In today's online supplement to the Journal of Adolescent Health, experts from the U.S. Centers for Disease Control and Prevention reviewed studies on the links between bullying, depression and suicide in youth.
Between 20 and 56 per cent of young people are involved in bullying annually, as either a victim or perpetrator, or both, the review estimated.
"It is not inevitable that bullying results in suicide; nor is it inevitable that bullying will occur in the first place," editor Marci Feldman Hertz of the CDC concluded.
They suggested that teachers, school administrators and health experts "consider broadening their focus beyond just providing services to those who are already involved in bullying or suicide-related behaviours, but also in implementing strategies to preventing bullying and suicidal behaviours from occurring in the first place."
Last month, mental health experts writing in the Canadian Medical Association Journal about student suicide called for school-wide interventions rather than focusing on the close friends of the suicide victim.
The journal's editors said three key themes emerged from the international research:
- Bullying among youth is a significant public health problem.
- There is a strong association between bullying and suicide-related behaviours, but that other factors such as depression and delinquency are also connected.
- Public health strategies can be applied to prevent both bullying and suicide.
Strengthening social connectedness such as supportive home and school environments, boosting individual coping skills and ensuring access to caring adults may pay dividends in both bullying and suicide, they said.
They noted poor mental and physical health among victims and perpetrators of bullying and those who experience both.
Studies suggest that bullying can have long-lasting, harmful effects, such as depression, anxiety, abdominal pain and tension months or even years later.
Lesbian and gay youth are more commonly victims, with 60 per cent reporting victimization during the past 30 days in one survey compared with 28.8 per cent of heterosexual youth.
In one study, people who witnessed bullying but were not directly involved were more likely to report systems such as hurt feelings, inferiority and helplessness.
As for the question of whether youth who are bullied become depressed or if depressed youth are more likely to be bullied, a Dutch study suggested the answer may be both.
Victims of bullying were much more likely to develop new psychosomatic and psychosocial problems over a school year compared with children who were not bullied, but those with pre-existing depressive symptoms or anxiety were also more likely to be victimized for the first time.