An interview with Helena Sanchez, second-year clinical psychology PD student at Howard University
The mental health of graduate students matters not only for their well-being but also for the future of the profession.
Addressing financial stress caused by student debt is a crucial piece of this puzzle. According to the United States Government Accountability Office, federal student loan debt totaled $1.5 trillion as of January 2024, affecting 43 million borrowers, whose debt balances tend to increase with age rather than decrease. For psychology doctoral students, this creates a unique opportunity: by understanding how financial stress intersects with mental health outcomes, we can develop targeted interventions that support both current students and future practitioners.
Hopelab asked Helena Sanchez, a doctoral student at Howard University, to share more about her research, which explores these intersections and points to practical solutions.
This interview has been edited for length and clarity.
Why did you decide to focus your research on student debt?
Helena: My decision to focus on student debt for my research project was heavily influenced by my own personal experiences navigating student debt, particularly when applying for graduate school, which sparked an interest in how other students are impacted by this common experience.
Many individuals first take out student debt to attend an undergraduate institution, meaning the majority of these students are around 18 years old or in early adulthood. Depending on their financial education, many young people end up taking on large amounts of student loan debt without truly understanding how it will impact them later in life or considering the return on investment. Especially now, with an arguably strained job market, many students are realizing the debt they took on for school was not “worth it” as they were told in high school.
Given the current rising cost of living and the presidential administration’s attack on higher education, I felt that understanding debt from a practical and psychological viewpoint was particularly important. I chose to focus on health service psychology graduate students because we actively provide psychological services while in our programs, meaning our well-being is critical to the ethical delivery of services. All of these factors culminated in my decision to study how debt- and financial-related stress impact clinical and counseling psychology doctoral students.
What’s the connection between student debt and well-being? Have you been able to track any physical health outcomes among students with debt versus those without debt?
Helena: There is a clear connection between student debt and well-being, as highlighted in the literature across many student populations. Many studies examine this relationship among medical and law students, as their debt loads are significantly higher than those in other PhD and master’s programs. Despite the high earning potential of careers in medicine, the debt load is so insurmountable that these students are still struggling to pay it off. A systematic review of the literature found that mental health symptoms, such as anxiety and depression, in addition to academic performance, were negatively associated with debt stress among medical students (
). In other words, stress related to student debt is likely interfering with doctors’ abilities to do their jobs to the best of their ability. This review also found that debt unduly influenced specialty choice, often influencing students away from lower-paying specialties that are often more community-facing. These findings also map to psychology graduate students with poorer mental health symptoms, ultimately impacting performance in their programs. Higher debt loads may also push psychology graduate students towards more lucrative career paths, such as private practice, and away from careers in community mental health, a realm of clinical practice that is already understaffed despite growing needs.
Across the board, the research is telling us that student debt has tangible consequences across disciplines and program types. Graduate students are in a particularly precarious position, sacrificing their psychological and financial well-being for their academic and professional passions. These roles: doctor, lawyer, psychologist, are all essential to the general public, and with the attack on higher education currently being waged by the presidential administration, our communities must ring the alarm on this pressing issue to ensure we have competent, healthy providers to impart their services.
If education were free in America, how would that impact your life?
Hannah: If education were free, my life would probably look a lot different in the best of ways. I began my search for graduate programs already riddled with over $50,000 in student debt, greatly limiting my options, particularly given the new caps on federal student loans. Despite my family receiving financial assistance throughout my K-12 education at a private school in New York City, my undergraduate institution felt I didn’t need it, forcing me to take out federal student loans every year and, eventually, private loans in my last year of college to graduate. Now I am 27 years old, and despite receiving funding for my graduate studies, I still worry about how I will be able to repay the debt while making strides towards important life milestones, such as getting married, buying a house, and having children once I graduate.
My story is not unique; if anything, I am one of the luckier ones, with a “manageable” amount of debt to repay and (hopefully) no-to-minimal debt from graduate school. any live a different reality. Something many borrowers don’t consider is how the debt will affect them after completing their programs. For me, this meant paying a minimum of $400 a month, fresh out of college with a low salary, only to see my loan balance to decrease by $1000 in one year.
Thinking back now, having an extra $400 a month would have been life-changing as I navigated my first job, saved for graduate school, and began investing in my future. Not having debt would mean I could contribute to retirement, save for a down payment on a house, put money away towards a future wedding and for future children, and most importantly, enjoy the fruits of my labor. I think most other student loan borrowers would agree, not having a debt sentence would be life-changing.
