Four per cent of children do not want to go school most or all of the time. Sam was one such child.
But when Sam stopped bringing a basketball to school, his mother knew things were looking up.
Sam was attending a small, six-month program at mental health-focused Travancore School to help him attend a mainstream school regularly.
His mother Suzanne said Sam was nervous at first and would bring along his basketball.
"Eventually he would go with nothing," she said. "That was a huge sign that he was starting to feel better, that he didn't need to have something in his hands to keep him occupied."
Suzanne said "beautiful" teachers and counsellors built Sam's confidence through intensive care and support.
"He was so happy to go there, and in the end he was ready to not go there any more." Sam now attends a mainstream school.
School attendance is compulsory to at least 17 years of age across Australia. But persistent school refusal - which is complex and often distressing for children and their families - has become increasingly prevalent, said Travancore School principal Judy Ring.
"We've been seeing more young people coming into mental health services with some form of school attendance issues," she said. "Everyone is saying more and more of our work is sitting in this space than, say, 10 years ago," she said.
School refusal may take the form of refusing to attend specific classes, school camp or school altogether, said Monash University's Dr Kelly-Ann Allen.
"Students may refuse to get dressed in their school uniforms or get out of bed in the morning," said Dr Allen, who worked as a school psychologist.
"They may refuse to travel in the car or leave the car when they arrive at school. It is not unusual for school psychologists or teachers to be called to carparks to assist parents in coaxing their children out of the car."
Dr Allen said school refusal hurt academic achievement and relationships with peers and teachers.
According to Australian research, parents or primary carers say 3 per cent of primary school students and 5 per cent of secondary school students persistently refuse to attend school due to severe emotional distress or fear.
Of the children who refuse to go to school, 78 per cent have a mental health disorder, primarily anxiety, said lead author Associate Professor David Lawrence of the University of Western Australia.
"There isn't just one reason why kids refuse school. Some kids are acting out, some kids have behavioural problems and anger issues, and you have the anxious group as well," Associate Professor Lawrence said.
The research found children with mental health issues were much more likely to miss school, and miss more days as they get older.
They are absent almost 12 days a year in years 1-6, then 23 days in years 7-10, and almost 26 days in the senior years.
By comparison, students without mental disorders were absent an average eight days in years 1-6, almost 11 days in years 7-10, and 12 days in senior years.
"In the secondary school years, over one-fifth of males and one-third of females with a mental disorder were absent for more than 20 days in the course of the school year," the report stated.
"This level of absence can be considered substantial, as it is likely to have a significant impact on students’ learning, which may place their mental health and other outcomes at further risk."
The figures are from the recent Australian Child and Adolescent Survey of Mental Health and Wellbeing, which was based on more than 5000 children aged between four and 17 years attending an Australian school.
Sam attended the In2School intervention program run by Travancore School, the Melbourne Graduate School of Education and Royal Children's Hospital Mental Health.
The program is available to children aged 11-14 who have missed large chunks of school and have diagnoses of anxiety and/or mood disorders.
Students work with teachers and clinicians and practice being in a classroom. They are encouraged to go back to their mainstream school, whether it be for a day or even a half day. Once students finish the program, the program helps their schools to maintain momentum.
Melbourne University's Dr Lisa McKay-Brown, a former Travancore School teacher who developed the program, said about 71 per cent of attendees were attending school full-time six months after the program.
This was an "excellent" result given many hadn't been at school for anywhere from three months to beyond 12 months.
She said the students and their families reported their quality of life had improved. In addition, students' mental health improved to the point that most were discharged from their mental health service about three to four months after returning to school.
Suzanne said young people who refused to go to school were "made to feel like they're not great".
"It's something that is more common than they realise and I think these kids need to realise it, too, because they're great young people."