Home » Many Reasons Why Bullied Teens Don't Seek Mental Health Services, Study Finds

From the American Academy of Pediatrics

Many Reasons Why Bullied Teens Don't Seek Mental Health Services, Study Finds

Better communication needed between medical providers, school officials and parents to remove barriers to help for middle and high school students.

While nearly one in three U.S. adolescents are affected by bullying, placing them at risk for health problems including attention deficit hyperactivity disorder, anxiety, depression and self-harm, fewer than a quarter of these teens receive help. New research identifies some of the reasons why.

Researchers, presenting at the American Academy of Pediatrics (AAP) 2015 National Conference & Exhibition in Washington, DC, surveyed 440 students in high school and middle school in Cumberland County, North Carolina. Mirroring national trends, an average of 29 percent of the respondents reported being bullied in the past. Among 11- to 14-year-olds, 54 percent reported being bullied, compared with 46 percent of those 15 to 18 years old.

Many barriers  

Researchers identified 28 barriers to mental health services, 11 of which were specific to respondents who experienced prior bullying. Chief among these was a lack of adequate screening and counseling by medical providers, said Amira El Sherif, MD, FAAP, a private practitioner with Kidzcare Pediatrics in Fayetteville, North Carolina. Other obstacles included school system barriers such as inaction by educators and poor enforcement of investigation procedures, and inadequate school follow-up and communication with parents.

Findings from the study, funded by an AAP Community Access and Child Health planning grant, have major implications for improving access to mental health services for victims of bullying, Dr. El Sherif said.

"As a pediatrician, this study reminded me that we can always do more for our patients," Dr. El Sherif said. "Bullying should become a part of the normal conversation in the office. Doctors, parents and school officials should also work together to address bullying when it occurs and to make sure mental health services are accessible when needed."

Schools also need training programs that include frequent evaluations to ensure quality standards are consistently met, Dr. El Sherif said.  Overall, improving communication between medical providers, school officials and parents would allow for a team approach to bullying, which would improve mental health screening and access to services, she said.

Middle and high school students who are both bullies and victims of bullying are three times more likely than students who are neither to seriously consider suicide, intentionally injure themselves, report being physically abused by a family member, witness violence in their family, and to use drugs and alcohol, says the Centers for Disease Control and Prevention (CDC).

Strong link between bullying and mental health problems 

Multiple studies have documented the association between substance use, poor academic achievement, mental health problems, and bullying, and a small but growing body of research suggests that family violence is also associated with bullying. 

"Bullying is a pervasive public health problem requiring comprehensive solutions," said the CDC report. "The results underscore the importance of primary bullying prevention programs and of comprehensive programs and strategies that involve families.

Although evidence of bullying prevention programs changing behavior among U.S. students is mixed,7 several violence prevention programs and strategies, including some involving families, have demonstrated effectiveness in decreasing violent behavior," the report notes.

In May 2010, Massachusetts joined 44 other states with similar laws by enacting a comprehensive bullying prevention law that covers all types of bullying and requires all school districts to develop, adhere to, and update a plan to address bullying prevention and intervention in consultation with school staff members, families, and community members.

To assist schools in their efforts to implement comprehensive strategies to prevent bullying, other types of violence, and unintentional injuries, the CDC developed School Health Guidelines to Prevent Unintentional Injuries and Violence.

These guidelines include the following recommendations:

  • establish a social school environment that promotes safety;
  • provide access to health and mental health services;
  • integrate school, family, and community prevention efforts; and
  • provide training to enable staff members to promote safety and prevent violence effectively.

Because bullying is associated with many other risk factors, including exposure to violence outside of the school setting, comprehensive strategies that encompass the school, family, and community are most likely to be effective

To assist schools and communities in their efforts to prevent youth violence, including bullying, the CDC launched the national initiative, Striving To Reduce Youth Violence Everywhere (STRYVE), which promotes increased awareness that youth violence can be prevented using strategies based on the best available evidence. Links to resources are available on the STRYVE website


American Academy of Pediatrics 

Abstract.  "Barriers to Mental Health Access for Students Affected by Bullying,"  Sherif AE, Trent EN, Snider J,  Khazanchi A, Sherry S Abbey B, Jain A. Presented at American Academy of Pediatrics National Conference and Exhibitition, Washington, D.C. October 24-27, 2015.    

McKenna M, Hawk E, Mullen J. Bullying Among Middle School and High School Students -- Massachusett, 2009.  MMWR (2011). 60(15);465-471.

Posted October 23, 2015