Synopsis
Formulate school-attendance difficulty and bullying without blame, distinguish anxiety-maintained avoidance from illness, unmet need or unsafe education, identify suicide and safeguarding danger, and coordinate timely educational, family and mental-health support.
- School refusal is not a formal diagnosis and can imply wilful choice; emotionally based school avoidance or attendance difficulty better describes many children who feel unable to attend.
- Ask what makes attendance hard and what makes it possible, separating arrival, particular lessons, social times, sensory spaces, performance, travel and return home.
- Assess anxiety, depression, self-harm, bullying, trauma, autism, ADHD, learning and language needs, physical illness, sleep, caring roles, poverty, transport, family stress and exploitation.
- Bullying has no single UK legal definition; it is commonly understood as repeated behaviour intended to hurt physically or emotionally, including online behaviour and identity-based harassment.
- Do not prescribe attendance sanctions as a clinical treatment or use anxiety to excuse a school from making safety, SEND or reasonable adjustments.
- England's statutory attendance guidance expects schools and local authorities to understand barriers, work with families and join educational, health and wider support; education law and processes differ elsewhere in the UK.
- When anxiety and avoidance maintain the difficulty after safety and access needs are addressed, use a collaborative graded return linked to CBT principles, not sudden forced exposure.
- Create a named school contact, safe arrival, predictable timetable, supported breaks, catch-up plan and response to bullying, then review attendance and distress together.
- Share information proportionately with consent when possible; serious harm, abuse or exploitation can justify safeguarding disclosure despite a request for secrecy.
Key red flags
Current suicide planning, self-harm escalation, severe hopelessness or statements that death is preferable to school requires urgent mental-health assessment and a safety plan.
Assault, sexual harm, stalking, extortion, hate-motivated threats, weapon access or coercive online contact may be criminal and safeguarding matters as well as bullying.
Repeated missing episodes, unexplained money or gifts, controlling older peers, substance supply or fear of disclosure suggests exploitation rather than ordinary non-attendance.
Weight loss, dehydration, sleep reversal, panic, inability to leave home or near-total social withdrawal indicates significant health and functional deterioration.
A child who fears a staff member, family member or journey home must be offered private assessment before information is shared or return is arranged.
Investigation priorities
Map onset, days, lessons, transitions, somatic symptoms, successful exceptions and consequences of absence.
Elicit fear, bullying, abuse, identity harm, online events, symptoms, strengths and preferred solutions.
Management branches
A child is late, misses lessons, is persistently absent or becomes highly distressed around school.
- Speak with the child privately and map the exact attendance sequence, physical symptoms, feared settings, safe exceptions and immediate consequences.
- Assess mental and physical health, bullying, safeguarding, SEND, learning, family, transport, poverty, caring and exploitation factors.
- Bring family, school and relevant services together with consent or safeguarding authority and name one coordinator for a written barrier plan.