Chapter 2School refusal in Australia
2.1Following the information presented in the previous chapter on schooling and school attendance in Australia, this chapter provides a detailed overview of school refusal, its prevalence—including the impact of the COVID-19 pandemic—as well as its key drivers.
What is school refusal?
2.2Many inquiry participants highlighted Australia's lack of an agreed definition of school refusal. Terminology varies as well, with a range of submitters either noting, using, or advocating for, the use of alternative nomenclature such as school can't, school phobia, school avoidance, attendance anxiety, and/or emotionally based school avoidance.
2.3Conceptualisations of school refusal also differ. For example, some of the limited research available indicates that school refusal can be understood as a symptom of an underlying mental illness or disorder, or, alternatively, as 'a signal that all is not well in the young person's world'. In addition, school refusal has also been characterised in relation to its underlying motivations, which may be driven by either negative or positive reinforcement—or a combination of both.
2.4Despite the absence of an agreed definition and terminology, most descriptions of school refusal centre on the inability of a young person to attend school due to a severe negative emotional reaction to school.
2.5The emotional component of school refusal also featured in other evidence to the inquiry. For example, the Centre for Excellence in Child and Family Welfare concurred with the description of school refusal as 'difficulty attending school associated with emotional distress and can mean that children have trouble going to school or trouble leaving home'.
2.6The Western Australian Council of State School Organisations (WACSSO), offered a similar definition which referred to 'students experiencing intense emotional suffering that results in having difficulty attending school or leaving home'. Likewise, the Centre for Multicultural Youth understood school refusal to occur 'when a young person is unable to attend school due to emotional upset, worry or anxiety', while the Victorian Governmentdefined school refusalas:
… severe distress and a reluctance to attend school due to a range of factors such as anxiety and mental health, not feeling included at school, negative student transition experiences and changes in family circumstances.
2.7According to School Can't (School Phobia School Refusal) Australia (School Can't Australia), young people's experiences of school refusal can range from mild to severe, with some students able to attend school but unable to complete work, while others cannot attend school at all and exhibit 'signs of severe distress or a nervous system shutdown response'.
2.8The School Can't Australia submission showed that mild experiences may involve expressions of reluctance to go to school, reports of feeling unwell, and anxiety before the school week. Children may be persistently late to school and/or may miss several days of school each term. Severe experiences often persist for more than six months and children may not be able to leave their room or their house. They may develop atypical sleep patterns and may show signs of self-harm, clinical depression or severe anxiety.
2.9More broadly, the signs of school refusal appear to include:
an expressed reluctance to attend school;
sleep disturbances;
frequent absences from school or late arrival at school;
psychosomatic complaints, such as headaches or nausea;
emotional distress when faced with the prospect of attending school, including anger, crying and meltdowns;
avoidance behaviours such as not wanting to get out of bed or to get ready for school, hiding or refusing to leave the house, refusing to leave the car;
hiding when at school, or running home from school;
declining academic performance, avoiding or refusing school work and home work; and
an inability to talk or move physically (flight, fight, freeze, shutdown).
2.10In some instances, parents also reported that the signs of school refusal escalated to threats and instances of self-harm, suicidal ideation, and suicide attempts.
What makes school refusal different?
2.11Evidence presented to the committee indicates that school refusal differs from other attendance problems, such as truancy and school withdrawal. Some of the key differences identified by participants included:
students not hiding their reluctance to attend school;
parents being aware of their child's absence from school;
parents having made multiple attempts to address their child's non‑attendance; and
an absence of antisocial behaviour.
2.12This was borne out in evidence provided to the inquiry which described parents' attempts to get their children to attend school. These attempts included bargaining, distractions and even physical coercion or force. Almost all parents who participated in the inquiry had also sought assistance from health service providers, including youth mental health services, paediatricians, psychiatrists, psychologists, and other therapists.
2.13Submitters such as WACSSO also pointed out that school refusal differs from truancy in that it is not a deliberate choice:
Current research suggests that it should be understood as a school phobia and that it would be more accurate to say a student can't, not won't, go to school. Often the child wants to be able to go to school, but they simply can't due to experiencing a range of problems that can be identified as a threat by their nervous system, to which they respond with a shutdown, fight or flight response. This is a stress-based behaviour …
2.14For this reason, various submitters expressed a preference for other terms, such as 'school can't' or 'attendance anxiety', as opposed to school refusal.
