School refusers found to have significant psychological problems 

Early diagnosis and treatment vital to prevent vulnerable children losing educational opportunities

Children who refuse to go to school have significant psychological difficulties compared with school attenders, according to the first community study on the problem.
Until now the true size of anxiety and depressive disorders among school refusers has not been known, because no standard diagnoses have been made across populations.
This study set out to determine the prevalence of depression and anxiety in school refusal cases referred to Child and Adolescent Mental Health Services (CAMHS), and those referred to education social services, to see if they were similar.
Three prospective groups were compared:

1. school refusers referred to CAMHS (28 cases)
2. school refusers referred to educational social workers and seen by the community paediatrician (22 cases)
3. a control group of school attenders matched for age and school (33 cases).
Four parent and child questionnaires were used in the assessment. One of these identified psychological problems in 61.5% of children in group 1, compared with 53.3% in group 2 and 34.4% in the control group.
A second questionnaire showed depression in 50% in group 1, 76.2% in group 2 and 9.1% in the control group.
Poor self-esteem was found in 39.3% in group 1, 70.6% in group 2 and 6.1% in the control group.
78.6% of group 1 were found to be anxious, 89.5% of group 2 and 48.5% of the control group.
The authors of the study concluded that the significant psychological difficulties found among referred school refusers highlight the need for further service provision to diagnose and treat them. Early intervention is vital to prevent problems becoming entrenched, and prolonging periods of absence from school.

22nd September 2004



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