The pandemic has catalysed an epidemic of school avoidance for anxious teenagers and despair for helpless parents. But hope is possible.

Reflections on how “school refusal”, “school avoidance” or “emotionally based school avoidance” amongst adolescents impact parents’ mental health and wellbeing.

Dr Hannah Ryan

As a psychologist who supports parents of school-avoidant adolescents, I have experienced many versions of the same conversation since 2020. Let’s imagine it’s with a fictional mother, Laura, and a daughter, Flora. The conversation goes a bit like this:

“My daughter used to love school when she was younger. She was- she still is – super bright, insightful, articulate, and wise beyond her years. She has always been sensitive, but she’s never had any problems with her mental health and in primary school, she had a couple of solid friendships. 

That all changed after the pandemic, which coincided with puberty and the transition to secondary school. After being out of school for so long, starting secondary school, feeling self-conscious in her body and feeling like she didn’t quite fit in – it was all too much. There was increased academic pressure, too, and we started to notice some signs of, well, maybe ADHD, maybe neurodiversity, we’re not quite sure. 

But it was manageable until earlier this year when she had a huge falling out with a group of friends- there was an incident on Snapchat. She won’t really tell us the details. Then we found out she was self-harming, and it was such a shock. She won’t talk to us about it either; she says we always say the wrong things. Since then, she’s stopped going to school. She has panic attacks and often runs away if she feels overwhelmed. She says she wants a good future but can’t face going in and seeing those girls. Kids can be so cruel. 

And the school – they don’t really get it. A few times, she’s not shown up for class or had her ear loops in because she’s sensitive to noise, and they see her behaviour as deliberately disobedient. I think they don’t have much sympathy, and she feels misunderstood by them. They nag her about little things we think they could probably pick their battles on – like not wearing her school jumper because it’s itchy. She has a strong sense of justice, and if she feels they are being unfair, she shuts down, and that’s it. She says she wants to learn but hates every second of school and can't bear it. We feel so helpless, and we want to help her. Can you help?” 

This is a version of the phone call I’ve been having with panicked parents since the pandemic. It can be about a boy, a girl, or a young person who identifies as non-binary. Sometimes, the primary issues are neurodivergence, academics or fitting a round peg into a square hole. Sometimes the problems are not with attention or academics but with perfectionism and crippling anxiety. Sometimes, the primary issues are friendships, bullying and peer dynamics, and the academics are entirely unproblematic. Sometimes the young person is exceptionally bright but suffers from crippling perfectionism and achievement anxiety. There are often whispers of trauma: a “toxic boyfriend” who pressured her, “grooming on Snapchat”, an “incident” at a party. Sometimes there is conflict at home, sometimes not. Sometimes, there is neurodiversity, sometimes not. More often, there is a combination of all of the above. 

However, all these parents are left feeling helpless, overwhelmed and terrified. Many speak of a poignant loss and longing to reconnect with the child they were so bonded with before the pandemic. Of course, it is natural to grieve the increased distance that expands when a child becomes a teenager. Still, this can be magnified when a teenager struggles with significant mental health challenges and undergoes apparent personality changes and withdrawal from the parent and the world. Parents can question, “Is this them, or is this their mental health?” and “How much of them will I get back?” At times, parents will say they glimpse the little person they once felt so connected to in moments of silly jokes and dancing in the car and that they will let their child know this. Their child might say that this leaves them feeling conditionally accepted, as if the parent only wants the happy version of them and is trying to rush them through their sorrow. 

They may have a point. Watching your child go through misery is excruciating for a parent to bear, and often, it is virtually impossible to remain fully present with and accepting of the child’s despair and hopelessness in the way they might need or want. As Caitlin Moran has spoken about, she tried to encourage, cheer, cajole and persuade her teenage daughter out of a state of severe mental ill health, even buying her a pet rat to try to lift her spirits, before eventually realising that her job was to sit and validate her daughter’s feelings. Easier said than done, especially when doing so triggers your own feelings of despair and catastrophic thinking. 