2.15This sense of avoidance, rather than refusal, was reflected in the evidence of multiple parents, who explained that their child would like to be able to attend school but is simply unable to do so.
2.16In recognition of these differences, Associate Professor Glenn Melvin put forward a definition of school refusal propounded by Dr Ian Berg, which includes some of the elements that differentiate it from other attendance problems. According to Associate Professor Melvin, Dr Berg's definition involves:
(1)severe difficulty attending school;
(2)severe emotional upset—such as fear, depression, anxiety—at the prospect of having to go to school;
(3)parents being aware of the child's absence from school (in contrast to truancy);
(4)parents making reasonable attempts to secure their child's attendance at school (in contrast to school withdrawal); and
(5)an absence of severe antisocial behaviour (in contrast to truancy).
The prevalence of school refusal in Australia
2.17The ability to determine the prevalence of school refusal in Australia is hampered by a lack of data. ACARA collects and reports on attendance data provided by state and territory departments. As such, this attendance data collected and reported by ACARA at a national level does not differentiate school refusal from other forms of absenteeism. The data also does not accurately capture or reflect part‑day attendance.
2.18In addition, information provided by various education authorities points to significant variation in the ways that absences are recorded across states, systems and schools. Most of the responses received indicated that school refusal was not listed as a reason for absence.
2.19The committee requested data from state and territory departments of education, along with independent and Catholic education bodies in each state and territory, but received several responses stating that data on reasons for absenteeism were either not published, or not were not collected centrally by them at either the national or state level.
2.20Even where data on school refusal is available, it does not appear to be comprehensive. For example, the Catholic Education Diocese of Parramatta pointed out that it is the only Catholic school system in NSW that collects disaggregated data on school attendance problems, including school refusal.
2.21There are also questions about the accuracy of the available data. For example, Victorian Government data suggests that school refusal accounted for less than two per cent of absences from its schools in 2021. However, it noted that the true figure could be higher as school refusal might have been recorded incorrectly as an unexplained absence or another type of absence, such as 'medical' or 'truancy'.
2.22In his submission, Associate Professor Melvin provided some insight into the potential barriers to more accurate reporting:
School refusal can be a difficult construct to measure. Lack of knowledge about school refusal combined with feelings of shame and embarrassment by parents who report feeling judged about their child’s behaviours are barriers to the reporting [of] school refusal.
2.23The difficulties created by the lack of nationally consistent guidance on recording school refusal absences, as well as the shame and fear felt by parents was also highlighted by School Can't Australia. For example, responses to its recent survey of parents indicated that school refusal absences for their children had been recorded variously as 'parent choice', 'illness', 'explained absence' or 'truancy'. In addition, responses to its earlier (2019) survey showed that 30percent of respondents did not know how their child's absence was recorded, while 21percent reported that their child's absence had been recorded as 'illness'.
2.24Given the lack of reliable data on school refusal, some participants turned to Australian and international research to estimate rates of school refusal in Australia. For example, Triple P International cited research that found school refusal affects approximately one to five per cent of children and adolescents, while the Australian Association for the Education of the Gifted and Talented referred to a study that reported the prevalence of school refusal as 8.2 per cent.
2.25Despite the lack of definitive data, there was a view among many participants that the prevalence of school refusal is on the rise in Australia. This was particularly apparent in evidence provided by schools and service providers working in the area of school refusal. Ms Lisa Coles, principal of an independent specialist school, escribed the ment growth in her college as exponential:
We are a college of 1200 young people of whom all have experienced school refusal or school can't and we have grown exponentially over the last five years. Five years ago, we were a college of 128 young people. Today we are at 1200, so that would indicate that there's certainly a major issue.
2.26Family support provider, the CatholicCare Diocese of Broken Bay, also reported an increase in parents struggling with school refusal:
In the month of November 2022, at least 50 per cent of referrals made to the Child, Youth and Family Support team identified school refusal as being one of the reasons for referral. Additionally, through our casework, school refusal is reported to be increasing in prevalence, despite this not always being identified as a reason for referral.
