Bullying and Suicide: Are they really related?

This topic is really hard to write about. Or even think about. I don’t really know why I have chosen to do either.

Bullying and suicide, as all of us know, can be tremendously painful experiences for young people. And both issues – independently - are causes for public concern. But with the extensive media coverage of the deaths by suicide of young people who were victims of bullying, we could almost assume a causal relationship.

The link between the two might be a little more complex than that.

When we talk about bullying we’re referring to the intentional and repeated intimidating behaviour by an individual or group against another person or group, in the context of ongoing social relationships. It can take many forms and can occur in a ‘real’ or virtual environment. Bullying that occurs face-to-face can be verbal, physical, relational/social, and indirect (involving a third party). Cyber-bullying involves intimidating behaviour or degradation via technological resources such as mobile phone text messages, email, chat rooms/discussion groups and online social networking sites. Methods of bullying tend to overlap, so often if young people are cyber-bullied that also tend to be bullied face-to-face.

Bullying can be seen as a significant public health problem because it is prevalent and harmful. Australian data reveal that 1 in 8 young people have experienced verbal bullying over the past school term and half of year 8 students reported being victimised in a large-scale Victorian survey. Around 10% of Australian students have reported being cyber-bullied. In 2010, bullying was ranked the third highest issue of concern for 11 to 14 year olds. Specific subgroups are more likely to be victimized. For example, in one survey bullying victimization was found to be more prevalent upon lesbian and gay youth—60% reported victimization during the past 30 days prior to the survey compared with 28.8% of heterosexual youth.

For young people involved in bullying in any capacity—youth who bully others, who are bullied, or who both bully and are bullied - this involvement is correlated with poor mental and physical health and engagement in other risk behaviours. Youth who are bullied are more likely to be depressed or anxious, have lower academic achievement, report feeling like they do not belong at school, have poorer social and emotional adjustment, greater difficulty making friends, poorer relationships with classmates, and experience greater loneliness. Bully-victims (those who bully and are bully) are more likely than those who bully, those who are bullied, or their uninvolved peers, to report being physically hurt by a family member, to witness family violence, and exhibit suicide-related behaviours. Those who bully others are more likely to drink alcohol and use cigarettes, to have poorer academic achievement and poorer perceived school climate, but to also report greater ease of making friends.

Involvement in bullying can also have long-lasting, detrimental effects months or even years after the bullying occurs. Young people who are bullied are more likely than uninvolved youth to develop depression and anxiety and report abdominal pain and feeling tense over the course of a school year. One study examining the impact of bullying victimization of those who were between 9, 11, and 13 years of age when they were victimized found, that over a 7-year period, youth who were bullied were more likely to develop generalized anxiety and panic disorder as adults while bully-victims were more likely to subsequently suffer from depression, panic disorder, and suicidality. Another longitudinal study found that those who were perpetrators of bullying at age 14 were more likely to receive a diagnosis of antisocial personality disorder, to have low job status at age 18 years, and to use drugs at ages 27–32 years.

Many studies have examined the relationship between bullying and suicidality, which includes suicidal thoughts and behaviours. One recent meta-analysis – a study that rounds up all the studies to date on the topic – examined 47 studies on bullying and suicide among students in K-12 settings. The studies were from a number of countries including the US, China, Australia, the UK and Finland. The meta-analysis found:

  • Overall, youth involved in bullying in any capacity were more likely to think about and attempt suicide than youth who were not involved in bullying.
  • The studies showed that bullies and bully-victims (youth who bully others and are also bullied themselves) all reported more suicidal thoughts and behaviours that those who were not involved in bullying.
  • Bullying and suicidality were most strongly related for bully-victims. This suggests that bully-victims are a group at a particularly high risk for experiencing mental health issues.

So, it appears there is a link between bullying and suicidal thoughts and behaviours. But it’s not just a relationship between the person who is being bullied and feeling suicidal. It’s to do with everyone involved. And there’s also some other things that might need to be considered.

For example, one study of fifth through eighth graders found that youth with no involvement in bullying reported significantly fewer thoughts of suicide and suicidal behaviours than youth who were involved in bullying in any way. However, once depression and delinquency (engaging in illegal behaviours) were considered, there were only small differences between youth who were not involved in bullying and kids who were targets of bullying and between these uninvolved kids and bully-victims. Another study has highlighted the role of low self-esteem and depression as factors contributing to suicidal ideation for sexual minority and heterosexual youth who had been bullied.

So after all of this analysis we can’t really do not know if bullying directly causes suicide-related behaviour. We know that most youth who are involved in bullying do NOT engage in suicide-related behaviour. It is correct to say that involvement in bullying, along with other risk factors, increases the chance that a young person will engage in suicide-related behaviours.

When we focus attention on the relationship between bullying and suicide it can have some positive impacts. It can raise the awareness of the serious harm that bullying can do to all the youth involved in bullying in anyway and it can highlight the significant risk for some of our most vulnerable youth.  

The risk though, is that if the discussion of the issue is of bullying being a single, direct cause of suicide it can be unhelpful and potentially more harmful. There’s the risk that that the increased attention could perpetuate the false notion that suicide is a natural response to being bullied which has the dangerous potential to normalise the response and thus create copycat behaviour among youth and it may encourage further sensationalized reporting. Furthermore, the focus of the response on blame and punishment can become misdirected from getting the required support and treatment to those who are bullied as well as those who bully others.

While a young person’s death by suicide is a tragedy and both bullying and suicide-related behaviour are serious public health problems, our response to such situations must reflect a balanced understanding of the issues informed by the best available research.

So, if bullying doesn’t directly cause suicide, what do we know about how bullying and suicide are related?

Circumstances that can affect a person’s vulnerability to either or both of these behaviors exist at a variety of levels of influence—individual, family, community, and society. These include:

  • emotional distress
  • exposure to violence
  • family conflict
  • relationship problems
  • lack of connectedness to school/sense of supportive school environment
  • alcohol and drug use
  • physical disabilities/learning differences
  • lack of access to resources/support.

If, however, young people experience the opposite of some of the circumstances listed above (e.g. family support rather than family conflict; strong school connectedness rather than lack of connectedness), their risk for suicide-related behaviuor and/or bullying others—even if they experience bullying behaviour—might be reduced. These types of circumstances/situations or behaviours are what we sometimes call “protective factors.”

In reality, most people will have a combination of risk and protective factors for both bullying behaviour and suicide-related behaviour.

And this is one of the reasons why we need to remember that the relationship between the two behaviours and their health outcomes is not simple. The ultimate goal of any prevention efforts is to reduce risk factors and increase protective factors as much as possible.

BUT, I suppose if I did have to sum it up as simply as possible it’d be this - The bottom-line of the most current research findings is that being involved in bullying in any way—as a person who bullies, a person who is bullied, or a person who both bullies and is bullied (bully-victim)—is ONE of several important risk factors that appears to increase the risk of suicide among youth.

I knew that would be hard.

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