Student Debt, Social Justice and Occupational Therapy

I have been in one of my quiet times on my blog. It’s been almost 3 months since my last post.
 
Today is the anniversary of my Mom’s death and the boomerang of losing two parents in less than a year took a bigger toll than I had imagined, or have been willing to admit at times. The toxic tone of the echo chamber that many of the OTD entry-level discussions have become has left me discouraged and not at all sure how to constructively contribute. It is my nature is to spend time, considerable time thinking about what “we” can do to solve problems and move our profession forward and I am stymied. 
 
For the last couple of weeks, I am back to thinking about an idea that has been both friend and foe over the last few years: social justice. I do not use the term occupational justice because I have not yet been convinced the construct has been sufficiently developed to be different than social justice. This time, the issue is justice and student debt.
 
There has been a fair amount of comment in the social media world about whether increased student debt that is likely to occur with movement towards the entry-level OTD is unjust. Many practitioners from around the world have joined the chorus of voices expressing exasperation about the impact of student debt on the profession of occupational therapy. Some are asking how professionals who value social justice can also support moving to a single point of entry at the OTD with its increased tuition costs. Others are more pointedly accusatory of those who hold differing views. 
 
Personally, I have become convinced that student debt is moving toward a crisis point in our country. Therefore, I would be disingenuous, if I did not acknowledge that it was not as much of a concern for me in 2014 when I served on the AOTA Board of Directors. Today, I am paying much more attention to those who speak in rational and respectful ways about the student debt issue and OT. I am not yet convinced that it is a reason for programs moving to the OTD to back off; however, it may be the tipping point to convince me that dual entry, at least for the foreseeable future is our most prudent course of action. 
 
Now to justice. Is student debt a matter of (social) justice? I am not yet convinced, but my resolve to the contrary is shaken. It is not a simple issue and I am reading, asking questions and listening to answers. 
 
For example, here is one question: 
 
If two prospective students are interested in occupational therapy but one has the resources to complete their education debt free and the other must finance all of their graduate education and bear the burden of that debt, is this unjust? We have some colleagues who believe so. 
 
A different but related question is: If there are prospective students who wish to pursue a career as an occupational therapist but cannot afford to assume the debt incurred and therefore cannot pursue this occupational choice, it is a social injustice?
 
This is a complex issue; one that will not be sorted out on Facebook or Twitter given the limitations of those platforms to having a balanced and thoughtful discussion focused on learning.
 
Currently I have more questions than answers and here are just a few. I’ve tried to alternate perspectives to represent the cognitive whiplash I feel sometimes when sorting through this maze.
 

• What about individual responsibility? On one hand it is not surprising that a 22-year-old would make some less than fully informed financial decisions. I certainly made my share of early financial mistakes.  But should a profession be expected to make a decision about what is best for its future to head this off at the pass, or choose a less than optimal path to protect these young adults from themselves? Shouldn’t even a 22-year-old be expected to assume responsibility for their own decisions?
• What about the social injustice of long-standing economic discrimination? Student debt does not affect all groups equally. As Amy Brown (2014) notes, “People of color are much more likely to have education debt: 34 percent of African Americans and 28 percent of Latinos have student debt, compared with 16 percent for whites. Shouldn’t we recognize this disparity and factor it into our decision making?
• Is it a reasonable argument that students have choices and that even at the OTD level, there are affordable (assign your own definition of affordable) options at state universities and teaching universities. Students don’t have to choose programs located in the most expensive private institutions and if they do, don’t they bear responsibility? 
• Do we know the average debt for OT students and what the average difference would be of moving to the OTD? It is not helpful to focus on either end of the range. Countering a story about a graduate with $200,000 of debt with a story about one with $10,000 gets us nowhere. 
• What about the difference between equitable versus equal access. Does social justice demand that all individuals can afford to pursue any opportunity for higher education (e.g. occupational therapy education) or just that they have the same opportunity for access if they can garner the resources?
• Does society have a responsibility to assure all people, regardless of the economic situation they are born into, have the option to pursue the occupation of their choice if they have the aptitude and interest in order to be a just society? 
• What are the roles and responsibilities of AOTA as of our professional association to address the issue of student debt? There is little consensus that student debt IS an issue of justice, but does it matter. Crushing student debt is undoubtedly negatively affecting current (and future) graduates and the potential for it to have wider effects such as our ability to recruit a diverse workforce is real. What can AOTA do and what should it do if anything to address student debt?

 
I don’t have answers to all, or even most of these questions; yet.
 
More than anything I hope this post does not present at all as “preachy.” My logic on these matters is far from solidified. It has and continues to evolve as I open myself to more information and more ways of thinking. I hope that leaders and influencers of the profession and of our professional communities remain open to new perspectives as well. I hope we all continue to ask questions and listen to answers. 
 
Here are some interesting reads on the issue of justice and student debt:
 
Student Debt and Social Justice: Tess Carter. National Association of Justice
 
https://www.nas.org/articles/student_debt_and_social_justice
 
Student Debt and Social Justice: Five Things You should Know. Amy Brown. www.FordFoundation.com
 
https://www.fordfoundation.org/ideas/equals-change-blog/posts/student-debt-and-social-justice-five-things-you-should-know/
 
Why Student Loan Forgiveness is a Social Justice Issue. Aaron Taylor
 
http://www.nationaljurist.com/national-jurist-magazine/why-student-loan-forgiveness-social-justice-issue