Students are increasingly refusing to go to school. It’s becoming a mental health crisis. (2023)

The police were in her driveway. They wanted her son.

Jayne Demsky’s teenage son was not a criminal. He never stole, used illegal substances, or physically hurt anyone. He just didn’t go to school.

It started in the middle of 6th grade when he began staying home from schoolon days his anxiety was too difficult to manage. Those days became more frequent, turning into weeks and months, until he stopped going altogether. Now an officer was at her house, waiting to take her son to school.

“I would describe it as hell,” said the mother from Mahwah, New Jersey, who recalled feeling hopeless and constantly "on the verge of an emotional breakdown."

Demskysoughthelp from educators, doctors and counselors, trying to understand what was stopping her son from going to school for nearly a year. Finally, a psychiatrist told Demskyabout a conditionthat affectsa growing number ofstudents with severeanxiety: school avoidance.

“It was almost like a revelation,” she told USA TODAY.

There’s no book on this, it’s not spoken about. It’svery scary and parents feel a sense of helplessness.

School avoidant behavior, also called school refusal, is when a school-age child refuses to attend school or has difficulty being in school for the entire day. Several mental health experts told USA TODAY it has become a crisis that has gotten worse since the COVID-19 pandemic.

"There's no book on this, it's not spoken about," said Demsky, whose son declined to be interviewed by USA TODAY but gave his mother permission to share their story."It'svery scary and parents feel a sense of helplessness."

The two continued to struggle with school avoidance for four years with little guidance. In 2014, she created a website to offer families the help and support she couldn't find. The site eventually turned into the School Avoidance Alliance, which spreads awareness and educates learning facilities and families of school avoidant children.

Students are increasingly refusing to go to school. It’s becoming a mental health crisis. (1)

School avoidance is not a concrete diagnosis andlooks different in every child. Some students consistently miss a couple of days a week, while others may leave during the day or escape to the nurse or counselor’s office. In some extreme cases, students don't step foot in a school for months or years at a time.

Half a dozen family members and students told USA TODAY that school avoidance has affected not only their mental health, often leading toanxiety and depression, but also their family dynamics, relationships with fellow students, and grades. It has threatened their prospects of graduation and a thriving future.

School avoidance is a complicated condition that neither parents nor school systems are fully equipped to handle. Some experts say school systems and national organizations are beginning to come up with strategies to get kids back to school, while others wonder if there's a better answer.

"Our waiting list is like 180 families right now," said Jonathan Dalton, a licensed psychologist who runs the Center for Anxiety and Behavioral Change in Maryland and Virginia, which offers treatment to those affected by anxiety and other related disorders, including school avoidance. "The mental health infrastructure was never designed for this level of need."

Students are increasingly refusing to go to school. It’s becoming a mental health crisis. (2)

‘Anxiety and avoidance are teammates’

In the passenger seat of her mother’s car, Anna saw the school slowly peek above the horizon. Her heart began racing, her body shaking. Her breathing grew shallow and fast. And then, the unmistakable sign of her panic attacks: her hand smacking her leg.

“It’s scary because it’s not voluntary at all. It’s just kind of happening to you,” said Anna, a Virginia college student who spoke on the condition that she not be fully named because of mental health stigma. “I’ll sit in the car and tell myself to go in, but my body won’t carry me inside.”

Anna, who was school-avoidant in 10th grade, said her school avoidance began spiraling after she recovered from a medical condition. Despite getting better, she hadn't been to school in a month, and the mere thought of returning generated anxiety.

Students are increasingly refusing to go to school. It’s becoming a mental health crisis. (3)

For most students, mental health experts say, school avoidance is typically a symptom of a bigger problem: anxiety.

“Anxiety and avoidance are teammates because they work on the same function,” Dalton said. “Kids feel very uncomfortable when they go to school or think about going to school, so they do what evolution teaches them to do and avoid something that makes them scared.”

Anxiety may be a common thread, but the basis of that fear varies with each student, said R. Meredith Elkins, program co-director of the McLean Anxiety Mastery Program at McLean Hospital in Massachusetts.

The mental health infrastructure was never designed for this level of need.

School avoidant behaviors most often occurin the transition between elementary, middle school and high school, she said.