Do you think we’d have a healthier population (mentally and physically) if student loans were forgiven, cancelled, or discharged? Why?
Hannah: I absolutely believe we would have a healthier population if student loans were discharged. We would have a more educated population —with financial barriers removed, more people would be able to afford higher education. Educational attainment has been linked to physical health outcomes, predicting them even more so than factors such as smoking. more educated population is a healthier one.
By removing student debt as a stressor to health service professionals (doctors, therapists, etc.), the general public would receive care from a healthier population. This would likely lead to higher-quality care
and reductions in mistakes or unintentional harm. Because of financial barriers, many prospective students from underrepresented backgrounds face additional obstacles to pursuing graduate education, contributing to more homogeneity within health service professions.
In addition, we would likely have more doctors, lawyers, and psychologists, and a more diverse population of these providers.
Does the current student loan system feel fair to you? What about it feels unfair or broken?
Hannah: The current student loan system does not feel fair at all to me, based on my personal experiences and the literature I have read. The astronomical price of college tuition at most private universities in the United States has gotten out of control, increasing every year while the quality of education remains the same. Professors are still underpaid. Our current system effectively makes higher education accessible only to the wealthy, with most Americans having to rely on loans they will likely spend the rest of their lives repaying. A degree is no longer a golden ticket to a well-paying, stable job. The predatory nature of the student loan industry, especially among private lenders, further contributes to this issue, offering a temporary solution to a systemic problem.
In addition to questioning the fairness of the student loan system, we should also be targeting our questions towards universities, specifically how they justify the exorbitant cost of attendance. Given the current job market, the return on investment for a Bachelor’s degree has become increasingly questionable, even though we continue to be sold the idea that the only way to progress professionally is with an undergraduate degree.
Many people forget that college was not always this expensive. Ronald Reagan played a massive role in making a college education inaccessible, creating policies that reduced government spending and effectively created the student loan system as we know it today. The student loan system was not created equitably. It makes higher education a privilege only a few can afford and creates an additional burden for students of color and low-income students.
When you think about your financial stress, where does student debt rank compared to rent, food, or health care?
Hannah: I think student debt stress and financial stress are intrinsically intertwined, especially for graduate students. Many undergraduate students rely more heavily on campus and familial resources for basic necessities such as food, housing, and health care. I was privileged enough to have parents who financially supported me throughout my undergraduate degree; my housing and food were covered through tuition, and I was able to stay on my parents’ health insurance until I was 26. Now, as a graduate student in my late 20s, living on campus and eating in the dining hall do not appeal to me, which means my expenses now include paying my own rent, food, and health insurance. While I am lucky enough to receive a stipend to help me cover these expenses, many others use student loan funds to afford these basic necessities. In other words, many graduate students are literally going into debt in order to feed and house themselves while working for their university.
In my experience with psychology doctoral programs, the stipends are not sufficient to cover daily expenses, especially in higher-cost-of-living areas. For example, my stipend as a student living in the Washington, D.C. area would be completely insufficient if I did not live with my partner, who covers the majority of our expenses. To put it further in perspective, my monthly income after taxes would cover only my rent, despite living in an unusually affordable apartment in D.C.
When politicians talk about student loan forgiveness, what makes you trust them—or not trust them?
This is a difficult question, as the political sphere in the United States has become more polarized, and feelings of fear and uncertainty are heightened; it is hard to fathom trusting any politician by their word. In my opinion, I do believe Joe Biden did fairly well regarding student loans and easing the strain of repayment. His income-driven repayment plans, particularly the SAVE plan, helped millions of borrowers, including myself, lower their monthly minimum payments, offering some relief. However, I do not think any politicians have been progressive enough in their stance on student loan forgiveness, often because they are so far removed from the experiences of the average American. Given the current economic climate, now is the time to take a radical stance on student loan forgiveness, giving people the opportunity to breathe a sigh of relief and invest in their futures.
I think the best way for a politician to earn my trust on the student loan forgiveness issue is to offer a concrete plan, not just a list of steps on how to approach forgiveness, but an in-depth, thoughtful plan of action, in addition to alternative plans in the event of interference. A politician whose other policies and beliefs align with student forgiveness, such as increasing taxes on the top one percent to decrease taxes for the average American, putting more funding towards social programs and community development, and working towards universal health care. A politician who is dedicated to economic justice and equity in all areas is one whom I would trust to walk the walk on student loan forgiveness.
