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Mental Health in Low-Income

Post-Secondary Students

 

Claire Hallett

Education is one of the biggest investments a person makes in their lifetime. During the 2019-2020 school year, the average cost of tuition for a domestic Canadian student was $6463.1 This figure does not include the cost of housing, transportation, food, textbooks, or other necessities. For students with low income, the price of going to school represents a significant stressor and can negatively impact their mental health. 

According to social stress theory, low-income individuals are more likely to be exposed to stressful circumstances. This, in turn, can contribute to mental health concerns.2 Unfortunately, low-income individuals are less likely to have access to mental health resources even though they have greater need for them. This can manifest in numerous ways in the context of postsecondary education. 

First and foremost, the cost of attending school can, in itself, cause a great deal of distress. In a study conducted at York University, Othman, Ahmad, El Morr, and Ritvo found that tuition fees were among the greatest sources of stress for students.3 They also determined that students with anxiety were 2.59 times more likely to have experienced financial hardship than students without anxiety. Furthermore, a U.S. study of low-income student experiences found that stress can be compounded by guilt about posing a financial burden to one’s family.4 

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Low-income status can also affect student wellbeing through its impacts on academic performance. For example, low-income students may need to work in order to support their studies. Time spent at work can take away from time spent studying or completing assignments. This can have a negative effect on academic performance. CNBC reports that 59 percent of low-income students who work 15 hours or more per week have an overall average of C or lower.5 As well, low-income students are less likely to have access to supplementary resources to improve their performance. Private tutoring is one such supplementary resource that can become quite expensive. The average price of private tutoring in Toronto is $25 per hour according to superprof.ca.6 In addition, preparatory courses to help students achieve admission to postgraduate programs can be massively expensive. The most popular Medical College Admissions Test (MCAT) preparatory course offered by The Princeton Review costs $2799 CAD.7 When it comes to supplements to education, low-income students are at a relative disadvantage compared to their peers, which may lead to poorer academic performance. Research has linked low grades and rejections from postgraduate programs to decreases in self-esteem and perceived academic competence.8,9 Therefore, low-income students may be more vulnerable to decreases in self-worth related to poor academic performance. 

Students with low income also have less access to resources to improve and maintain their mental health. Therapy and other formal mental health care can come at a significant cost. For example, in 2013, the Ontario Psychological Association recommended that psychologists in private practice charge $225 per hour.10 Fortunately, many Ontario universities offer therapy that is covered by student health insurance. However, it typically involves long wait lists, a limited number of sessions, and narrow options for treatment.11 Low-income students may also face barriers in creating and accessing informal social supports. Avenues for meeting new people and making friends can sometimes come at a cost. For example, school clubs or fraternities may require membership fees or dues. In addition, it may be difficult to socialize when this is often done in places like restaurants, movie theaters, and bars. Lower access to both formal and informal support systems places low-income students at greater risk for depression, anxiety, and suicidal ideation. 12,13,14

Critically, individuals with low income are more likely to belong to minority groups that place them at an even greater risk of mental health concerns. In the 2016 Canadian census, 20.8% of racialized individuals were classified as having low income as compared to 12.2% of non-racialized individuals.15 Unfortunately, there is little research on the mental health needs of racialized, low-income individuals in Canada.16 However, in the United States, the office of the surgeon general found that racialized and low-income individuals were less likely to have access to affordable mental healthcare and, when they did receive it, the care was of poorer quality.17 Furthermore, a study of the effects of race and socioeconomic status on the mental health of American youth found that Black and Hispanic individuals had higher levels of depression compared to Whites. This difference was attributed to a greater likelihood of Blacks and Hispanics having a low income. Based on the existing research, it is likely that minority students with low-income face greater stress and less care compared to their peers. However, more research is needed on the intersection between socioeconomic status and minority identities, particularly in a Canadian context.

