Having no intention of ever working in academia full-time again, I thought I’d offer a few reflections on the implications of a court finding against Bristol University announced last week, concerning a student suicide that happened there. I’ll admit upfront that getting going with this one has been a slog. For one thing, it partly concerns an unspeakably awful event in the life of a grief-stricken family. More trivially, writing about some of the aftermath of this event has pulled me back mentally into a world I have gladly left behind me – a place where the managerial speak is deafening, the decisions inevitably reactive and short-sighted, and the naked desperation to keep income flowing palpable. In other words, it has dragged me back to the modern British university - such a stark contrast with the place most people still romantically picture. Talk about triggering. But anyway, here goes.
These cases are always terrible in their specifics, and this one is no different. In 2018, Natasha Abrahart, a 20-year-old physics student took her life on the eve of a conference presentation, scheduled as part of her degree assessment. She had a diagnosis of Social Anxiety Disorder, a track record of demonstrable distress during oral assessments, and was faced with having to give a presentation in a large lecture theatre the next day. After her death, her father brought a case against the university, arguing that they should have found a way to avoid this assessment and one other earlier assessment, which also precipitated a crisis for his daughter at the time. The judge eventually found that this was the case. Speaking afterwards, Natasha’s mother said of Bristol management that they now:
“need to consider how their methods of assessment will impact on each and every student including those with non-physical disabilities and or mental ill health .., Policies and practices that fail this test should be changed unless there is a very good reason for not doing so. If those changes aren’t made then universities should expect to be held liable for the consequences, which, as our case sadly shows, can be utterly devastating.”
The Abrahart family has clearly suffered immensely and I don’t wish to add to their great burden in any way. Given the surrounding legal framework which I’ll shortly describe, the judgement may well be right – and certainly nobody could reproach grieving parents for bringing the case. What I want to do instead is talk about some inadvertent consequences of the current approach to student mental health conditions, treated as disabilities for which universities are legally liable. It seems to me that we are not discussing how important skills and aptitudes - formerly gained, almost without noticing, as by-products of being exposed to certain intellectual and social challenges during a degree – are being removed from the experience of the majority because of concerns about the mental health of a sub-section of students. This has knock-on consequences for society, and in particular for those sectors dominated by university graduates.
I don’t have solutions here. I simply draw attention to what I think we’re losing and ask readers to consider whether they think it matters.
In order to understand what follows, a brief foray into legal technicality is called for, with the obvious caveat that I’m not a lawyer and will probably phrase things imperfectly for their eagle eyes.
The judgement against Bristol was made possible by the UK Equality Act, and specifically what is known as the reasonable adjustments duty. This is a general legal duty intended to minimise disadvantage to disabled people in comparison to others who are not disabled. In relation to a University assessment – say, an exam, quiz, report, essay, viva, or whatever - working out what would count as a reasonable adjustment for a disabled student first involves identifying what count as the desired learning outcomes of the particular course in which the assessment features. Learning outcomes are, roughly, the things you want the student to be able to do in order to pass the course: demonstrating understanding of a particular set of ideas or concepts, or being able to produce a document to a particular professional standard, or being able to communicate certain kinds of information well, or whatever. When setting up a new course or module, you work out the desired learning outcomes for it, and then you try to set assessment methods for the course in question that will demonstrate the achievement of those learning outcomes – but without disadvantaging any student on the course with disabilities. Reasonable adjustments are - again roughly - adjustments you should make to reduce disadvantage to disabled students during the process of demonstrating the achievement of learning outcomes.
So to take a simple example, you wouldn’t normally insist that an exam answer be written by hand, given that some disabled students find hand-writing difficult and could equally well write their text with a computer. For these students, access to a computer would be a reasonable adjustment, and rightly so.
We can see from the details of the judge’s verdict in the Bristol case that Natasha Abrahart was on a course whose learning outcomes included being able to present her work at a conference (specifically: being “Able to collaborate with others in the presentation of experimental results in a conference setting”). The judge ruled that, given her disability, she could have been assessed in a way that demonstrated the achievement of this outcome but without requiring her to do a conference presentation in person. That is, she could have been asked to do it remotely. Earlier in her degree, she had been asked to do “interviews after conducting laboratory experiments” and these had greatly distressed her and resulted in a deterioration in her mental health. The related learning outcome intended for this part of the course seems to have been the capacity “to present the results of an experiment in a manner appropriate to a professional physicist”. In accompanying material advertising the course, tutors wrote: “We want to know how well you have understood the experiment, how deeply you have thought about it, and how coherently you can talk about it.” The judge ruled that these aims could have been achieved just as well, had the interviews been conducted via text rather than orally and face-to-face. Here too, he concluded that Bristol were at fault for not offering this to the student as a reasonable adjustment.