“In younger children, we’re more likely to see school avoidance motivated by separation anxiety,” Elkins said. “As kids get older and their social environment changes, the way they interact with peers becomes important, and we see social anxiety as a more frequent contributor.”

School avoidance also tends to be a gradual process – starting with missing a day or two, then missing a week until the student becomes school avoidant altogether.The longer a student is away from school, the harder it is to get them back into school, and it can affect other aspects of their life, like relationships and work opportunities, Dalton said.

“We don’t call it work refusal, we call it unemployment,” he said. “If (students avoid school) and gain short-term relief, they’ll become a master of avoidance, and that doesn’t play well for the future.”

What is school avoidance? This student mental health crisis is growing.

School avoidance has been on the rise for years, but experts say more students are struggling to get back to class since the COVID-19 pandemic.

Josh Morgan, USA TODAY

Students are increasingly refusing to go to school. It’s becoming a mental health crisis. (4)

‘This is a crisis,’ and COVIDmade school avoidanceworse

Some research suggests as few as 1% of students are school avoidant, while organizations like the School Avoidance Alliance estimate 5% to 28% of students in the country exhibit school avoidant behaviors at some point in their lives.

“How (school avoidance) is defined is nebulous,” Dalton said. “Different organizations use different language and criteria to describe it.”

Though it’s unclear how many students are affected, mental health experts agree the problem has gotten significantly worse since the COVID-19 pandemic. As schools began reintegrating in-person learning, many students didn’t return to the classroom.

In some cases, the pandemic halted the progress of many school avoidant students who were making a slow reentry. In other cases, experts said, the pandemic accelerated school refusal.

Students are increasingly refusing to go to school. It’s becoming a mental health crisis. (5)

“We saw a larger shift in kids who were on the cusp before and then after COVID started refusing completely,” said Krystina Dawson, a school psychologist and mental health supervisor for Trumbull Public School District in Connecticut. “Once the pandemic hit and we introduced remote learning, kids got comfortable in their homes.”

School refusalcases may have also grown as students report experiencing anxiety at record levels. A Kaiser Family Foundation analysis found adolescents experiencing anxiety or depression increased by one-third from 2016 to 2020. The same report also found access to mental health services worsened during the pandemic.

“A lot of school refusers, when March 2020 happened, they were like, ‘Welcome to my world,’” Dalton said. “This was these kids’ lives.”

Experts say it has been more difficult to get students to return to school as they become accustomed to learning and socializing virtually. Some parents are more likely to be home throughout the day working remotely, which makes it easier for school avoidant children to stay home.

“The family dynamics have changed,” Dawson said. “Sometimes now there is one parent staying at home, which can be enticing for a child.”

Students are increasingly refusing to go to school. It’s becoming a mental health crisis. (6)

‘Unless you've been through it, you don’t understand’

Katherine and her son Peter started nearly every morning crying together in the school parking lot. The tears were hot and flowing.

They always drove to the building with hopes he would make inside. But eventually the pair headed home, longing the next day would be better.

His school avoidance peaked in 2021 during seventh grade. Katherine, who who lives just outside Boston, spoke on the condition that she not be fully identified because of the stigma associated with mental health.

Katherine identified her son’s affliction after a Google search led her to the School Avoidance Alliance, where she educated herself and found solidarity in the organization's Facebook group. But she still found little empathy or understanding among friends, family and peers, she said.

Students are increasingly refusing to go to school. It’s becoming a mental health crisis. (7)

Her son would say, "‘I just want to be normal.’ It was heartbreaking,” she told USA TODAY. “As a parent, it is so isolating. It is so lonely because unless you’ve been through it, you don’t understand.”

The family struggled for years to find the origin of Peter’s anxiety until he was finally diagnosed with pediatric acute-onset neuropsychiatric syndrome, or PANS, which is a sudden onset of neuropsychiatric symptoms typically linked to an infection, according to Nemours Children’s Health.

With the help of treatment and counseling, Peter is now a freshman in high school and goes to school most days. Katherine was able to secure an individualized education plan for her son, but others are not so lucky.

There’s shame, blame, and parents also don’t know how to deal with the schools. It’s a huge maze.

