My Child Won’t Go to School: Is It Depression, Stress, or Something Else?
A clinical psychologist’s guide for parents in Singapore
Every morning looks the same. Your child says they feel sick. Their stomach hurts, their head hurts, they feel like they’re going to throw up. You take them to the GP, nothing comes up. You let them stay home, and by mid-morning they seem fine. But the next school day, it starts again.
Or maybe it’s not physical complaints. Maybe they’re crying. Maybe they’re angry. Maybe they just shut down and refuse to move.
If this is happening in your family, you’re probably asking yourself: Is my child depressed? Is this just stress? Are they being lazy? Is something happening at school that I don’t know about?
As a clinical child psychologist who works with families in Singapore every week, I see this pattern often, and I want to help you understand what might be going on, because the answer matters. How you respond depends on what’s driving the refusal, and getting it wrong can make things worse.
First: This Is Not “Just Being Lazy”
Let me be direct about this, because I know some parents hear it from well-meaning relatives: “In my day, we just went to school.”
School refusal is not a character flaw. It is a behaviour, and like all behaviours, it has a function. Your child is avoiding school because something about it feels genuinely threatening, overwhelming, or unbearable to them. The question is what.
Research consistently shows that school refusal is associated with internalising difficulties, anxiety and depression being the most common (Kearney & Albano, 2004). It is not the same as truancy, where a child skips school to do something more appealing. Children who refuse school are usually distressed, not defiant.
The Three Most Common Drivers I See in Singapore
1. Anxiety
This is the most frequent cause of school refusal in my clinical experience, and it shows up in many forms:
- Separation anxiety, more common in younger children (Primary 1–3), where the distress is about leaving a parent, not about school itself.
- Social anxiety, fear of being judged, embarrassed, or singled out. This often intensifies around Secondary 1–2, when social hierarchies become more complex.
- Performance anxiety, fear of failing, of not meeting expectations, of being “found out” as not good enough. In Singapore’s achievement-oriented education culture, this one is extremely common.
- Specific fears, a particular teacher, a bully, PE class, being called on in front of others.
What it looks like: Physical complaints that are worst in the morning and improve at home. Tearfulness or panic before school. Bargaining (“Can I go late?” “Can I skip just today?”). Avoidance that gradually expands, first it’s one subject, then a whole day, then multiple days.
What many parents miss: Anxious children are often compliant children. They’re not acting out. They’re suffering quietly, and the school refusal is the point where the distress has exceeded their capacity to push through.
2. Depression
Depression in children and adolescents does not always look like sadness. In younger children, it often presents as irritability, anger, or withdrawal. In teenagers, it can look like apathy, sleeping too much, losing interest in things they used to enjoy, or a persistent sense that nothing matters.
What it looks like: Your child may have lost motivation across the board, not just for school, but for friends, hobbies, and activities they previously enjoyed. They may seem flat, empty, or cynical. Their sleep patterns may have changed significantly. They may say things like “What’s the point?” or “I don’t care.”
How it differs from anxiety: Anxious children usually want to go to school but feel unable to. Depressed children often genuinely don’t see the point. Anxiety drives avoidance of something specific; depression drains the energy and motivation for everything.
An important note for parents in Singapore: A Duke-NUS and IMH study found that youth with depression and anxiety symptoms missed an average of 24 school days per year, and their academic performance dropped by an estimated 63%. This is not a small problem, and early intervention matters.
3. A Combination, and Often Something Else Underneath
Here is what I want every parent to understand: in clinical practice, it is rarely just one thing.
A child might be anxious and depressed. They might have undiagnosed ADHD that makes sitting through classes genuinely difficult, which leads to poor performance, which leads to anxiety about school, which leads to avoidance. They might be dealing with a social situation, bullying, friendship breakdowns, feeling like an outsider, that has triggered a depressive episode.
The behaviour (not going to school) is the surface. Underneath it, there’s usually a combination of factors that need to be carefully untangled.
When to Worry, and When to Act
Not every difficult morning is a clinical problem. Children go through phases. Transitions are hard, starting a new school, returning after holidays, adjusting after exams.
Consider seeking professional help if:
- The pattern has persisted for more than two weeks and is not improving
- Your child’s distress is escalating (more intense, more frequent, harder to manage)
- They are missing significant school time (more than a few days per month)
- You are seeing changes in sleep, appetite, mood, or social behaviour beyond the school refusal itself
- They have expressed feelings of hopelessness, worthlessness, or not wanting to be alive
- Your own strategies (reassurance, incentives, consequences) are not working or making things worse
What Not to Do
I say this with compassion, because I know parents are doing their best:
- Don’t force your child to school through punishment or shaming. If anxiety is the driver, this increases the threat level and often makes the avoidance worse.
- Don’t let them stay home indefinitely without a plan. The longer a child is out of school, the harder the return becomes. Avoidance reinforces avoidance.
- Don’t assume you know the reason. I have seen many families where the parent was certain it was bullying, but the assessment revealed an anxiety disorder. Or where the parent thought it was “laziness,” but the child was clinically depressed.
- Don’t wait for it to resolve on its own. Research is clear: early intervention produces better outcomes (Heyne et al., 2002).
What Helps
The evidence base for treating school refusal is strong. Cognitive-behavioural therapy (CBT) is the most well-supported approach, and it typically involves:
- Understanding the function of the avoidance, what is your child gaining by staying home, and what are they avoiding at school?
- Gradual exposure, a structured, step-by-step plan to re-engage with school, starting with what’s manageable and building up
- Skills training, teaching your child concrete strategies for managing anxiety, low mood, or social difficulties
- Parent coaching, helping you respond in ways that support recovery rather than accidentally maintaining the avoidance cycle
- School collaboration, working with teachers and counsellors to create a supported return plan
This is not a quick fix. But with the right support, most children can and do return to school successfully.
A Note from My Own Experience
I have ADHD. I know what it’s like to sit in a classroom where your brain doesn’t cooperate. I know what it’s like to feel like you’re working twice as hard as everyone else just to keep up. And I know that when adults don’t understand what’s going on inside, their well-intentioned responses can make a child feel more alone, not less.
If your child is refusing school, they are telling you something. The most important thing you can do is listen, not just to their words, but to the behaviour itself, and then get the right help to understand what’s underneath.
If your child is struggling with school refusal, I can help. I work with children, adolescents, and their families to understand what’s driving the avoidance and build a structured plan for recovery. Book a consultation →
Not sure if your child needs professional support? Try one of our free, validated screening tools:
Dr. Ong Mian Li is a US-trained clinical child and adolescent psychologist practising in Singapore. He holds a Ph.D. from UNC Chapel Hill and completed a postdoctoral fellowship at the Mayo Clinic. He is the founder of Lightfull Psychology Practice.
References
Kearney, C. A., & Albano, A. M. (2004). The functional profiles of school refusal behavior: Diagnostic aspects. Behavior Modification, 28(1), 147–161.
Heyne, D., King, N. J., Tonge, B. J., Rollings, S., Young, D., Pritchard, M., & Ollendick, T. H. (2002). Evaluation of child therapy and caregiver training in the treatment of school refusal. Journal of the American Academy of Child & Adolescent Psychiatry, 41(6), 687–695.
Chodavadia, P., Teo, I., Poremski, D. et al. (2023). Healthcare utilization and costs of Singaporean youth with symptoms of depression and anxiety. Child and Adolescent Psychiatry and Mental Health, 17, 60.