Generally speaking, it’s not just in terms of assessment that reasonable adjustments are called for, but in every aspect of a disabled student’s studies, including what happens in the classroom every week. Once a student is registered with university support services, she or he will be entered into the system as having a disability. After that it’s the legal duty of the University to offer reasonable adjustments wherever the student might be disadvantaged. The job of deciding what counts as the required adjustments for students is not decided by lecturers or other teachers, but by student disability advisors who place a note in the student’s records. When teaching a new group, it is the duty of a lecturer to identify the students in the group who have been registered as having a disability – which most of the time will be an unseen mental health condition - and then get up to speed on the particular adjustments which have been determined by disability advisors as appropriate for that student in that class. Lecturers are told they will be legally liable if they don’t comply with the instructions they have been given – indeed that they are liable, simply for failing to read the students’ records to find out what the instructions are.
Perhaps this doesn’t seem onerous or problematic. The trouble is, though, that Universities are overwhelmed with students with recorded mental health conditions. These are all automatically treated as disabilities, falling within the purview of the Equality Act. Usually, all you need to do to be treated as disabled in this way is to present a GP’s letter, or letter from a therapist or other qualified professional, saying you have a recognised mental health disorder. Between 2010 and 2019 there was a sixfold increase in the numbers of students disclosing mental health conditions to universities; and in roughly the same time period, a 450% increase in disclosure of mental health conditions when applying to UCAS. In my own experience of teaching, up to a third of students in any given seminar or lecture can have a recorded mental health condition, with required adjustments set out accordingly. Most often, the diagnosis is anxiety and/or depression, but ADHD and ASD also frequently figure, and each of these will have special requirements of their own. Many students come to University with a diagnosis already in place, and this is particularly likely to be true of those coming from more affluent postcodes, whose parents and teachers tend to know the system and also to have the habit of therapizing. Other students seek a GP’s letter when they first start encountering difficulties – indeed, they can be encouraged to do so by sympathetic lecturers in order to get extensions for late essays and other kinds of accommodation.
There’s a separate conversation to be had about how many of these students are genuinely impaired to the point that they need mitigation, and about how many are just going through the usual ups and downs of late adolescence or one’s early twenties. This article in The Critic written by an anonymous academic in 2020 suggests that a large number are gaming the system. I don’t think that’s right, exactly, but I do think that the system can’t distinguish between genuine need and temporary upset, and neither can the students for that matter. One terrible by-product of this fact is that the much smaller number of students who have very serious mental health problems get lost in the system, as services are swamped.
The reasonable adjustments duty in the Equality Act is anticipatory. Universities aren’t supposed only to react to individual disability claims, but also have a legal duty to anticipate the likelihood of such claims and adapt their processes in advance. As the judge put it in the Abrahart case, “For the avoidance of doubt it was not necessary for Natasha to identify reasonable adjustments at the time; if there was a duty to make reasonable adjustments in the first place then it was for the University to apply its mind to the adjustments that could be made”. In conjunction with the huge numbers of students affected, and the difficulty involved of getting bespoke arrangements in for all of them - particularly where their mental health conditions make them difficult to communicate with in the first place - this anticipatory duty gives university managers the jitters. The default tendency therefore is to go for large-scale solutions for everybody, trying to avoid particular processes and activities that prove challenging for some.
Good evidence of this is that, in the last few years, Universities UK (“the collective voice of universities in England, Scotland, Wales and Northern Ireland”) has instigated a programme called Step Change, which stresses a “whole university approach” to mental health. Among other things, they suggest to their member institutions that they should “review the design and delivery of the curriculum … to position health gain alongside learning gain”. It’s not clear what this actually means in practice, and nor is it clear why health gains and learning gains need be at odds with one another, but the rhetorical emphasis here is clearly on changes to the whole curriculum for everybody, and not just for some. In terms of approaches to assessment, meanwhile, they encourage their member universities to “make sure that assessments stretch and test learning without imposing unnecessary stress.” This reduction of stress again seems to be a general commitment for all.
Step Change was brought in by Universities UK apparently largely reactively, as a response to growing criticism that they were not doing enough to deal with student suicide. At Bristol alone, there were 11 between 2016 and 2018, including Natasha Abrahart. In that context, a judgement like the one last week both provides cause for further criticism from the powers-that-be, and also provides a massive boost of energy for anything within universities that sounds vaguely like it might help solve the problem. Bright-sounding phrases about “whole university approaches” to mental health, like other familiar forms of managerial propaganda, sound good. It’s hard for employees to push back against them, especially given the childishly emotionally-laden dynamics of the average university spat. (I can imagine the intelligentsia now: do you WANT vulnerable kids to commit suicide, Kathleen?). But just as vivid fears of suicide flatten out intelligent discussion and quash dissent in that other specialist subject of mine – you know the one - they do so here too. It is still worth asking what exactly we are getting, when we buy into the preferred solutions.
