The Disability Accommodation Trap on College Campuses

When I was a graduate student in Harvard University’s psychology department, between 20 and 50 percent of students in any given discussion section I taught in 2024 and 2025 had disability accommodations. They were granted extra time on exams. Private testing rooms. Deadline extensions. Tutoring services. The number varied semester to semester, but it was never small, and it was rarely questioned by faculty or staff. I didn’t question it either, at first. I had no way of knowing which students had genuine impairments and which had obtained a diagnosis because the system made it easy for them to do so and the benefits were substantial.

My sections were probably on the high end. Aside from greater mental health awareness among psychology students, the discipline skews heavily female, and young women are diagnosed with mental health disorders at over 1.6 times the rate of young men. While schools do not report what proportion of disabled students report mental disabilities, it could be the likely culprit behind the surge of disability accommodations. Psychiatry is inherently subjective, and there is no strict cutoff distinguishing between where ordinary psychological struggles end and mental disability begins.

It was well-intentioned when the Americans with Disabilities Act was amended in 2008 to include mental health conditions and learning disabilities as eligible for accommodations. But in practice, it created incentives for overdiagnosis. As The Harvard Crimson reported in December, the share of Harvard undergraduates receiving disability accommodations rose from roughly 3 percent in 2014 to 21 percent in 2024 — a sevenfold increase in a decade.

Harvard is not unusual among its peers. At Brown University, more than 20 percent of undergraduates are registered as disabled. At Amherst College, 34 percent. At Stanford University, a whopping 40 percent. Meanwhile, at community colleges, the rate is 3 to 4 percent and has not changed in a decade.

The numbers are particularly alarming at elite schools because the students there have the knowledge, resources, and competitive pressure to game the system.

Psychiatric overdiagnosis is a much broader problem than skewing school accommodations. American culture has increasingly treated the ordinary difficulties of growing up — social anxiety, trouble concentrating, sadness after loss, the turbulence of adolescence — as clinical conditions requiring diagnosis, treatment, and medication. According to the US Substance Abuse and Mental Health Services Administration, 34 percent of young adults aged 18–25 met criteria for mental illness in 2024.

Over seven decades and successive revisions, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has grown from roughly 100 recognized conditions to nearly 300. Proponents of these changes argue that more diagnoses reflect greater mental health awareness and improved screening of previously unrecognized symptoms. But with successive DSM revision, mental illness has become easier to define, to the point of pathologizing ordinary struggles.

Autism prevalence rose 40 percent between 2018 and 2022, according to the Centers for Disease Control and Prevention, an unprecedented and implausible increase for an inborn developmental disorder. Meanwhile, new disorders such as “prolonged grief disorder” pathologize grieving a loved one beyond 12 months — stigmatizing grief while offering little benefit over existing diagnoses which describe depressive symptoms. Even caffeine withdrawal is now a diagnosable condition.

The boundaries of what qualifies as a mental disorder have moved steadily outward, and every expansion creates a new population eligible for mental disability accommodations.

The gradual expansion of mental illness, to such a degree that over a third of young adults carry a psychiatric diagnosis, reflects a deeper problem with the field of psychiatry. And disability accommodations only work to create equity when they are accommodating genuine disabilities.

It is not surprising that overaccommodation appears most prevalent at elite colleges. These are students who have largely been steeped in therapeutic language since middle school, whose parents can afford the private evaluations that produce accommodations, and who face intense pressure to optimize every possible advantage in a GPA-obsessed, credential-driven competition. While some say it is that very competitive stress that is behind the rise in depression and anxiety among young people, most of my students appeared high-functioning. Some students outright admit that they only sought out a diagnosis because of favorable testing or housing accommodations.

No disability office wants to be the one that denies requests, because denial invites litigation and the accusation that a school doesn’t care about student well-being. The path of least resistance is always to approve. The problem is a collective action trap. Once a critical mass of students at one school has extra time on exams, students at peer institutions face pressure to seek the same or accept a competitive penalty for graduate school admissions, internships, and jobs.

Grade inflation followed exactly this dynamic for decades. In the psychology department where I taught, 60 percent of students received an A or A‑minus — a student at the 40th percentile, below average, still walked away with honors. Last month, Harvard’s faculty finally voted to cap A grades at 20 percent per course. It took coordination among peer institutions to break the trap, and it is encouraging that they are moving together. The same reckoning is needed when it comes to accommodations.

That conversation will be harder, because it carries the moral weight of preserving disability rights, and no one wants to be accused of indifference to suffering. But overdiagnosis is not compassion. It teaches a generation to mistake the ordinary difficulties of being young for evidence that something is clinically wrong with them and dilutes resources and attention away from the people who need them most.