Mental health struggles drive rise in school refusal among children, teens
Consultant Child and Adolescent Psychiatrist at Hospital Permai Johor Bahru, Dr Nor Rahidah Abd Rahim, said the issue is often misunderstood, with many assuming that students simply "do not want to go to school", when in fact the problem is rooted in deeper psychological issues that require clinical attention.
"Children don't refuse school without a reason. When we investigate, we often find underlying issues such as social anxiety, panic attacks, learning difficulties or even trauma," she said during the Malaysian Child and Adolescent Mental Health and Psychiatry Conference (M-Champ) 2025, held here yesterday.
Dr Nor Rahidah said common triggers include separation anxiety in younger children, peer-related stress such as bullying, and academic pressure — all of which have become more evident since the Covid-19 pandemic.
"Post-pandemic, many students are struggling to re-adapt to school routines. Some feel overwhelmed by social situations they haven't encountered in two years," she said, adding that prolonged online learning has also led to increased screen dependency and avoidance behaviours.
Dr Nor Rahidah stressed that school refusal is often mislabelled as truancy or misconduct, leading to delayed intervention and a worsening of the child's condition.
"Parents and teachers may think the child is lazy or disobedient. But when a child cries, complains of headaches, or begs not to go to school, it's usually a cry for help," she said.
She called for stronger collaboration between schools, families and healthcare providers, and stressed the need for early detection and support.
"Teachers should be trained to recognise red flags. Schools must have clear referral pathways to mental health professionals," she said.
She also warned that children who remain out of school for prolonged periods face serious risks, including academic decline, social isolation and worsening mental health symptoms — in some cases, requiring hospitalisation.
Dr Nor Rahidah said Hospital Permai, one of the few centres in Malaysia offering specialised child and adolescent psychiatry services, continues to see a rising number of referrals for school refusal — highlighting the urgent need for systemic support.
"School refusal is a silent epidemic. We need to act now with empathy, awareness, and coordinated care," she said during her presentation titled Unpacking School Refusal: Understanding Its Roots and Psychological Underpinnings, under the main topic Fear to Flourish: School Refusal.
The three-day M-Champ 2025 conference, themed Mind in Bloom: Enhancing Child and Adolescent Wellbeing, ends today. It is being held at Casuarina Meru and brings together experts from across the country to share best practices and strategies for early intervention and community-based support. – BERNAMA
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