A systematic review examining the relationship between debt and the mental health outcomes of anxiety, depression and suicidality within the United States

Kendra Rooney; Saige M. Addison; Lauren E.Gil Hayes; Chabli Hodge; Crys Carman; Andrea Wilson; Aislinn Conrad

doi:10.1016/j.ssmph.2026.101915

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A systematic review examining the relationship between debt and the mental health outcomes of anxiety, depression and suicidality within the United States

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A systematic review examining the relationship between debt and the mental health outcomes of anxiety, depression and suicidality within the United States

Kendra Rooney, Saige M. Addison, Lauren E.Gil Hayes, Chabli Hodge, Crys Carman, Andrea Wilson and Aislinn Conrad

SSM - population health, Vol.34, 101915

06/01/2026

DOI: 10.1016/j.ssmph.2026.101915

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Abstract

Background: Personal debt in the United States has reached historic highs, raising growing concern about its impact on mental health. While prior reviews have examined debt and mental health, less is known about how specific debt types relate to distinct psychological outcomes within the U.S. Methods: Following PRISMA 2020 guidelines, we systematically searched PsycINFO, Scopus, and Web of Science for English-language, peer-reviewed articles published between 1980 and 2024. Eligible studies used quantitative methods, included adult U.S. populations, and reported statistical associations between personal debt and anxiety, depression, or suicidality. This review is registered with PROSPERO (CRD42024594465). Results: Thirty nine studies met inclusion criteria, covering debt types such as student loans, unsecured debt, mortgage debt, and bankruptcy. Debt was consistently linked to higher symptoms of anxiety, depression, and suicidality. Mechanisms included financial strain, debt collection pressure, and diminished sense of control. Under certain conditions, some secured debt (e.g., mortgages) appeared protective. Conclusions: Debt operates as a psychosocial stressor with significant mental health consequences. Findings highlight the importance of standardized measurement, longitudinal research, and integrated financial-mental health interventions. Structural reforms and targeted supports are needed to reduce the psychological burden of personal debt.

Details

Title: Subtitle: A systematic review examining the relationship between debt and the mental health outcomes of anxiety, depression and suicidality within the United States
Creators: Kendra Rooney - University of Iowa
Saige M. Addison - University of Iowa
Lauren E.Gil Hayes - University of Iowa, School of Social Work, College of Liberal Arts and Sciences, Iowa City, IA, United States
Chabli Hodge - University of Iowa
Crys Carman - University of Iowa
Andrea Wilson - University of Iowa
Aislinn Conrad - University of Iowa
Resource Type: Journal article
Publication Details: SSM - population health, Vol.34, 101915
DOI: 10.1016/j.ssmph.2026.101915
ISSN: 2352-8273
eISSN: 2352-8273
Publisher: Elsevier
Language: English
Date published: 06/01/2026
Academic Unit: School of Social Work; Center for Social Science Innovation; Injury Prevention Research Center
Record Identifier: 9985153527902771

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