My worry is that we are reaching a stage where, wherever a certain process or activity is presented as particularly difficult for a particular group of students, it tends to be easier for managers to get rid of it altogether than to preserve it for only some and put in alternatives for others. And I would suggest that this can be to the detriment of the social development of the majority of students; and where that’s true, it is a general societal loss.
This is what we see in relation to university exams. Exams are some of the most demanding in terms of resources required for making reasonable adjustments. Computers, extra time, scribes, and separate rooms to minimise distraction or anxiety will frequently be offered. To give some idea of the scale of the problem, some universities simply don’t have enough teaching space to accommodate all the requests for separate rooms at exam time. Once again, when coupled with the anticipatory duty, there is a pressure to remove exams for everyone.
Taking exams away looks very attractive from a certain perspective. Managers can then be sure that no previously unnoticed vulnerable student will face a breakdown because of the looming presence of exams; and it will also save an operational headache for managers in terms of stretched resource (albeit that it causes new operational problems, like how to avoid internet cheating – but that’s another story). This motive for removing exams is often wrapped up in a lot of flannel about replacing them with “innovative”, “real-world”, “cutting-edge” (etc.) assessment techniques. However, it seems to me no coincidence that, whatever the proposed sexy new replacement for an exam is, it very rarely places students under similar psychological pressures: timed performance demands, with only their creative minds and memories to rely upon. The days of that sort of challenge are going, if not have already totally gone in some disciplines.
The upshot is that for thousands of students, the opportunity to be challenged in the specific way that an unseen university exam can challenge you is no longer available. And I think that’s a bad thing – not just in terms of narrow pedagogical aims, but in terms of wider life skills and competences. For many, exams can be a rite of passage; a challenging, stimulating, nerve-wracking experience you might have hated at the time but are still pleased you went through afterwards. And even if you aren’t pleased in retrospect, it still can be true that exposing yourself to strongly stressful events like exams, and coming through them - still standing afterwards - enhances your own self-image, and fortitude to undergo relatively intense performance challenges in later life. Not all stress is bad for you.
Another ordinary feature of university experience, fast disappearing, is the expectation that students should be able to manage several assessments at the same time. When I were’t nipper, and this were all fields (etc.), I took all my assessments for the last two years of my undergraduate degree within two weeks (and even worse, get this - they were all exams). But these days clustering deadlines for assessments are treated by some students as a kind of psychological torture. In asking some of them to hand in three bits of work close together in order to get their degree, you might as well be asking them to do the Three Peaks Challenge, and they are similarly outraged at the request. Lots of staff go along with this idea that bunched deadlines are automatically bad, as do managers. As this op-ed in the Times Higher puts it:
“Well-intentioned academic staff understandably guard their territories and earnestly assess everything they teach; but, for students, this presents an overwhelming burden of assessment and bunched deadlines. The sheer quantity of assessment can exacerbate existing mental health problems and provoke new ones.”
In other words, the mere possibility of mental health problems is being presented here as a trump card, and there is no consideration about whether bunched deadlines encourage a student to develop time management and organisation skills, and whether that might be good.
A final example: in recent years, lecturers in some institutions have started to encounter the instruction, coming down the line to them from student disability advisors elsewhere in the university, not to ask particular students with diagnosed anxiety any direct questions in class. Now, for most of my teaching career, I prided myself on being able to run a seminar discussion so that everybody, including the shy and tongue-tied ones, usually got involved. Partly I did this by lowering the pressure in various ways – saying there were no stupid or wrong answers (obviously I was lying, but it helped get them talking); and that everybody was welcome to participate but that nobody absolutely had to. I would tell them that, if I asked a question of someone who didn’t want to respond, they should indicate that they wanted to pass, and that would be fine (and it genuinely was). I would also keep mental track of who had spoken and who hadn’t, and try to gently encourage everyone to have a turn.
Towards the end of my teaching career, though, I started to see the instruction not to ask particular named students questions, proposed by advisors as an adjustment for their anxiety. Academic philosophy is a discipline where pretty much the only thing you do as a lecturer in a seminar is ask a student questions and guide their answers, so obviously avoiding questioning up to a third of students in a given seminar – and even remembering who these students are, when you have a lot of them - poses a bit of a challenge. When I first saw the requested adjustment, I was disturbed by it. I felt sure that avoiding exposing students to questions in class would mean that their chances of ultimately overcoming anxiety in this area would be reduced, and that this wouldn’t help them later. I once quizzed managers about it in a meeting but was met with the usual blank credentialist stare. This was the student advisors’ domain, not mine, I was told; and avoiding asking anxious people questions in public was “best practice” therapeutically, apparently.