“There’s shame, blame, and parents also don’t know how to deal with the schools,” Demskysaid. “It’s a huge maze.”

Some educators don't take school avoidance seriously,families told USA TODAY. Schools sometimesthreaten students' graduation or take students to family court.

The students who spoke to USA TODAY said that while they know some educators may view them as truant or misbehaving, they understand they’re missing educational milestones and experiences, and they want to return to school. But many of the schools’ solutions seem to only fuel their depression and anxiety.

"We had the resources, and it was still incredibly difficult" to treat Peter's school avoidance, Katherine said. "That's just not OK."

Students are increasingly refusing to go to school. It’s becoming a mental health crisis. (8)

‘Avoidanceruins lives’

Educators and psychologists say the goal for every case of school avoidance is to get the child back into class.

It’s important for students to stop using avoidance as a coping strategy before it becomes their primary way of dealing with problems for the rest for their lives, Dalton said.

“I don’t treat anxiety. I don’t have to treat anxiety because anxiety istemporary and harmless,” Dalton said. “What I treat is avoidance, and avoidance ruin lives.”

Others also argue returning to in-person class is important for social development.

Students are increasingly refusing to go to school. It’s becoming a mental health crisis. (9)

“You’re increasing the diversity of exposure to social interactions that is difficult to replicate at home because there are some things that are uncontrolled at school that benefits your social development,” said Na’im Madyun, a school psychologist at Prince George County Public Schools in Maryland. “You’re more informed about how to navigate those nuances when you develop.”

But there’s no standard guidance how how to get kids back in the classroom, which leaves school officials to come up with their own solutions.

“It really takes a team approach,” said Mara Nicastro, head of Nora School, a small college preparatory school in Silver Spring, Maryland. “We work in conjunction with the family and the therapist ... and talk about what is it that can help make this transition smooth because the student is ready and knows it’s time to find a space to move forward.”

It really takes a team approach. We work in conjunction with the family and the therapist ... and talk about what is it that can help make this transition smooth.

Before making that leap, Dalton said most school avoidant students undergo a combination of cognitive behavioral therapy and exposure therapy to understand what exactly thestudent is avoiding and gradually build their tolerance to that source of anxiety.This may look like staying in the car at the school parking lot or walking into the guidance counselor’s office and leaving.

Parents with anxiety have difficulty guidingtheir children in uncomfortable situations, Dalton said, as they reckon with their own traumasrelated to school. But it's important to seek help.

Schools need to work with parents and therapists to make the appropriate accommodations, Nicastroadded.

“We recognize that our students are learning how to move through their discomfort, their anxiety, and give them opportunities to use those coping strategies.”

Students are increasingly refusing to go to school. It’s becoming a mental health crisis. (10)

Looking forward: What’s being done to help students?

Experts say not all schools – especially large districts – have the resources to operate like the Nora School, which limits enrollment to 70 students.

Many schools don’t reach the American School Counselor Association recommended counselor-to-student ratio of 1 to 250. The average ratio across all schools is 1 to 464, according to the association, and nearly 3 million of those students don’t have access to other school support staff, like a school psychologist or social worker.

But experts say things are slowly changing. For example, the Biden administration announced Monday nearly $100 million will be awarded across 35 states to increase access to school-based mental health services through the Bipartisan Safer Communities Act, which was signed into law June 2022.

Meanwhile, school systems and professional organizations are engaged in a national conversation about school avoidance and related protocols, said Duncan Young, CEO of Effective School Solutions, a mental health services provider for K-12 school districts.

Students are increasingly refusing to go to school. It’s becoming a mental health crisis. (11)

Some protocols have been implemented and include a social-emotional curriculum, mental health counseling and personalized care for students whose mental health challenges impede their ability to operate in a traditional school setting.

“We’re seeing this transition right now,” Young said. Instead of viewing school avoidance as a behavioral problem, “school districts are building their mental health literacy and understanding the linkage between school avoidance and mental health.”

Meanwhile, some families question the rigid structure of a traditional school system.

Katie, a mother of three who lives in the St. Louis area in Illinois, said her high-school-age son was school-avoidant, but his mental health has significantly improved after transitioning full time to remote learning.