2.27Similarly, the Tasmanian Office of the Education Registrar (Tasmanian OER) disclosed that school refusal had increased as a contributing factor in non‑attendance in Tasmania—rising from 13 per cent in 2019 to 23 percent in 2021. Interestingly, it noted that the number of Compulsory Conciliation Conferences (following referrals to the Tasmanian OER) rose from 144 in 2020 to 234 in 2021, but the percentage related to school refusal remained relatively constant.
2.28A similar trend was noted by Virtual Schools Victoria, which reported that while its intake of students with school refusal presentations had increased from 386 in 2018 to 895 in 2022, school refusal presentations as a proportion of total enrolments had remained fairly stable at approximately 32 to 33 per cent.
2.29Other submitters pointed to the growth in the membership of their organisations or groups, to highlight the increase in school refusal. For example, analysis by School Can't Australia showed that its membership has almost doubled in size each year since its inception in 2014—and is expected to reach 15 400 in early 2024.
The prevalence of school refusal within specific cohorts
2.30As with the prevalence rates of school refusal in the broad, national sense, a lack of accurate and reliable data makes it difficult to determine whether school refusal rates vary across student cohorts, year levels, and/or school types and locations.
2.31Evidence provided to the committee on this point was mixed. For example, according to Victorian Government data, school refusal is more prevalent in secondary and specialist schools, disadvantaged schools, and schools in rural and regional areas. Conversely, Triple P International cited research showing school refusal was most common in five- to six‑year‑olds and 10 to 11‑year olds. Further, Independent Schools Australia (ISA) reported that although school refusal impacts both primary and secondary students, it is 'now occurring in younger children than was previously observed'.
2.32The evidence was more consistent in relation to an increased prevalence of school refusal around the time of key school transitions—that is, between preschool and primary school, and again between primary school and high school. Participants such as Save the Children and 54 reasons, the TasmanianOER and the ACT Council of PCA identified transition points—particularly the transition from primary school to high school—as a time of increased risk for school refusal. This was supported by Victorian Government data, which showed an increase in the number of students reporting school refusal between Years 6 and 7.
2.33However, the most consistent evidence provided to the committee indicates that school refusal is most prevalent among students with disability (particularly neurodivergent students) and those with mental health challenges. Forexample, research cited by Triple P International suggests that among autistic students, school refusal accounts for 43 per cent of absences. Neurodivergent individuals and those with mental health challenges were also overrepresented in the personal accounts of school refusal provided to the inquiry.
Impact of the COVID-19 on the prevalence of school refusal
2.34There was a general view among participants that the COVID-19 pandemic has increased the prevalence of school refusal.
2.35For example, UNICEF Australia noted that school refusal rates in Victoria 'are estimated to have increased by 50 per cent between 2018 and 2021', while TripleP International suggested that rates of school refusal had 'tripled since COVID-19'. In addition, ReachOut reported more users accessing its online school refusal resource, with the largest growth in New South Wales and Victoria (growth of 127 per cent and 114 per cent respectively).
2.36Although estimates of the impact of the COVID-19 pandemic varied, MrAndrew Pierpoint of the Australian Secondary Principals' Association (ASPA) described its effect as 'school refusal, but it's now on steroids'.
2.37However, most participants stressed that while COVID-19 had intensified the issue, the rate of school refusal had been increasing well before the pandemic. For example, Ms Coles told the committee that although school refusal had 'absolutely' become more frequent in recent years, the increase was not driven by COVID-19:
We don't link that with COVID. We think COVID fuelled and perhaps fast‑tracked the issues for our young people. But I think it was a trend already well before COVID arrived.
2.38In a similar vein, Yellow Ladybugs explained that COVID-19 had simply exacerbated what has been a long-standing problem for autistic young people:
… the impact of COVID, has essentially been to highlight and in some cases, exacerbate what was already a systemic problem of school-based trauma for the autistic community.
