The HSC is a stressful experience for almost every year-12 student and it is normal to experience some anxiety.
Anxiety disorders are the most common mental health problem our teenagers face. A recent representative survey of Australian teenagers, showed that at least 7 per cent of high school students experience a significant problem with anxiety such as uncontrollable worry, crippling fear about what others think, or fear of being away from their parents.
For some children, however, high levels of anxiety can also impact on exam performance, resulting in an exam mark that may not reflect their true ability. For that reason, many students with an anxiety disorder will request disability provisions for the exams.
These requests are made to the NSW Board of Studies, Teaching and Educational Standards by the school and require documentation from the student's GP, psychiatrist or psychologist, and typically, in the case of anxiety disorders, include requests for rest breaks during the exam.
Far from helping, a prescribed rest break during an exam may even prolong anxiety.
Sometimes students may request to complete the exam in a separate room with no other people present, or they may request to bring something along to calm them during the exam.
In recent years, the Board of Studies has witnessed a significant rise in the number of people seeking and receiving disability provisions like rest breaks for anxiety during the HSC, with the number of students receiving approval for rest breaks having increased by 62 per cent since 2011.
On the one hand, the fact that these disorders are being recognised and that children and families are seeking help is a big step forward. For many years, anxiety disorders have been under-recognised and often overshadowed by other mental health problems. Left untreated, a young person with an anxiety disorder can experience life-long suffering from their anxiety, resulting in more sick days, lower productivity at work, and less life satisfaction and happiness.
But is this the right step? One of the major reasons anxiety problems persist is because our natural response to a potentially scary situation is to stay away from it. But avoiding the situation means the child misses out on the opportunity to learn accurate information about the situation, like "I can handle it" or "nothing bad really happened".
Avoidance of the situation can sometimes be really subtle, like always needing to have a special person or object with you. The outcome is the same: the young person never learns that the situation is safe and that they can handle the situation without these supports.
Ultimately, disability provisions for anxiety can in some cases be a form of avoidance. Providing the student with extra rest breaks during an exam may send the message that the exam is too anxiety-provoking and they can't handle it.
What's to happen when they get their first job? Will be they given extra time to complete their tasks? Not likely. Rather than continuing a pattern of avoidance that is not going to prepare the child for life after school, treatment strategies should focus on breaking this vicious cycle of avoidance, making them think more realistically about the situation and to gradually face situations rather than avoiding them.
Many students who struggle with anxiety continue to request provisions throughout their schooling life, with some making requests a year in advance to their exams, rather than embarking on a course of evidence-based treatment that, for the majority of children, would render the disability provisions unnecessary.
Avoiding the situation means the child misses out on the opportunity to learn accurate information about the situation, like 'I can handle it'.
These provisions become a band-aid solution to a treatable problem, particularly due to the fact there is substantial lack of evidence that rest breaks actually help the student to reduce their anxiety and improve their performance. It may in fact just prolong their worry and anxiety. Some children who have been allocated rest breaks report not knowing what to do during the breaks.
Educators and practitioners should be providing students with effective and tailored strategies to reduce the student's arousal during the allocated rest breaks, rather than just prescribing the rest break.
However, dropping these disability provisions altogether is not the solution. Sometimes anxiety disorders may develop in the weeks leading up to the exams and hence there is not enough time for an adequate dose of treatment. So this provision needs to be available for children to prevent severe anxiety from significantly affecting their performance.
Students, parents, educators and health professionals need to be requesting or recommending disability provisions sparingly, in conjunction with the provision of evidence-based treatment, and only in cases where the provision will be used effectively to reduce anxiety.
It is important for young people who have a problem with anxiety that might be exacerbated by exams to seek help. There are face-to-face and online programs available to help (brave-online.com or mq.edu.au/CEH).
Importantly, whatever treatment option is sought, it needs to be focused on facing situations that cause anxiety, rather than continuing to avoid them.
Professor Jennie Hudson is director of the Centre for Emotional Health at Macquarie University.