The awkward truth about excuse notes

As more students ask for extensions, profs ask: is this real?

Joe Houghton/Flickr

I met Anna Drake, a University of Waterloo assistant professor, at recent event in Toronto and asked: what are professors talking about these days? She said they’re discussing how many students are presenting with notes from counsellors or doctors saying they’ve been mentally unwell or extremely stressed and are in need of extensions or exam deferrals.

Drake, a political scientist, doesn’t recall this being an issue when she was an undergraduate or when she started teaching as a master’s student in 2001. But a few years ago, a professor warned her and other teaching assistants at Queen’s University that, “it seemed to be fairly easy for students to get notes of this kind.” Too easy, perhaps.

Later, teaching her own course at the University of Victoria, she was surprised when four students out of roughly 40 presented with notes near the end of the term asking to defer their semesters.

At Waterloo, where she was hired last July, she’s only had one course deferral, but a handful of students in each class during each term ask for extensions. Drake sometimes suspects these students have faked extreme stress or illness to get out of their work, but she would never accuse.

“It would be a very risky move to tell a student, ‘I think you’re lying,’” she says, “because if you say that it might become this whole horrible issue.” If they’re telling the truth, there could be terrible consequences. And she does not want to stigmatize asking for help, she says. She makes clear that there is real problem with mental health on campus and that many of the claims are legitimate.

Still, the awkward truth is that as more awareness is built around mental health, students may be shifting their strategies for getting out of school by faking extreme stress or anxiety. And how is anyone to know whether a student’s stress is normal or something more pathological?

This week, McGill University published a report on the huge increase in the number of students seeking various types of mental health services on campus: about 20 per cent year over year.

One figure that’s up even more dramatically—57 per cent in a single year—is the number of emergency drop-in visits during final exam months. In December 2011 there were 176. In December 2012 there were 277. Figures aren’t yet calculated for April, but Dr. Robert Franck, McGill’s Mental Health Services Director, says there’s been a comparable increase.

What’s causing the flood of exam-time emergencies? “[Students] are more interested in seeking help when they’re running into trouble and I think that’s great,” says Dr. Franck. “At the same time there are a number of students who think ‘this may be a way for me to defer an exam,’” he adds.

Sometimes Dr. Franck gets the sense that students, “read up the DSM [Diagnostic and Statistical Manual of Mental Disorders] on some diagnosis and give you all the classic symptoms,” he says. “Do they get the note? If they’re good enough liars,” he says, “but I think that’s the vast minority.”

Whatever the number of fakers, it comes at a price. In December when the number of emergency drop-ins swelled so too did the waiting list for regular counselling appointments. It grew to four or five weeks long as regular appointments were cut back to deal with the emergencies.

That people who need help might not get it is concerning for Prof. Drake. Still, since each syllabus spells out that there will be no extensions for high workloads, it would be unfair to give some students more time without proof of an illness. She also thinks it’s best to send students to be assessed to make sure that people who are overwhelmed get the help they need, and also in the hopes that others would think twice about going to an overburdened counselling service.

Of course, not every student who wants to delay an exam presents an excuse note. “There are students who can be really clever about avoiding the need to get notes,” says Drake. “[Professors] will say, ‘go to the doctor and get a medical note,’ and they’ll say, ‘I called the doctor, he said you have Norwalk Virus, you’re contagious and you can’t come in.’ There’s nothing a professor can do.”

The truth is, says Drake, “if students want to cheat the system they don’t have to rely on mental health notes to do it.” Still, she says it’s a shame when students use services that others truly need.

The awkward truth about excuse notes

  1. Wow. As a student with severe mental illness, just about the last thing that myself or people like me need is a magazine saying that some students might be faking our illnesses to get out of exams. First of all, why in the hell would you not interview a psychology professor about this, at the very least, who at least understands the basic DSM stuff (whether you agree with the DSM or not), instead of this political science prof, who as far as I know, knows nothing about the challenges that the mentally ill in society today face?

    Second of all, it’s obvious that not a lot of people back in her day were getting sick notes for mental illness because mental illness was, and STILL very much is, a largely stigmatized and widely misunderstood phenomenon. If you’re going to use the “not in my day” argument, you could talk about how being gay or trans wasn’t widely accepted (and still isn’t), and how people used to be able to physically punish children in schools and these were “normal” societal standards. Point being: just because a certain attitude exists at a certain point of history doesn’t mean it’s right.

    Third: you appear to be quizzical of the sudden increase of the amount of students that are asking for help around exam times. Well, let me see if I can provide some answers – or at least some thoughts: it is obvious that students are increasingly (but ONLY just so) comfortable about talking about their mental health problems. Sure, *some* people may use sick notes falsely, but as you say, those are in the vast minority of cases. What’s more likely, however, is that the students are finally opening up about what’s probably been bothering them for years, or what was once dormant that has been triggered by sudden academic pressure. Regarding exam periods, there may or may not be some unidentified variable that has caused this surge in help-seeking behaviours, such as a shift in Ontario’s mental health services that somehow leaves less students covered, or the increase in pressures of problematic economic circumstances that make it difficult to even attend school. Speaking of the economy, it’s terrible, and that in itself is enough to cause mental breakdowns in the working poor demographic.

    Regarding the article as a whole, I appreciate that there is an increasing awareness of the unique needs of mentally ill students in general, but we really, really don’t need more stigma right now, even if that wasn’t the intent of your article. You might ask students about their own experiences with the mental health system what their experiences are with university, and if they actually feel they’re getting all the support they need, or if it’s easy to get a note. Some people might just be seeing a really chill doctor. A lot of people I know do not have such luck.

    If you want to try and figure out why there are more people seeking help for mental health issues while trying to not further stigmatize mentally ill students, you might dig for alternatives to “meh, most of them probably aren’t faking it, but who *knows* what it could be?” when entitling your article “the awkward truth about excuse notes”. Thanks, but we already have intrapsychic and/or institutional barriers to our success. We don’t want or need you to erect another one.

    • I’m not saying this to cast shame on people with invisible illnesses, but if people fake the flu and other illnesses why wouldn’t a lazy and unethical person think “Hey, to get a sick note for [insert mental illness here] all I have to do is say I’m stressed, have no appetite, and can’t sleep,” then pull an all-nighter and see a doctor? Sounds easier than faking a flu to me.

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