2.39Evidence provided in relation to the reasons for the pandemic's impact appeared to suggest a complex relationship between the COVID-19 pandemic and factors that pre-dated the pandemic, such as illness, disability, and increased anxiety and mental health challenges among young people.
2.40For example, a number of participants highlighted the disruption to routine and school connection created by the COVID-19 pandemic. ISA suggested that, for students with existing mental health conditions, this disruption to routine contributed to increased school refusal.
2.41Some participants also noted that COVID-19 lockdowns had reduced the ability to prepare young people for the transition into—or between—schools, which affected whether they felt safe in their new environments. According to MsVeronica Elliott of the ACT Council of PCA, this was a particular issue for students with disability:
For some students with disabilities, they would be lucky to have had one pre-transition visit to a setting. … We forget how much of a change it is particularly from primary to high school. Going from one class with one teacher to six, seven, eight classes with eight different teachers and lots of different staff is a very overwhelming environment.
2.42Mrs Dianne Giblin AM of ACSSO, spoke about the increased anxiety students and parents experienced during the height of the COVID-19 pandemic:
There was anxiety from families and anxiety from children, and then there was the whole COVID anxiety of the safety of, 'Am I going to get sick? AmI going to get in trouble if I get sick and the teacher doesn't know until the next day?' There were lots of shutdowns happening all of a sudden. Therewas lots of increase in anxiety and not wanting to go back to school, because it wasn't a safe place anymore.
2.43However, Mrs Giblin also noted that anxiety in primary school children had been on the rise prior to the COVID-19 pandemic. This was supported by other participants, including Dr Stephen Stathis, Clinical Advisor at Queensland Health, who stated that while the COVID-19 pandemic had been a catalyst for referrals to child and youth community mental health services, it was also 'very clear' that referral rates were already increasing prior to the pandemic.
2.44Similarly, Ms Megan Gilmour of MissingSchool contended that student mental health issues had been rising 'for many years prior to COVID-19 and the COVID-19 lockdowns'.
2.45Other submitters, such as Aspergers Victoria suggested that the increased prevalence of school refusal was not necessarily related to the anxiety and social dislocation associated with the COVID-19-related lockdowns. Rather, it contended that these periods of home schooling simply led some young people to regard this as a viable and preferrable way to learn.
2.46A similar view was shared by Mrs Kirsty James of the Home Education Network, who explained that there had been a 60 per cent increase in home schooling in Victoria since the COVID-19 pandemic. While not all the increase was attributable to school refusal, Mrs James reported that 'a significant number of people just found that their kids were happier at home', which led them to the realisation that school was not the right environment for their child:
We saw a lot of people who realised that their child's anxiety was not about learning; it was about school. So even if they had not previously identified as families with children with 'school can't', that COVID period allowed them to see that the school, as it stood for their child at that time, was not the right environment.
Drivers of school refusal
2.47The drivers of school refusal are difficult to disentangle from the drivers of other attendance problems and school disengagement more broadly. For example, research suggests that the drivers of school refusal are complex, multifactorial and associated with risk factors that include 'individual traits, socio-economic conditions, family structure, the school environment and society more broadly'.
2.48This appears to align with the research literature on school absence, which groups risk factors into the following four domains:
individual factors – including psychological problems, developmental disorders, physical health, substance abuse, and learning disabilities;
family factors – including family structure, functioning and parenting style, socio-economic disadvantage, parental physical or mental health problems, low parental involvement in schooling, and overprotective parenting style;
school factors – including school transitions, changes in pedagogical practices (such as going from a single primary teacher to subject-specific teaching); poor classroom management, and failure to prevent or manage bullying, social isolation and unpredictability at schools; and
community factors – including pressure on students to achieve academically, perceptions of threats, and neighbourhood characteristics and structural barriers such as poverty, lack of transport infrastructure and remoteness.
2.49However, without agreed definitions and clear data on school refusal, it is difficult to determine whether, or how strongly, each risk factor (or combination of risk factors) correlates with school refusal. For example, while it is known that young people who have caring responsibilities or substance abuse issues are likely to have lower attendance and to leave school early, school refusal—as defined by this inquiry—may not play a part in their disengagement or detachment.
