I’m a clinical psychologist—here’s how exams are damaging young people’s mental health

GCSE results have come out and in all of the UK and Ireland teacher-predicted grades will be used. The weeks when exam results come out are regularly stressful, but this year has been off the scale. It was always going to be hard to allocate grades for exams which hadn’t been sat, but in England in particular the handling of A level results has been a farce, causing young people huge and totally unnecessary stress. There are negative repercussions for their mental health.

As a clinical psychologist, I regularly work with young people and their families who present in significant distress. There are many interacting factors which contribute to child and adolescent mental health problems, but exams and exam results play an important role in both precipitating and exacerbating mental ill health.

I remember working in my first newly qualified job on an adolescent mental health ward back in 2008, before all mental health units for teenagers were continuously full as they are now. We would have cyclical admission rates, with results time and back-to-school time both being significant peaks in need. The back-to-school rates were partly explained by teachers noticing problems that had been brewing over the summer, but the exam results peak was clear cut. Getting grades which were below what was expected was a significant stress for young people and could cause huge upset, sometimes resulting in severe self-harming behaviours as they felt all their chances had been blown. Now, when I’m working with young people who are not in hospital, I will work with them to draw out a map of the things that are causing them to worry. Exams are often somewhere on there—even when they are two or three years away.

I’ll bet that you can still remember what grades you got, and probably remember something about results day or the build up to it. But for young people today, the meaning of exams is even greater than before. It’s hard to encourage distressed young people to realise that they are much more than the sum of their exam grades when the system is strongly suggesting otherwise.

The league tables which rank schools on exam results—without taking into account the demographic of the population served by the school, or the number of children excluded or not allowed to take exams—have increased teacher stress and encouraged “teaching to the test.” None of us learn best when we are stressed about the outcome. As Alan Watts described, we’re teaching children to rush to the end rather than enjoy the process of learning, and these lessons can translate across to how we expect people to approach their lives: constantly striving for an achievement in the distance rather than enjoying the ride where we are.

Of course, this year, everything has been turned upside down. There were no exams. We could have told young people far in advance not to worry about grades day, and explained a clear process, but instead there has been chaos, confusion, unfairness. There have been U-turns all over, and in England that U-turn came a few days too late, pushing an unnecessary problem downstream to now oversubscribed universities. It was always going to be difficult, but it didn’t need to be this bad.

During the Covid-19 pandemic, children and young people have already experienced great stress, disruption and uncertainty. The additional stress of having predicted grades down-graded, and having to negotiate appeals processes and rejection from universities and colleges of choice, has been significant. The use of an algorithm in the first place—which unfairly reduced the predicted grades of young people from schools with a history of lower grades—was a clear perpetuation of social inequalities and cause of additional stress to pupils from state schools and colleges. Given the significant effect of exam stress on mental health, surely it was obvious that the detrimental effect on student wellbeing that the now defunct algorithm would cause was not worth warding off potential minor grade inflation, which was cited as the reason for sticking with it for so long.

There are lessons to be learned if we want them. This is a chance to look at the school system and ask ourselves if we’re really happy with our approach to exams, which so sharply affects young people’s mental wellbeing and learning. How have we got to a place where it is predictable that a significant minority of young people will express suicidality in response to the stress of exams and exam results? And how have we reached a place where social inequality in educational achievement is so much expected that we create models to perpetuate it?

Imagine if some of the energy that was put into creating league tables was put into facilitating conversations which involved teachers, students and mental health and social care professionals; into devising policy about how the school system could hold wellbeing in mind as much as the testing of learning outcomes. Like many things in the wake of lockdown, we have a chance here to pause and to think about doing things differently. I wish I thought that the government would take it.