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