“He’s much healthier,” Katie said, who is on the school board and spoke on the condition that she not be fully identified. “He’s participating in schoolwork, he’s socializing, he’s attending family dinners again, his depression is so much better, anxiety is so much better.” He's also workingandvisiting colleges with plans to continue his education.

If your child is experiencing school avoidance:

ShowClose and skip

Experts urge families to seek professional help through a doctor, therapist or school counselor if anxiety becomes debilitating enough that it affects daily life, relationships and job, or if someone is having thoughts of hurting themselves or others. If you or someone you know may be struggling with suicidal thoughts, dial 988 to reach someone with Suicide and Crisis Lifeline. They're available 24 hours a day and provide services in multiple languages.


In the real world, most people can choose whom they work for or where they go to college, she noted. But students don't have that flexibility in a traditional school system.

"Children have not always been educated in this one little box," Katie said. "Whatever that looks like for (my son), I have all the faith in the world that he will be successful one day. I don’t question it for a second anymore."

Despite avoiding school for four years, Demsky's son graduated, secured a job and manages his anxiety independently, she said.She hopes her story comforts otherparentsand shows that childrencan haveproductive lives after school avoidance.

"I had that fear that my son was going to live in my basement for the rest of his life. ... That is the fear of every parent," Demskysaid. Now, her son is "thriving."

"I'm really proud of him."

Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.


Is mental health a reason to not go to school? ›

California is among twelve states that now allow students to take “mental health days” as excused absences, as reported by Today. While some adults worry that teens will abuse the policy, mental health experts are encouraged by the step forward and stress that the benefits outweigh the risk of misuse.

Is school ruining students mental health? ›

Lower education is generally associated with a lack of control and resilience, as well as exposure to more day-to-day stressors. This can negatively impact a person's mental health and lead to disorders like depression.

Why do students struggle with mental health in school? ›

Key Messages. Stress factors at school—such as unempathetic and unsupportive teacher-student relationships and a poor classroom or school climate—increase the risk for children and adolescents of developing mental health problems.

How many students suffer from mental illness because of school? ›

According to the U.S. Department of Health and Human Services, one in five children and adolescents experience a mental health problem during their school years. Examples include stress, anxiety, bullying, family problems, depression, learning disability, and alcohol and substance abuse.

How does mental health affect students attendance? ›

School attendance plays an important role in a child's academic success. For some children and teens with anxiety disorders, depression, or other mental health diagnoses, school can become so overwhelming that they may frequently struggle to get to school, stay at school, or be engaged in classroom activities.

Should schools let students have mental health days? ›

Mental health days are important because they give kids time at home to recharge. Whether your child is struggling with a mental health challenge or just a rough week, a day off to recuperate can reduce stress and help them get back on track.

What makes students mental health worse? ›

Students spend a large percentage of time engaged in academic pursuits at university, and poor academic performance can harm their mental health. Receiving worse grades during their studies can have a severe impact on student's mental health, leading to the development of SAD (28).

Should schools take mental health more seriously? ›

Because teens spend most of their day at school, it just makes sense to have mental health awareness and education become part of the curriculum. When we empower students with knowledge, and encourage dialogue, students will be able to get the help they need.

What are the factors that affect mental health of students? ›

Stress, life events, past experiences and genet- ics all play a part in determining our mental health. Student life exposes in- dividuals to risk factors affecting mental health including financial worries, periods of transition, substance use, parental pressure, culture shock and disconnection from previous supports.

How does school stress affect mental health? ›

But research shows that feeling overwhelming school-related stress actually reduces your motivation to do the work, impacts your overall academic achievement, and increases your odds of dropping out. Stress can also cause health problems such as depression, poor sleep, substance abuse, and anxiety.

Does school cause stress and anxiety? ›

Back-to-school is an exciting time. But for many kids, it can cause stress and anxiety—even children who are usually easy going may experience butterflies and those with some anxiety may get more nervous and clingier than usual. Parents feel the pain, too. Leaving a crying child at school is hard for everyone.

What are the most common mental health problems in students? ›

The most common mental illnesses in adolescents are anxiety, mood, attention, and behavior disorders. Suicide is the second leading cause of death in young people aged 15–24 years.

