The Power of Compassion: Unveiling the Emotional Battle of School Refusal in Children with Mental Health Struggles


If I had a dime every time I judged a student or parent for tardiness or absences when I was a teacher, I would be retired. The funny thing is when karma returns your judgment back to you as a parent raising children struggling with mental health that results in high anxiety and you guessed it… school refusal.

As a young teacher, I was clueless in understanding what mental health was, the biology of it all, and what it looked like in a classroom. Like many people my first instinct was always to assume it was a matter of choice, lack of effort, or defiance yet I never held the same skepticism with my students that had diabetes or asthma. 

Mental health is so misunderstood and stigmatized that we often don’t realize, forget, or aren’t ready to accept that brain health is as real of a medical condition as diabetes or asthma.  If I had a student that had an asthma attack and was absent for a week, I wouldn’t question that but mental health was harder for me to wrap my head around. 


Parenting School Refusal

As parents of children with significant mental health conditions, it can be difficult to know how to react when your child expresses feelings regarding school that are outside the realm of normal reluctance or resistance. It is our job as parents to ensure that our kids understand their emotions and experiences, but also have the necessary strategies and supports in place to help them cope with these realities.

Feeling overwhelmed or lost in a large school environment, struggling to make friends, or having difficulty understanding subject material are all common factors that lead to school refusal among students with mental health challenges. 

Even more so than other students, these young people may experience an increased sense of anxiety when faced with new tasks or environments. This can manifest itself through physical symptoms such as nausea and headaches, and often can lead to a reluctance or refusal to attend school.

It is important to remember that when these feelings of anxiety begin to interfere with regular attendance at school, it is not necessarily an act of defiance. Students with mental health challenges face unique struggles that are often misunderstood. Therefore, it is critical for parents and educators to collaborate on effective strategies that provide support in order to reduce the negative effects of school refusal.

What to Do

Some approaches that have been shown to be effective in managing school refusal include:

1)Individualized Behavioral Awareness Plan – This plan involves identifying triggers for your child’s anxiety and developing an action plan for how they can respond appropriately when they experience those triggers at school. It may then involve a team effort to ensure the plan is followed and the child’s progress is monitored.

2) Modifying School Demands – If we think about asthma again, we would never ask a child going through an asthmatic attack to run a mile so why do we expect our kids struggling with their mental health to just “suck it up” and push through? If attending school or completing certain tasks has become too overwhelming for your child, talk to their teachers about how you can adjust their workload so that it better meets their needs. Create a win-win plan that helps teach the child how to self-advocate, accommodate, identify triggers, and develop a plan to meet the child’s needs. 

3) Monitoring Academic Performance – Make sure that your child’s academic performance is being tracked so that both you and the school are aware of any changes or areas of difficulty. For many students, it can start with one small task that quickly build up to an overwhelmed amount of anxiety, falling behind, and frustration.

4) Creating Positive Incentives – I am unaware of any adults that would willingly go to work to sit and listen to other adults talk to them for eight hours a day without being paid and then ask them to go home and do more work. It’s not realistic to say that young people should just want to do well in school. 

For children struggling with their mental health it can take every ounce of energy for them to hold it together and try to be successful all day every day at school. Over time it can become too much and some shut down while others increase in undesired behaviors to escape tasks or get attention. Motivate your child to attend school and complete tasks by providing positive reinforcement for their efforts.

5) Connecting with Mental Health Professionals – Consider seeking out additional support from mental health professionals who specialize in working with children and adolescents.  Many schools have in-house therapists and some are at no-cost but you need to ask the school counselor, oftentimes, to access these services.

6) Talk to Your Child- I think this is the most important yet often most forgotten step along the way.  Oftentimes we try to fix things for our kids without asking them what they want and need.  

While it may not be realistic to agree with their proposed solution of never going to school again, but if we dive a little deeper and ask questions like, “When do you feel most anxious in the day” or “What is the part of the day you dread the most?” we can start to see some answers emerge. 

With that information and understanding we can work with the child, educators, and mental health professionals to create a plan that will help set the child up for success.

By being aware of these approaches, parents can work together more effectively with educators to ensure that all students are supported, regardless of their mental health challenges. 

It is important to remember that creating a safe space for your child is key, as it will help them feel more comfortable expressing their needs and difficulties in the classroom setting. With the right tools and resources, students can begin to enjoy school once again and look forward to future successes.


Chang, A., & Grossman, C. (2015). Understanding school refusal and effective approaches for support. In T. Sattler & J. Walker-Hirsch (Eds.), Supporting students with mental health challenges in K-12 schools: A practical guide for school personnel (pp. 83–96). New York, NY: Routledge.

Grizenko, N., Bouffard, M., & Joober, R. (2014). School refusal behavior and child/adolescent anxiety: A review of the literature and treatment implications. Canadian Journal of Psychiatry, 59(1), 15–23.

Kearney, C., Albano, A., Silverman W., & Beidel D (2005). Cognitive behavioral therapy for school refusal. Journal of Clinical Child and Adolescent Psychology, 34(1), 33-48.

Schad, A., & Schonert-Reichl, K. (2018). School refusal: An ecological approach to understanding student absenteeism. Canadian Psychology/ Psychologie canadienne, 59(2), 171–182.

In addition to tips on school refusal, I’m also here to answer any questions that you might have along the way. Check out for more resources and join our Facebook Community Raising a Beautiful Mind.

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Jennifer Ulie, Ph.D.

2x Founder, CEO, Motivational Speaker, Author, Teacher, PhD, and Geek about holistic health and evidence-based practices to help people unlock the best parts of themselves again. Follow @mymensana.

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