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There are several actions that postsecondary institutions might take to increase equity between students of different socioeconomic statuses. For one, universities should offer greater flexibility in deadlines and grading. Due to circumstances beyond their control, students with low income may have fewer resources to prepare for assessments in the allotted time. By adopting a more understanding attitude toward students’ circumstances, colleges and universities would better allow students to achieve their potential. In addition, postsecondary institutions should consider expanding and diversifying the mental healthcare that is covered by student health insurance. This might include lowering the cost of care, offering a wider range of services, and providing training to school counselors about sensitivity to individuals with low income and other identities that expose them to greater stress.18 Lastly, postsecondary institutions should provide platforms for their low-income students, hear their concerns and suggestions, and, most importantly, act on them. 

Edited by Stacey Butler & Emily Mastragostino 

References

1. Stats Canada. (2019). Tuition fees for degree programs, 2019/2020. https://www150.statcan.gc.ca/n1/daily-quotidien/190904/dq190904b-eng.htm

2. Schwartz, S., & Meyer, I. H. (2010). Mental health disparities research: The impact of within and between group analyses on tests of social stress hypotheses. Social  science & medicine, 70(8), 1111-1118.

3. Othman N, Ahmad F, El Morr C, Ritvo P (2019). Perceived impact of contextual determinants on depression, anxiety and stress: a survey with university students. Int J Ment Health Syst. Mar 26;13:17. 

4. Hyun, H. (2018). The Impact of Low Socioeconomic Status on the Mental Health and  Self-Efficacy of College Students. The Proceedings of GREAT Day, 64, 74.

5. Carnevale, A.P. (2019, October 24). Working while in college may hurt students more  than it helps. CNBC. https://www.cnbc.com/2019/10/24/working-in-college-can- hurt-low-income-students-more-than-help.html

6. Super Prof. (2020, November 29). What Tutoring Rate Should I Charge https://www.superprof.ca/blog/fair-cost-tutors/

8. Crocker, J., Karpinski, A., Quinn, D. M., & Chase, S. K. (2003). When grades determine  self-worth: consequences of contingent self-worth for male and female engineering and psychology majors. Journal of personality and social  psychology, 85(3), 507.

9. Crocker, J., Sommers, S. R., & Luhtanen, R. K. (2002). Hopes dashed and dreams  fulfilled: Contingencies of self-worth and admissions to graduate school. Personality and Social Psychology Bulletin, 28, 1275–1286.

10. Ontario Psychological Association. (2013). What to expect when seeing a psychological  professional. https://www.psych.on.ca/About-Psychology/Getting-help/What-to- expect-when-seeing-a-psychological-profess

11. Nunes, M., Syed, T., De Jong, M., Provencher, M. D., Ferrari, J., Walker, J. R., . . . Furer, P. (2014). A national survey of student extended health insurance programs in postsecondary institutions in Canada: Limited support for students  with mental health problems. Canadian Psychology, 55(2), 101-109. 

12. Lorant, V., Deliège, D., Eaton, W., Robert, A., Philippot, P., & Ansseau, M. (2003).  Socioeconomic inequalities in depression: a meta-analysis. American journal of epidemiology, 157(2), 98-112.

13. Rankin, J. A., Paisley, C. A., Mulla, M. M., & Tomeny, T. S. (2018). Unmet social  support needs among college students: Relations between social support  discrepancy and depressive and anxiety symptoms. Journal of Counseling  Psychology, 65(4), 474–489.

14. Arria, A. M., O'Grady, K. E., Caldeira, K. M., Vincent, K. B., Wilcox, H. C., & Wish, E. D. (2009). Suicide ideation among college students: A multivariate analysis. Archives of suicide research, 13(3), 230-246.

15. Block, S., Galabuzi-Grace, E., & Tranjan, R. (2019). Canada's colour coded income  inequality. Canadian Centre for Policy Alternatives.

16. Chiu, M. (2017). Ethnic differences in mental health and race-based data collection.  ICES report. Healthcare Quarterly, 20(3), 6-9.

17. Satcher, D. (2001). Mental health: Culture, race, and ethnicity—A supplement to mental  health: A report of the surgeon general. US Department of Health and Human  Services.

18. Hensley, L. (2019, October 9). ‘One size doesn’t fit all’: Canadian campuses  desperately need better mental health services. Global News.  https://globalnews.ca/news/5969461/mental-health-canadian-campus/