In recent years, there has been a growing concern about the issue of school refusal, particularly given the adverse effects on young people’s social, emotional and educational development. School refusal is understood differently within contemporary literature; as a symptom of an underlying mental illness or disorder, or alternatively, as a signal that all is not well in the young person’s world. These varying construal’s have important implications for education responses to school refusal. This study explores education professionals' views and experiences of school refusal within second level schools in Ireland. The findings from seventeen in-depth interviews highlight the complex nature of school refusal and unique challenges it presents for professionals, young people and parents. Key themes include emotional and psychological distress experienced by young people and their exposure to adverse childhood experiences and trauma; the influence of family socio economic status and unequal access to support services and resources; the pressures for academic achievement and resulting conflictual relationships within the school environment and between home and school. This study highlights the need for trauma-informed approaches in schools and urges future research to consider school refusal within wider debates on social justice and the goals and purposes of education.