Bullying is a public health issue

Two fascinating recent studies have highlighted the links between the experience of bullying and later mental and physical health problems.
The latest was press released this morning, and can be read here Arsenault paper.

It shows with convincing data, good controls and appropriate design that the bullied cohort do significantly worse in physical terms, with obesity rates of 26% rather than 19%, and increased inflammation (linked with heart disease and stroke). It’s a shame that the team have made silly claims about eliminating 12% of obesity, but it’s still a strong contribution to the field.

Equally, you don’t have to buy the conclusion of the Wolke et al paper from April that bullying is more damaging to psychological health than abuse and neglect, to appreciate that their days clearly shows the bullied cohort have significant problems, with rates of depression, for example, increased from 5% to 11%.

Now, about two hours after a paper like this is released there is an orderly queue of people pointing out that correlation does not imply causation. Quite right. But irrespective of the academic arguments, when confronted by someone who reports bullying, we now have good data that they have worse outcomes in physical and psychological terms. So we have the opportunity to examine their needs holistically, and intervene early to mitigate these harms.

But what about stopping bullying? Yes, we should make people aware of the potential impact, we should think deeply about social media, and clearly when there is evidence of bullying in a school they must, and do, act.

But responding to either individual complaints of bullying or a population problem with a quasi-legal investigation, stamping out the problem with ‘zero tolerance’ policies and social media bans, is the wrong way to approach the problem.

The problem is that bullying is a subjective experience, and there are vast grey areas around it.  If you just try to tackle it as a behaviour, you get several unwanted effects. Firstly, those accused will quickly become defensive,  secondly, teachers feel under pressure, especially when they don’t see overt bullying and yet it is still reported:  I for one am tired of headteachers proclaiming “there is no bullying in my school” but this is an understandable reaction to a problem they cannot solve because they don’t understand it. Finally, when the bullies have been identified (rightly or wrongly) the bullied person is told that the bad guys have been caught, told off, and it’s all over, but the underlying issues are usually ignored or minimised by this approach, because it is assumed that removing the bullying is enough.

It’s not enough, and we will never ‘stamp out’ bullying. Only by adopting a public health approach, recognising the experience of bullying as an adverse event with consequences for the person, and acting early to support their needs, can we start to correct this significant brake on good health.

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