Introduction

Graduate students balance multiple responsibilities including schoolwork, theses/dissertations, internships, assistantships as well as external responsibilities such as family and/or childcare (Johnson & Haun, 2008; Nelson et al., 2001). Graduate students report higher levels of stress than other populations which contributes to susceptibility to mental health difficulties (Evans et al., 2018; Marks et al., 2011). They are six times more likely to experience depression or anxiety than non-graduate students. Approximately 7% of a graduate student sample reported thoughts of suicide (Garcia-Williams et al., 2014) and 60% reported their functioning was moderate to severely disrupted by their anxiety (El-Ghoroury et al., 2012). Many seek psychological treatment and 50% report considering seeking mental health services (Hyun et al., 2006). However, 46% cite financial constraints as a barrier to receiving services (El-Ghoroury et al., 2012).
Despite the need for healthcare, many graduate students may be uninsured or underinsured and lack access to adequate health care. Graduate students frequently rely on stipends through graduate assistantships, part-time jobs, or student loans which often cover the basic needs, and may leave little income for health insurance whose premiums range from $100 - $500 a month (National Conference of State Legislatures, 2018). Furthermore, finances and debt are a significant source of stress to 64% of graduate students (El-Ghoroury et al., 2012). Despite graduate students being a population that has the potential to be uninsured yet need access to healthcare, research has not examined health insurance in graduate students nor its impact on their mental well-being. It was hypothesized that there would be significant differences in depression, stress, and anxiety based on health insurance status.