IntroductionIn the UK, as in many other high-income countries, debt due to higher education has increased substantially in recent decades. For example, as of 2018, the average student in England will have accrued £50,000 of debt upon university completion. The prevalence of common mental health problems has also increased, alongside these increased financial pressures. However, it is as yet unclear whether there is an association between financial stress and mental health among higher education students.Methods We conducted a rapid review of the peer-reviewed scientific literature to examine the links between indicators of financial stress and mental health among university students in the UK. Studies were located through a systematic search of Psychinfo, Pubmed and Embase up to November 2018. Eligible studies were English-language publications testing the association between any indicator of financial stress and mental health among higher education students in the United Kingdom. ResultsThe search strategy above yielded 1,272 studies, from which only 9 met the inclusion criteria. A further two studies were identified through hand-searching. Financial indicators included amount of debt, experience of financial difficulties and financial concerns/debt worry. There was little evidence that debt level was associated with mental health—only 3 of 7 studies found an association in the expected direction between higher debt and worse mental health. Evidence was more consistent for a cross-sectional relationship between subjective measures of financial difficulty (7 of 7 studies) and debt worry/financial concern (4 of 5 studies) with worse mental health, though longitudinal evidence was very limited. ConclusionAmong higher education students in the UK, there is little evidence that the amount of debt is associated with mental health, while subjective measures of higher financial stress are more consistently associated with worse mental health outcomes. The identified evidence was judged to be weak due to uncertain study generalisability, and the potential for bias due to common causes of financial stress and mental health outcomes (confounders). Thus, further research is required to examine whether links between financial stress and mental health outcomes are robust and causal in nature.
International mental health outcomes and benchmarking using the FACE approach