A bit later, discussing on Twitter The Critic article I referred to just now, I foolishly joked about ignoring the instruction not to question certain students. The next day an outraged article appeared in my local paper, the Brighton Argus, in which I was described as “ableist” and students were described as suitably disgusted. On publication of this article my problems multiplied, as I was then asked to account for myself to university managers (not for the first time) and to reaffirm my commitment to the reasonable adjustment process, as if I had seriously been in breach all along. About a year later, I received an email from a student disability advisor, saying that I had inadvertently asked an anxious student a direct question in class, and that I was not to do it again.
Perhaps needless to say, after all this I started to feel somewhat anxious myself, and so very wary of asking students anything directly at all in class. The net result for my students was seminar discussions where the only ones who spoke were those with the confidence to do it on their own without prompting. Discussion then tended to be dominated by the same few loud voices, and a lot of people just sat there listening, waiting and perhaps even hoping to be asked, but without an overt cue from me. I assume that, as soon as this instruction not to ask questions appears from on high for certain students in a group, the average lecturer will be disincentivised to ask direct questions generally of the whole group, even without the – let’s say - unusual degree of hostile attention I was getting at the time.
In the face of pressure to make reasonable adjustments for anxious students, in theory there are various ways that universities could go, other than the option of removing stressful experiences from the degrees of everyone. They could try to build the sorts of specific skills and aptitudes demanded by exams, clustering deadlines, direct questioning (and so on and so on) explicitly into learning outcomes, and argue that these features of university life are an essential way of demonstrating what specific courses are designed to teach. In the case of the physics degree that Natasha Abrahart was on, Bristol tried to argue in court that “an ability to explain and justify experimental work orally is a core competency of a professional scientist”. This defence was rejected by the judge. I think the problem here is a general one: namely, the skills I have been talking about are good for life generally, and for producing resilient, flexible people, but it is still a push to argue persuasively that they are essential to meeting particular disciplinary standards in a given subject area, as traditionally understood.
An alternative would be to tack a specific near-mandatory course into every degree, that focused on time-management skills, presentational skills, recall skills, and other stressfully acquired competences. Those with anxiety disorders or other relevant disabilities could opt out of it, leaving the rest to do it. But apart from the fact that this doesn’t fit with the new choice ethos demanded by fee-paying students and their parents, I can’t help feeling that you’re much more likely to produce in young people the abilities to deal with anxiety-producing and stressful situations, if you don’t deliberately produce those situations in the explicit name of anxiety-reduction. The brilliant thing about the old system was that most students got these abilities without even noticing they had got them.
Another thing universities could do, in theory, is beef up what counts as “fitness to study” in the first place. Perhaps it’s cynical of me, but I suspect that if universities ever started to make clear - in advance of application cycles - that anyone applying with a diagnosis of anxiety and/or depression would face additional processes to establish whether university was really the right place for them to be, half the diagnoses would disappear in a second, courtesy of the parents. But this is unlikely to be something universities will consider, and for all I know there may be further legal ramifications as well. Narrowing the range of students eligible to attend university does not play well in times where the bland mantra of inclusivity no-matter-what has been raised to the status of a religion. And in any case, most universities badly need the dosh from fees.
Meanwhile, everyone remains completely baffled about what the role of a university is supposed to be. Do they act ‘in loco parentis’, as then-Universities Minister Sam Gyimah claimed in 2018, or not? When Gyimah said this, there was pushback from those who thought that this infantilised adult students, but if I’m right they are being infantilised by stealth anyway, and nobody seems to have noticed. But in any case, the answer is surely no. Universities can’t act in a quasi-parental role any more, if they ever really did. The demands are now far too onerous, and in response universities simply can’t fail but to be negligent parents. Student numbers are too large, resources stretched too thin, and cultural tides towards youth vulnerability too implacable. It doesn’t help that the British tradition of sending students far from their homes and dumping them somewhere completely different for their degree persists, even as far more mundane and everyday experiences are labelled deeply traumatic for them. And we should remember that we are also asking universities, incoherently, to fulfil only a very narrow part of what being a parent is – the bit where you are responsible for protecting them from certain kinds of harm - but not intervening otherwise in their moral guidance. Universities are not being asked, say, to actively encourage students not to take drugs and to get to bed on time.
Nobody wants to talk honestly about these tensions though. So the pressures on universities to look after the mental welfare of students in a strong sense will continue to be issued from many quarters, just as the material conditions of many of them worsen: stranded in scummy flats far from home with exploitative landlords; working shitty jobs on top of studying in order to keep afloat financially; and worrying about whether they will ever get a proper job or afford a house in an unstable economy afterwards. Universities can do nothing about any of that. All they can do, it seems, is talk endlessly about well-being and self-care, bring in support dogs for students to pat once a week, and remove somewhat challenging experiences from the curriculum, with which most would have coped fine in the end, had they had the chance. Oh yes … and they can give everyone a 2.1 or a 1st. But that too is another story.
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