The role of bullying in suicide among our young people has been intensely scrutinized in both media and research. As the deleterious impacts on mental and physical health for both perpetrators and targets—suicide being the most severe—become more evident, calls for framing of the problem from a public health framework have increased. A scientifically grounded educational and public health approach to both bullying and suicide prevention is required.
So let’s look at the science regarding the connection between bullying and suicide. As with most highly emotional phenomena, there has been a tendency to both overstate and minimize the connection. As Jeffrey Duong and Catherine Bradshaw point out: while the prevalence of bullying is high (approximately 20% to 28%), “most children who are bullied do not become suicidal.” At the same time, children who have been bullied have an increased risk of mental and physical problems. Melissa Holt warns us that bullying should be considered one of several factors that increase a young persons risk for suicide. We must be careful, though, not to confuse correlation with causation. That is to say, that bullying most typically has an indirect effect on a young person taking their life, rather than being the sole cause. Finally, the suicide rate (both attempts and completions) among our young people is unacceptably high and requires systematic efforts for prevention and intervention.
Bullying is an abuse of power. By definition, bullying is seen as behavior that is intended to be hurtful and targets individuals perceived to be weaker and unable to defend themselves. Bully can be direct and face-to-face, or may be conducted through social media. Amanda Nickerson and Toni Orrange Trochia reviewed recent research showing that all children involved in bullying (targets, perpetrators, and those who are both) are at higher risk for mental health problems and subsequently higher risk for suicidal behavior. This risk increases with repeated involvement in bullying and, for targets, the belief that they are alone in their plight. At the same time, social environments (community, school, family, peer) that support differences and caring relationship provide greater protection from the harmful effects of bullying.
While the question of who gets bullied and why is complicated, we know that some groups are more likely to be the target of bullying than others. Those children who present themselves as “different” are more likely targets than those who fit in comfortably to school norms. Children from stigmatized or marginalized groups, including those with psychiatric problems, physical disabilities, sexual and gender minorities, are at higher risk for being targets of bullying and for suicidal behavior. Again, individuals from stigmatized groups with higher community, school, and family support fare better than those who perceive themselves to face torment alone.
A cultural perspective is important to understand the connection between bullying and suicide. The research on the complexity of ethnic differences in bullying and suicide is sparse and in some cases contradictory. By paying attention to bullying behaviors that happen between people of different ethnic groups and those that exist within the same ethnic group, a clearer picture arises. Different cultural patterns related to aggression and emotion expression help to understand and decode what behaviors warrant being labeled “bullying” within different cultures. Differences between ethnic groups of youth need to be taken into consideration when trying to understand whether bullying and/or suicidal behavior are on the increase. Finally, specific care and attention must be paid to the risk of both suicide and bullying among sexual and gender minority youth. Both of these groups are among the highest at risk.
In conclusion, even one suicide death that is triggered by a recent torment of bullying is too many. As we move to better our responses to the threat of suicide due to bullying, we are assisted by the careful scientific exploration of differential risk and protective factors. By taking community oriented, culturally informed approaches, we believe that current interventions can be improved and new interventions can be created.