2.50During the inquiry, the individual risk factors for school refusal most frequently highlighted by participants were disability (including autism, ADHD and learning disorders) and mental health challenges (including anxiety and depression).
2.51However, submitters such as School Can't Australia observed that a focus on disability as the cause of the issue risks overlooking the failure of schools and education systems to support inclusion. Ms Tiffany Westphal of School Can't Australia expanded on this view in her evidence to the committee:
This is an inclusion issue. This is about the burden of stress disproportionately carried by students with a disability within the context of school and the burden of stress their parents and carers carry as they seek to support their children to access education. This is a wellbeing issue. Wemust stop looking only within-family and within-child factors that impact 'school can't'. An ecosystems perspective demands that we also look at the way we do school, the environments we create, the curriculum and the structure of and design of schools.
2.52This aligns with broader criticism of medical models of disability, which 'locate the problem within individual students and families' and can serve to reinforce negative stereotypes and deficit perceptions.
2.53By contrast, the social model of disability, while not denying the reality of an individual's impairment, challenges society to address the physical, attitudinal, communication and social barriers to equal participation. As one teacher (also the parent of children with school attendance difficulties) explained:
We must recognise that people with disabilities experience barriers and stressors in daily living and in attendance at school, that those without disability do not. If a child with disability is not coping at school, you will see stress behaviour. It is a sign that there in an unmet need. Something,perhaps many things, in the environment, whether physical or social or embedded in the very expectations we have for that child, is getting in the way of what that child needs.
2.54School-based factors also featured heavily in the reasons for school refusal reported by parents to the ACT Council of PCA. These included:
students not feeling safe at school;
schools not addressing disability needs or providing an inclusive environment;
sensory overload or unsuitable sensory environments;
a lack of appropriate support for students;
bullying;
changes in school routine;
boredom and a lack of interesting or relevant work;
students feeling like they don't belong; and
unmet needs.
2.55Therefore, at its core, school refusal appears to arise largely as a stress response from young people whose underlying symptoms or difficulties put them at risk of refusal.
2.56This view appeared to be supported by multiple participants. For example, DrGreg Elliott of the Catholic Schools Parramatta Diocese, described school attendance issues as often being 'a proxy for students who aren't getting the adjustments they need at school'.
2.57Similarly, while noting that some of the issues affecting school attendance originate outside schools, the Commissioner for Children and Young People, South Australia stressed that 'it is the way that schools are equipped to respond to these issues that matter and can either further isolate a student or give them the support they need'.
Other contributing factors
Access to appropriate health system supports
2.58Given the focus of the inquiry on school refusal, it is unsurprising that most of the feedback received by the committee related to the experience of young people in school environments.
2.59Nevertheless, a significant number of participants also highlighted the role of the health system in supporting young people experiencing school refusal. For example, the Peter Underwood Centre noted that 'schools cannot do this on their own—support is also needed from the education and health systems'.
2.60Despite this, multiple participants reported significant challenges in accessing support from the health system. These challenges included shortages of health care providers, long waiting lists for services, a lack of providers who understand school refusal, difficulties navigating the system, the cost of services, and a lack of collaboration between the health and education sectors.
The role of technology
2.61Some participants highlighted technology use as a contributing factor in school refusal, although views were mixed in relation to the role it plays—some ascribed it a causal role, while others saw it as an indicator of, or response to, underlying issues.
2.62For example, the ASPA stated that the 'unrestricted use of technology' was contributing to school refusal via gaming addiction and the inability of parents to address the issue. Gaming addiction or excessive gaming and internet usage were also raised as contributing factors by the Association of Independent Schools of South Australia, the School Refusal Clinic and the Tasmanian OER, among others.
2.63Conversely, The Therapy Place noted that for some children, technology use was a response to the underlying issues and served to dull the emotional stress they feel by allowing them to withdraw to a place 'where they are not required to interact in a real social environment, avoiding the anxiety that social interaction with actual peers makes them feel'.
2.64This chapter has outlined the various definitions and drivers of school refusal, and what can be ascertained about its prevalence across the country. The following chapter will examine the impact of school refusal on young people, parents and carers, families, and school and service providers.