'Students are less mentally ill once GCSEs are over'

Students' mental health issues are reduced after GCSEs - this clearly tells us that we have a problem, says Tara Porter

GCSE results: It is no coincidence that young people's mental health issues reduce once the exam season is over, says clinical psychologist Tara Porter

For me, as a clinical psychologist in child and adolescent mental health Services (Camhs) and private practice in North London, August is a quiet month. 

That’s not unusual in any workplace, but the reason for the hiatus in my work does not come about because my patients are on holiday. It comes because it seems that children and adolescents are less mentally ill once they’ve finished their exams and it’s the school holidays.

That’s a bit shocking, isn’t it?

Thus the 16-year-old who suffers with long-term anxiety, is on medication and felt suicidal around May half-term, has been “much better since they finished their GCSEs”. The 18-year-old who was bingeing, vomiting and not sleeping, with anxiety driving them to micro-manage all of their life, has been symptom-free over the summer. 

Mental health is a continuum, and the exam pressure pushes these kids over the edge. Unfortunately, with rates of diagnosable mental illness running at approximately one in eight, this is now more than a minority issue. 

Mental health and GCSEs

The government and the powers that be regularly state that this is nothing to do with any changes they have made. Roger Taylor, chair of Ofqual, stated that exam stress is higher because pupils are mentally fragile, but isn’t that a bit like saying a chicken is born because an egg was laid?

Damian Hinds, the former education secretary, believes that exams are inherently stressful, but that this is character building. But isn’t that saying that what doesn’t kill you makes you stronger? I’m not sure that’s what we want childhood to be like. 

And yet on the other hand….

It seems that teachers, parents and pupils disagree with Ofqual and Damian Hinds. 

Wellbeing: young people under pressure

The trouble is that in this soundbite-friendly, adversarial world, everyone simplifies the problem to blame someone else, when actually the problem is multi-factorial. The politicians blame the snowflake children (they may not use that word, but that’s the clear implication); the parents might blame social media; the teachers may blame the politicians and the pushy parents. And everyone blames Camhs, as no one can get their children seen

And the children? Well, in my experience, the children blame themselves. They think they aren’t good enough, or clever enough. But another thing, too, and one grandparent summed it up: he said, “I don’t really think they have a childhood nowadays. They worry about adult issues so much more. If you didn’t pass exams when I was young, you could still have a successful life. But now you’re painted as a failure if you don’t get into university.” 

So, yes, the politicians are right: children have sat exams since the beginning of education. But I agree with Grandpa Dessie. A generation ago, I walked into an exam, without having seen a tutor, and where the sum of my academic advice was: “Dot your ‘i’s and cross your ‘t’s." My life expectations would have probably been summed up as: “I’ll probably be OK and be a bit like my parents.” I didn’t expect my exam results to determine my life, and had no career path, until I stumbled into a careers office in the last year of uni. 

Nowadays, of course, it’s different. The increased scrutiny on schools filters down to the children and they feel the pressure. The end of a job-for-life culture, the rise of globalisation and increased house prices mean that parents feel worried about their children’s futures, and that too filters down to the children. Increased visual culture and social media means children worry about owning commercial products and have higher expectations for themselves. All of which means that we create in children’s minds exams that are extremely high-stakes, do-or-die, make-or-break situations, and these sort of situations are very stressful, and poor for mental health. Children haven’t had a childhood.

We're all to blame

It’s not the teachers’ fault, nor the parents’ fault, nor the politicans’ fault, nor social media’s fault, nor Camhs’ fault. It’s all our faults, and by simplifying the problem and blaming each other we are not going to solve it. Children and adolescents have really poor mental health at the minute. The exams are making this worse. So what are we, the adults, going to do about it? 

I would really like it if we could reduce child mental health problems, and make every month as quiet as August. 

How do we put the genie back in the bottle on mental health and exam stress? My ideas include:

  • Adults should avoid the message that exams are the only route to success, and give the message that the path to a good life can be winding, long and have lots of diversions.
  • Exam burden should be minimised where possible: Sats need to reduced in length and scope, and incorporated into children’s normal teaching life. An indication that this has happened would be that the word “Sats” would drop from children’s vocabularies. 
  • Children should be encouraged to enjoy the stuff that does not require stacks of cash: fresh air, nature, friendships, exercise, laughter, games, dance, family, music.
  • All school league tables should come with the following government health warning: “Children’s achievements go up and down year by year because cohorts of children are different. Achievements are not a pure indication of the quality of teaching, leadership or anything else, but reflect in part the innate potential of the children and their home circumstances. Constant upward trajectories are unrealistic.” 
  • There should be second chances built into the system. Schools shouldn’t be so driven by exam results that they exclude pupils from joining their sixth form because they’ve missed a grade or two. 

Schools should educate for opportunity, but also realistically for society. We will always need builders, bakers, carers and a host of other workers, and their school education should not be dominated by a narrative of failing exams. 

A third fail and re-fail maths and English at GCSE. They are as important to society as the university-educated. They should enjoy school and learn stuff that helps them in their lives. 

Dr Tara Porter is a clinical psychologist at the Royal Free London NHS Trust and Anna Freud National Centre for Children and Families, as well as Tes' mental health columnist. The views expressed are her own

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