Mental health articles

OF mental health care and mentally ill

School Refusal in Teens

Teens who present with problems of school attendance represent 5 per cent of clinic referrals. The problem can present in a variety of ways including abdominal pain and headaches in the mornings before setting out for school. Onset may be abrupt in which case a precipitating factor can be found, or gradual with the teens increasingly reluctant to attend school.

The teens are often fearful of separating from the parent and leaving home. There is often a lack of authority on the part of the parents to enforce attendance. Emotional over-involvement by the parents can also play a part. In contrast to the school-phobic teens, truants stay away from school to engage in other activities without the knowledge of their parents. Truancy is linked to conduct disorder, male sex, large families, parental criminality and poor supervision at home. Treatment and management involves dealing with the underlying condition particularly separation anxiety. Family therapy to help parents enforce school attendance may be necessary. Effective liaison with the school is essential to deal with issues such as bullying and to harness teachers’ support. Change of schools rarely helps unless there are particular problems, for example, distance from school, academic ability, necessitating change. Medication is not helpful in most cases.

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