Why more Swiss children are seeing doctors over school problems

Forty-four per cent of Swiss paediatricians encounter school-related problems at least once a day. That figure places the doctor’s surgery inside a problem many families first experience in a classroom, a playground or on the journey to school.

The finding comes from a study by gfs.bern, commissioned by Stiftung Mercator Schweiz. Researchers surveyed 469 practising paediatricians and conducted 17 interviews with specialists in education, psychology and medicine. Among doctors who treat school-related difficulties, 89% say the cases have increased during their careers.

Children arrive with symptoms that can be difficult to separate from the circumstances around them. Younger pupils may complain of stomach aches, behave disruptively or struggle to concentrate. Older children can develop depressive moods, eating disorders, self-harm or suicidal thoughts connected to school problems.

The survey does not claim that school itself makes children ill. Education specialists stress that school can offer structure, belonging and protection. The pressure emerges when the demands of school, the child’s development and the relationships around them fail to fit together. In Switzerland, paediatricians are often among the first professionals with the time and mandate to recognise that something has gone wrong.

Among pupils in years seven to nine, 75% of paediatricians frequently encounter depressive moods linked to school problems. The same group of doctors reports eating disorders in 58% of cases, self-harm in 54% and suicidal thoughts in 51%.

These figures describe doctors’ reported experience, rather than the share of all Swiss pupils affected. They show how the character of school-related distress changes as children move into adolescence, when academic demands, social comparison and decisions about future education become more prominent.

Concentration and attention problems remain common across age groups. For younger children, distress may appear through physical complaints or difficult behaviour. Such symptoms can send families to a paediatrician even when the underlying problem involves bullying, exclusion, classroom expectations or a breakdown in trust with a teacher.

The report identifies several pressures at work. Paediatricians frequently mention performance pressure. Specialists interviewed for the study also point to marks, selection and comparison on social media. Reducing performance and selection pressure is viewed across the professional groups as one of the most promising interventions. That conclusion shifts attention towards how schools organise assessment and progression, alongside the support available when a pupil begins to struggle.

Seventy per cent of paediatricians frequently suspect a strained teacher-pupil relationship in school-related cases. A further 60% point to frequent changes of teacher. Those findings place continuity and trust alongside academic ability when doctors assess why a child is struggling.

The study also highlights bullying and social exclusion, a mismatch between schoolwork and a child’s level, and conflict with teachers. No single cause explains the pattern. A child’s experience is shaped by classmates, teaching methods, school organisation, family circumstances and wider social pressures.

A stable relationship with a teacher can protect younger children and help staff notice changes early. Repeated changes can make it harder for pupils to build that trust. They can also increase the strain on teachers who must repeatedly learn the needs of a class.

The report recommends strengthening existing support rather than relying on diagnosis as the first gateway to help. Paediatricians say some school problems could be prevented more effectively through educational measures. Yet a formal diagnosis can become the route to therapy, additional resources or classroom accommodation. The authors call for low-threshold educational support before a diagnosis is required, giving children and teachers assistance while difficulties are still manageable.

Nearly one in three paediatricians has seen developmental difficulties recognised before enrolment and then insufficiently accounted for at school. The transition from early support into compulsory education can therefore leave gaps precisely when a child’s needs should be carried forward.

Switzerland already has relevant services. Paediatric practices, early special-education provision and parental counselling can all identify concerns or help families respond. The report says these services are often poorly connected, leaving parents to navigate the handover between health, education and social support.

The study favours teaching environments that accommodate variation from the outset. It also points to later grading and later academic selection where possible, measures intended to reduce the pressure created by early judgments about a child’s capacity.

One proposal is permanent team-teaching by two qualified professionals. Such a model could offer pupils greater continuity and give teachers more capacity to respond when a child falls behind, withdraws or begins to act out. The practical challenge is familiar across Swiss public services: co-operation requires time, qualified staff and money. Asking professionals to collaborate more closely cannot solve shortages by itself.

Doctors, teachers and mental health specialists are already working together, yet collaboration often begins after a child’s problems have become serious. The survey points to a system that frequently waits for a crisis before assembling the people who could have supported the child earlier.

Paediatricians may refer children to psychologists or psychiatrists. Schools may involve specialist staff, families or education authorities. Each step can be useful, but delays matter when a pupil is refusing school, losing weight, self-harming or speaking about suicide. Early, accessible educational support could reduce the pressure on medical services and prevent some cases from requiring a clinical label before help arrives.

The findings give Swiss cantons and municipalities a practical agenda. They can improve the handover from early childhood services to schools, reduce unnecessary teacher turnover, strengthen classroom support and examine the effects of marks and selection on pupils. Schools also need clear routes for families seeking help before symptoms become severe.

Paediatricians will continue to see the consequences of school distress. The report asks Switzerland to improve the support surrounding children so that the doctor remains an important safeguard, while the classroom becomes a more effective place to identify and address problems early.