor, then realize you can’t afford it. She’ll spend some time thinking about it, she said, and “one day wake up and be like, okay, I'm going to get help, and then I'll realize I have $7 in the bank account.” When she thinks about mental health and student debt, what she’s noticed is that “more people than not struggle.”
If you or someone you know is struggling with mental health, help is available. Please find more resources on accessing help here. If you or someone you know is going through a crisis, you can contact the National Suicide Prevention Lifeline at 988.