Why mental health is important in school? ›

Mentally healthy students are more likely to go to school ready to learn, actively engage in school activities, have supportive and caring connections with adults and young people, use appropriate problem-solving skills, have nonaggressive behaviors, and add to positive school culture.

Do you believe mental illness is common among students? ›

The truth is that, among students, anxiety, depression and eating disorders are extremely common. According to mental health research conducted by the National Alliance on Mental Illness (NAMI), one in four students has a diagnosable mental illness.

How many students skip school because of stress? ›

More On: students

“Emotional stress” was the most-cited reason for students wanting to drop out, coming in at 55%. “Personal mental health reasons” — included as a survey response for the first time this year — were the second-most cited, at 47%.

How does missing school affect learning? ›

Effects of Poor School Attendance

When children are absent from school, they miss out on consistent instruction that is needed to develop basic skills. Children in early grades are particularly susceptible to falling behind in fundamental reading skills, which can have a snowball effect that impacts future learning.

What is the relationship between school attendance and health? ›

Chronic school absenteeism, starting as early as preschool and kindergarten, puts students at risk for poor school performance and school dropout, which in turn, put them at risk for unhealthy behaviors as adolescents and young adults as well as poor long-term health outcomes.

Why schools increasingly offer mental health days for students? ›

The goal is to bridge the gap between how we treat physical and mental health. Taking a mental health day from school is a chance for teens to reset their nervous system and get out of fight-or-flight mode. It's a break from the everyday stress of tests, deadlines, and social pressures.

Why should kids stay in school? ›

Staying in school is a great way to develop essential skills that can benefit you in college, in the workplace, and even in your personal life. This can include study habits, time management skills, interpersonal skills, critical thinking, communication skills, and more.

Why do children struggle with mental health? ›

There is no clear reason why some children develop mental health issues, but some things, like being exposed to traumatic experiences, can make it more likely. Traumatic experiences for a child might include: having a long-term illness. moving home and/or changing school.

Is there a student rise in mental health issues? ›

The majority of college students (more than 60 percent) meet the criteria for at least one mental health problem—a nearly 50 percent increase since 2013, according to the Healthy Minds survey, published earlier this month.

What causes mental health issues in youth? ›

Physical, emotional and social changes, including exposure to poverty, abuse, or violence, can make adolescents vulnerable to mental health problems.

Is mental health education effective? ›

Mental health education provides necessary awareness and resources for individuals and their loved ones. It helps break the stigma associated with mental health.

What are three contributing factors that impact children's mental health? ›

These factors include:
  • having a long-term physical illness.
  • a parent who has had mental health problems, problems with alcohol or has been in trouble with the law.
  • the death of someone close to them.
  • parents who separate or divorce.
  • experiencing severe bullying or physical or sexual abuse.
  • poverty or homelessness.
Aug 12, 2021

How does depression affect school? ›

Depression and anxiety are triggers for poor performance, social isolation, absenteeism, cognitive impairment and can also result in students being bullied by their peers. This effects mental health as well as academic outcomes and can even lead to eventual loss of life if treatment is not received by the student.

Why do students get so stressed with school? ›

The main cause for stressed out students is the heavy coursework they are taking on. Teens who want to get a jump on college may also sign up for extra classes, only adding to the burden. Too often, the teen takes on subjects that exceed their academic ability, causing added stress. Not enough sleep.

What is the most common cause for school stress? ›

There are many causes to school stress:
  • Lack of sleep.
  • Too much work or homework.
  • Different routine.
  • No support.
  • No time to relax.
  • Having learning disabilities.

What causes mental stress in students? ›

Some of the things students commonly cite as causes of stress include: examinations. deadlines. returning to study.

Is school a main cause of depression? ›

School is usually not the main cause of depression. However, it can be a factor in causing or increasing teen depression due to the various stressors that occur in school, including bullying, academic pressure, and challenging peer relationships.

Why is it so hard to go to school? ›

Some children have severe separation anxiety and can't tolerate being apart from their parents. Other anxiety-related problems that motivate children and teens to avoid going to school include social anxiety, phobias (such as of illness or germs) and obsessive-compulsive disorder, along with depression.