And there can be so much catastrophic thinking that is completely understandable in these circumstances. If your child has stopped going to school, regressed in their education, fallen out with friends, or has been self-harming, it would not only be odd but also even concerning if parents were not worried. I often invite parents to externalise their catastrophic images of their child’s future gone wrong. Do they picture their son playing video games surrounded by takeaway boxes in their front room when he’s forty? Do they see their daughter becoming a cat lady who never leaves the house? Often, these images feel very real and drive parents to a place where they feel panicked and petrified. Often, that terror can understandably push them to lock horns with their child in the mornings in ways that can lead everyone to spin in circles of misery and helplessness. This is nobody’s fault. After all, what else is there to do? 

Holding some hope can be powerful, and I often suggest to parents that the language of parts can help. One part of them may feel as though it’s all going to hell in a handbasket and that their child will end up institutionalised or in a cult if things continue. That's fair enough. However, there may be another part of them that has a quiet faith that things will come right in the end, that the glimmers of their child’s authentic self, their opinionated, feisty, charming, articulate, insightful, sweet, lovely, rebellious, talented, bright, amazing self will carry them forward and that they will find their path and their people. I wonder which part gets activated under which circumstances?

The irony of these conversations is that whilst I have heard these stories many times, each parent's story is singular. Parents are also often remarkably disconnected from others going through similar challenges at their child’s school or local community. They tell me that they talk to friends, but friends don’t really understand how agonising and consuming it can be because how can you really get it unless you have a child who is seriously depressed and who has partially given up on the world? They tell me they have a concerned grandparent or relative but that they are of the ‘pull yourself up by your bootstraps, love and get yourself to school’ generation. They are given competing advice by friends, sisters-in-law, co-parents, teachers, children and psychologists, and they want to scream into a pillow because no matter what they do, they feel like they're messing it all up and getting it wrong. They feel resentful of their child because school avoidance is coming between their work, goals and life, and then they feel guilty for blaming their child for something they know logically is out of their control. They oscillate between deep empathy and fiery frustration. They feel confused, they feel accepting, and they feel despair all in the space of a morning. They dread having to phone the school to say, "She's not going to make it in again today, she's not feeling well, sorry", because even if the person on the end of the phone is understanding, they will always wonder if they are being a little bit judged for being a little bit weak and letting their child down. 

They tell me that they feel deeply alone with this, even if they have a partner because they are carrying so much loss, so much worry, and so much vicarious pain for their child that they don’t know what to do with and that their pain always comes second to their child’s suffering which takes up so much space in their home, hearts and minds. “You are only as happy as your least happy child,” they all tell me, and they don’t need to finish the sentence. Ultimately, the situation can feel incredibly depressing, incredibly frustrating and incredibly stuck.

While parents rarely come to me looking for support for themselves, they are often surprised to find that that is what I tend to offer first. That is not because parents are to blame for this situation – far from it. The challenge of school refusal is a multifaceted crisis of meaning for young people, a symptom of a fundamentally broken world. It is about all the usual suspects: social media and how it has magnified the crises of peer exclusion, rejection, sexualisation and bullying, a world that is existentially falling apart and for which young people carry the burden, an education system that is crippling young people with academic pressure and which is in many cases stuck in the dark ages of behavioural, punitive approaches to conformity and control, a culture of perfectionism and capitalism that permeates everything and to top it all off a pandemic which, for many of these young people, came at precisely the wrong time and affected them in ways that have not yet been dissected because we are still too close to it and we are still too eager to put it behind us and move on. The pandemic was not the cause of the school refusal, but it was the catalyst for many; like the one Jenga block that toppled the tower, a piece that perhaps pulled the whole precarious thing apart. 

In some families, conflict at home is a major contributory factor; in some, this is not an issue. We cannot, and should not, boil this down to simplistic “one cause” tickets of blame. When so many children are running from schools we must ask ourselves if the problem is with the individual people involved or if we need to zoom out and wonder what the hell is really going on. We certainly should not blame mothers, who have been blamed enough throughout history already, who carry the disproportionate mental, emotional, administrative and financial load of caring for children with additional needs and who have more than earned a day off. 

Nonetheless, parents have a crucial role in facilitating a healing environment. Getting there is not simply about learning a laundry list of top tips and nifty skills; it’s often about first processing the parents’ own trauma, loss and pain because often this is unnamed and unattended to. I used to remind CAMHS clinicians: remember that every time a child self-harms, you are talking about a trauma in that adult’s life too. You are talking about something likely to come with deep feelings of distress, worry, helplessness and inadequacy for that parent. When we separate “children’s issues” from “adult issues”, we sadly miss the space in between. We must hold space for parents and apply compassion to their distress first (and then share some top tips and nifty skills too of course to help with the unbearable feeling of “what to say” and “what to do”).

