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Is School Refusal A Mental Illness?

Is School Refusal A Mental Illness?

School refusal, also known as school avoidance and school phobia, is not classified as a mental illness by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). School avoidance is defined by Stanford Children’s Hospital as “a term used to describe the signs or anxiety a school-aged child has and his or her refusal to go to school.” School refusal is considered a symptom and “may be associated with diagnoses such as social anxiety disorder, generalized anxiety disorder, specific phobias, major depression, oppositional defiant disorder, post-traumatic stress disorder, and adjustment disorder, among others.” Hence, it is not uncommon for an adolescent with school refusal to have previously struggled with social anxiety, depression, undiagnosed learning disabilities, and/ or has a history of separation anxiety. There are also several situational reasons (e.g., bullying, divorce, moving, death of a loved one, difficulty getting along with teachers, lacking close friendships, etc.) that may trigger the onset of school avoidance. School refusal is not uncommon, and data suggests that it occurs among 2 to 4% of all children, from early childhood through high school. There are several natural consequences of an adolescent repeatedly missing schools such as falling behind academically, diminished self-confidence, social isolation, friendship difficulties, and more.

Warning Signs

Infrequent refusal to go to school is normal, but when this becomes a routine problem for a young person, it may be indicative of school avoidance. To help a young person manage school avoidance, it is essential to be able to be aware of its signs and symptoms. Harvard Medical School provides the following examples of commonly exhibited behaviors in school avoidant teens: 

  • Refusing to get dressed in the morning
  • Purposefully missing the bus to school
  • Constant complaints of different physical ailments
  • Neglecting to do homework
  • Anxiety
  • Weight fluctuation
  • Depression
  • Social isolation

The symptoms surrounding a teenager’s school avoidance typically only appear on school days and are absent on days when school is not in session. It is important to bear in mind that most adolescents with school refusal are unable to articulate their discomfort and do not actually know why they feel ill.

For Information and Support

Every family in need of mental health treatment must select a program that will best suit the needs of their family. When one member of a family struggles, it impacts everyone in the family unit. To maximize the benefits of treatment we work closely with the entire family to ensure that everyone is receiving the support they need through these difficult times.

Seeking help is never easy, but you are not alone! If you or someone you know needs mental health treatment, we strongly encourage you to reach out for help as quickly as possible. It is not uncommon for many mental health difficulties to impact a person’s life, in the long term. Pursuing support at the beginning of one’s journey can put the individual in the best position to learn how to manage themselves in a healthy way so they can go on to live happy and fulfilling lives.


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