How can we reduce school stress? ›

What are the Best Techniques to Help Students Manage Stress?
  1. Keeping a journal.
  2. Getting plenty of exercise.
  3. Eating healthy, regular meals.
  4. Making sure you get enough sleep.
  5. Meditating.
  6. Downloading an app that provides relaxation exercises (such as deep breathing or visualization) or tips for practicing mindfulness.
Nov 10, 2022

What is the most popular mental health problem? ›

The most common are anxiety disorders major depression and bipolar disorder. Below is more information on these disorders and how ACCESS can help.

How can homework affect mental health? ›

Students with too much homework have elevated stress levels.

Higher-achieving students — those who may have more homework — are at particular risk for stress-related health issues including sleep deprivation, weight loss, stomach problems and headaches.

What causes mental health issues? ›

childhood abuse, trauma, or neglect. social isolation or loneliness. experiencing discrimination and stigma, including racism. social disadvantage, poverty or debt.

Is mental health more important than school? ›

Your accomplishments will likely be even sweeter when you are healthy enough to enjoy them. Grades and reaching goals have their place, but your mental health is always more important than anything else.

Do you think mental health affects how students think feel and act and why? ›

It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.

Why do people with depression not go to school? ›

People with depression exhibit a host of concerning symptoms including sad mood, lack of energy, poor concentration, and low motivation. Because of this it is not uncommon for kids with depression to not want to go to school.

Is anxiety a valid reason to miss school? ›

Mental health professionals and educators say what used to be considered run-of-the-mill truancy could actually be something else. Some cases of chronic absenteeism are now being called "school refusal," which is triggered by anxiety, depression, family crises and other traumatic events.

Does Ohio allow mental health days? ›

Ohio is making a push to prioritize the mental health of students. Ohio House Bill 38 defines a mental health day as a school day during which a student attends to their emotional and psychological well-being instead of attending school.

Why do kids not want to go to school? ›

School refusal usually goes along with disorders like separation anxiety, depression or panic disorder. An evaluation from a professional can tell you if your child needs treatment. Cognitive behavioral therapy (CBT) and exposure therapy are used to treat school refusal.

Is school a big cause of depression? ›

While school offers many benefits to adolescents, such as connecting with peers, overscheduling and academic pressure can be a significant source of stress, contributing to mental health issues including teen depression.

Is depression a reason to stay home from school? ›

You may consider a Leave of Absence if: Your mental health is disrupting your ability to participate in academic and campus life, even with supports and accommodations. You feel you are in crisis or that your level of distress is becoming intolerable.

Does school make anxiety worse? ›

Back-to-school is an exciting time. But for many kids, it can cause stress and anxiety—even children who are usually easy going may experience butterflies and those with some anxiety may get more nervous and clingier than usual.

What states allow students to take mental health days? ›

There are currently 12 states where students are legally allowed to take mental health days: Washington, California, Illinois, Maine, Virginia, Colorado, Oregon, Connecticut, Arizona, Nevada, Utah, and Kentucky.

Am I allowed to take a mental health day? ›

Employers should understand that people need to take sick days, and there shouldn't be an issue about taking one. So if you're nervous about asking, we bet there is a good chance they will respond with something short and sweet. If you feel the need for a mental health day from work, know that you're deserving of one.

Is taking a mental health day valid? ›

A mental health day is a day you take off from work or school, and minimize any commitments or responsibilities. You can use this time to focus on relieving stress, relaxing, having fun, and preventing burnout.

Is school good for the brain? ›

Education and lifelong learning help us use our brains to their maximum potential by stirring up our curiosity and intellect, Dr. Lagoy adds. The more you use your brain, the more oxygen it requires, and your body increases blood flow to it to fulfill the higher demand.

Is mental health important or school? ›

Students' mental health in school is a crucial part of the education system. Ultimately, students with positive mental health can build relationships more effectively, make decisions, and work together. These positive effects support the individual student and their larger community as they enter adulthood.

Is homeschooling beneficial or harmful to children? ›

Homeschooling is associated with higher rates of academic achievement as well as higher career achievement after graduation. The home-educated typically score 15 to 30 percentile points above public-school students on standardized tests for academic achievement.


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