One day, I dream of running two concurrent groups: one for parents of young people struggling to go to school and one for their children. One day, when I am less tired and less busy, I wonder if this (combined with some direct work with schools to be more trauma-informed, mental health supportive and neurodivergent friendly) could make a difference. 

If you have been parenting a teenager whose mental health and school attendance deteriorated after the pandemic, please know that you are not alone and that I do not believe it is your fault. Even if the place you are in feels very dark and lonely, you are in a vast, invisible boat, and if you look around, you will see the stricken faces of other parents who are just as lost, scared and worried as you are. It can be so hard to find timely help, especially with long waiting lists for CAMHS, but if you are feeling stuck with how to help your child, you don’t have to go it alone; there are psychologists and at the very least, support groups and resources that can help you on this journey. If you reach out to me and I am full, I will be happy to point you in the direction of others who might be able to help. 

Remember that even when you feel full up with despair, another part of you always wants to be hopeful. So, let me leave you with a little poem on hope by Emily Dickinson. 

“Hope” is the thing with feathers – 

That perches in the soul – 

And sings the tune without the words – 

And never stops – at all – 

And sweetest – in the Gale – is heard – 

And sore must be the storm – 

That could abash the little Bird 

That kept so many warm - 

I’ve heard it in the chillest land - 

And on the strangest Sea - 

Yet – never – in Extremity, 

It asked a crumb – of me. 

My experience working with parents and young people struggling to attend school has left me with this truth: there is almost always a part of that young person that desperately wants to achieve, holds fiery ambitions and feels left behind. And that part of them is battling with the part that is petrified of being in an environment that has come to feel like a prison, a place where their heart pounds, where they feel trapped, judged and unwelcome by peers, teachers or both. It is a place where they feel stupid or unpopular, ugly or overwhelmed or objectified or at risk of falling apart in front of everyone or all of the above, and their bodies can’t manage this, so all they can manage to do is run and press the escape button. 

Finding a way forward is not easy. It involves accepting that the path ahead will not be linear, that the goal will not necessarily be to get your child back into that school, but to nurse them and you back to good mental health first and foremost and to ignite a spark of passion in them again. It might involve letting go of what you thought your life was going to look like for a while and finding a way to build towards a present and future that works for you both. My experience tells me that most children do find their way back to education in some form or another. In the meantime, you deserve to feel less alone, and to discover that hope really is possible. Feel free to get in touch if you would like support with getting there.

Sources, References and Resources

Naomi Fisher’s Not Fine in School Website has the most comprehensive set of resources for families of school avoidant children, and I highly recommend taking time to explore what it has to offer: Not Fine in School - School Refusal, School Attendance

Facebook has a growing number of groups for parents of school avoidant children. For example, School Avoidance Alliance, School Refusal Support Group, Parents of Children and Teens with School Anxiety and School Refusal, School Refusal Support Services for Phobia, Refusal & Separation Anxiety.

I recommend listening to Caitin Moran’s podcast interview on the iWeigh podcast in which she talks about her experience of parenting a child with an eating disorder, depression and self-harm: I Weigh with Jameela Jamil: Caitlin Moran on Apple Podcasts.

The language of “parts” comes from Richard Schwartz’ model of therapy called Internal Family Systems. For an interview between parenting psychologist Dr Becky Kennedy, director of Good Inside, and Dr Schwartz, on how IFS and parts language can be applied to parenting, click here.

I also recommend the episode of Psychologists Off the Clock with Dr Adele La France called Talking to Kids and Teens Who Have Big Feelings which explains the Emotion Focused Validation skill of communication, which I highly recommend for parents of school avoidant children: 240. Talking to Kids and Teens with Big Feelings with Adele LaFrance (EFFT Part 1 of 2) – Psychologists Off the Clock (offtheclockpsych.com). You can also try LaFrance’s book What to Say To Kids When Nothing Else Will Work.

Another book you may find helpful is Parenting a Teen Who Has Intense Emotions by Pat Harvey.