At Stanford, one of the most prestigious universities in the world, 38 percent students is registered as people with disabilities. At Amherst 34 percent, at Harvard and Brown more than 20 percent. That's not a typo. It is a reality that no one predicted.
If you are diagnosed with a mental disability, the university provides various accommodations such as extra exam time, flexible deadlines and separate test rooms, allowing you to work at your own pace and demonstrate knowledge without time pressure. In addition, you get the ability to record lectures and access to a quieter environment for testing.
Fifteen years ago, the share of people with disabilities was below five percent. At community colleges that admit students regardless of grades or family budget, the share remains at a steady 3-4 percent. What happened? And why did it happen only at elite universities?
NUMBERS THAT MAKE NO MEANING
There is something very strange about this data. Because if variety is a biological reality, if ADHD is a genetic predisposition, if anxiety is a brain disorder... then the rate of those difficulties should be about the same everywhere. Maybe a little higher for poorer people who don't have access to health care. Maybe a little higher in people exposed to trauma.
But it shouldn't be ten times higher among the wealthier, more privileged, more academically successful young people in the country. And yet, it is. A student at Stanford is ten times more likely to be registered as a person with a disability than a student at a community college. Not because he is sicker. Not because he has a major learning disability. The reason is much more complicated. And much sadder.
The first factor is the change in diagnostic criteria. In 2013, the DSM-5, a new version of the psychiatric manual, was released. The criterion for ADHD was lowered from six to five symptoms. The age limit for the onset of symptoms has been extended from 7 to 12 years.
Sounds trivial, doesn't it? But research shows that the technical change qualified an additional 5,2 percent of students for the diagnosis. These are not new cases. These are the same people with whom different standards have been applied.
Another factor is the relaxation of documentation standards. After 2008, when disability laws in America were changed, universities were recommended to give more weight to students' personal stories and less to medical evidence. A 2013 University of Georgia survey shows that most universities only require a doctor's note for special study conditions due to ADHD. Just a confirmation. Not a detailed assessment. Not objective tests.
The third factor is real: the mental health of students has really deteriorated. A 2023 survey shows that 44 percent of college students reported symptoms of depression, 37 percent of anxiety, and 15 percent of suicidal thoughts. Those are terrifying numbers. And they are real.
But here's the paradox – mental health has deteriorated everywhere, both at elite universities and community colleges. And the rate of registration of disorders increased only at elite universities.
A STORY ABOUT MONEY
Let's put it this way: James' parents can afford a private psychiatrist, and he charges $2.000 for an evaluation. The psychiatrist recommends additional time for exams, the possibility of breaks, flexible deadlines.
Maria attends a local college. He feels the same anxiety. He has the same difficulty with concentration. But her family doesn't have $2.000 for a private appraisal. The University does not have the resources to provide free evaluations. Maria continues without adapted teaching.
Which of the two is a person with difficulties? Who deserves help? The system has decided: James deserves it, Maria doesn't. Not because James is sicker but because he is richer.
Professor Alison Harrison from Queen's University conducted a small experiment - she created a fake neuropsychological report. The student in the report has normal scores on all cognitive tests. No objective evidence of a problem. But the report contains ambiguous wording that suggests ADHD: language that sounds professional but doesn't actually say anything. She sent that report to the departments supporting students with developmental disabilities at various universities.
The result? One hundred percent approval. Each university gave the student extra time in the exams. For a student who has no evidence of a real problem.
FEAR THAT GUIDES DECISIONS
Universities are intimidated by lawsuits. If they reject a student, and that student can prove discrimination, the university could lose millions of dollars in lawsuits.
If they approve a student who may not need help, then there are no consequences. Maybe a little more work for the professors. Perhaps a more complicated assessment. But there is no lawsuit. So what does a rational administrator do? He approves of everything. It's best to play it safe.
One professor wrote anonymously on Reddit: "I spend more time taking care of students' needs outside of the classroom than in it."
Imagine teaching a course with a hundred students. Out of a hundred of them, as many as 38 have recognized difficulties. That means: 38 different exam rules. Some need extra time, some need special rooms, some need readers, others need breaks. Some may postpone the essay without notice. Some may request a reassessment. Some come into your office crying as they explain why they couldn't do an assignment.
And the university tells you: your responsibility. Take care of them. Be empathetic. Take a "mental health first aid" training class.
But no one asks what happens when the professor snaps from overload! Who cares about him?
RESEARCH THAT COMPLICATES EVERYTHING
A 2021 Queen's University study shows: students who had more special needs in high school had significantly lower grades at university. How is that? Don't special conditions encourage student development?
Possible explanations: Teaching adjustments don't do what we think they do at all. Accommodations help during school, but they don't prepare students for reality. Students with more special needs may indeed have more difficult problems, but it is possible (and this is unsettling) that special classroom conditions may even harm progress.
Some universities are proposing a new solution: universal design. Instead of adapting to some, to design classes and exams so that they are accessible to all. Flexible deadlines for everyone. More ways to display knowledge. Audio and visual materials. Technology that helps everyone.
But then the question arises: if everyone can procrastinate essays, what's the point of the deadline? If everyone can choose how they will be tested, what does the degree confirm? If there are no common standards, what is the meaning of the certificate? And we are back at the same place: balancing aid and standards.
ATTITUDE TOWARDS MENTAL HEALTH
A generation of college students grew up believing that mental health should be treated as seriously as physical health. That asking for help is not weakness. That special needs are not a shame. That's progress. That's good.
But that same culture of change has created an environment where it's normal to say "I have anxiety" after a tough exam. Where it's normal to say "my ADHD" when you're having trouble concentrating. Where self-diagnosis becomes a new identity.
The line between clinical disorder and human difficulty has become so blurred that even clinicians cannot agree where it lies.
The author is a psychologist
