AAP: Bullied adolescents face mental health care barriers

One of the biggest barriers to mental health services for victims of bullying is the fact that too few medical providers are screening adolescents for bullying, according to a recent study.

“Efforts are needed to encourage medical providers to screen for bullying and to refer to mental health services when necessary,” said Dr. Amira El Sherif of KidzCare Pediatrics in Fayetteville, N.C. The study by Dr. El Sherif and her colleagues was presented at the annual meeting of the American Academy of Pediatrics.

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“There is also a continuous need for school training programs to ensure staff respond appropriately to bullying incidents, and that investigation procedures are followed,” Dr. El Sherif said in an interview, echoing her research team’s conclusions. “Finally, it is critical to streamline a process of communication between medical providers, school officials, and parents to allow for a team approach to bullying,” she said.

Almost 30% of U.S. adolescents are involved in bullying, which is linked to various mental health conditions, such as attention-deficit/hyperactivity disorder, anxiety, self-harming behaviors, suicidal thoughts, and suicide attempts, the researchers noted. Yet only one in five children who need mental health evaluations actually receive services.

To learn what factors are contributing to poor access to services, Dr. El Sherif and her associates conducted focus groups with bullying victims and their parents as well as interviews with teachers and community mental health providers. Based on the findings from these interviews and focus groups, the team developed a survey they administered to 440 middle school and high school students in Cumberland County, N.C. Among these students, 29% said they had been victims of bullying in the past.

All the students rated answers to questions on a Likert scale which assigned 5 points to the greatest potential barrier to receiving mental health services. Of the 28 barriers reported, students who had previously been bullied reported 11 more often.

“Our study showed that the biggest barriers to mental health care were the lack of screening and counseling about bullying by medical providers,” Dr. El Sherif said in the interview. “There were also school system challenges, including inaction by school personnel and poor enforcement of investigation procedures. Inadequate school follow-up and communication with parents were other major obstacles.”

Among barriers with the highest scores from adolescents who had been bullied were not having the school investigate the bullying incident, and the teen’s doctor not talking to the school or counseling the student.

Because the study was limited to one North Carolina county, it is not clear how generalizable the findings are, Dr. El Sherif said, indicating the need for larger, more nationally representative studies.

“We noted that girls were more likely to be bullied than boys,” Dr. El Sherif said. “Larger studies may be necessary to ascertain differences between racial/ethnic groups.”

In this study, 55% of respondents were male, but 44% of those who reported being bullied were male. Although girls made up 45% of the sample, they represented 56% of those who said they had been bullied. Among all the respondents, 18% were white, 65% were black, 5% were Latino, 1% were Asian, and 11% were of another race/ethnic group.

The implications of the study, however, still apply to children across the United States, Dr. El Sherif suggested.

“In general, all children should be screened for mental health concerns during their annual physicals, particularly children with risk factors for mental health sequelae such as bullying,” she said.

Parents also have an important role to play in helping their children if they have been bullied, Dr. El Sherif said.

“Parents are a child’s primary advocate both at home and out in the world,” she said. “They should provide support and advice to their child at home on how to handle bullying, report the incident to the school, and seek help from their pediatrician if they feel that bullying is affecting their child’s everyday life.”

No disclosures or external funding were reported.

One of the biggest barriers to mental health services for victims of bullying is the fact that too few medical providers are screening adolescents for bullying, according to a recent study.

“Efforts are needed to encourage medical providers to screen for bullying and to refer to mental health services when necessary,” said Dr. Amira El Sherif of KidzCare Pediatrics in Fayetteville, N.C. The study by Dr. El Sherif and her colleagues was presented at the annual meeting of the American Academy of Pediatrics.

©monkeybusinessimages/Thinkstock.com

“There is also a continuous need for school training programs to ensure staff respond appropriately to bullying incidents, and that investigation procedures are followed,” Dr. El Sherif said in an interview, echoing her research team’s conclusions. “Finally, it is critical to streamline a process of communication between medical providers, school officials, and parents to allow for a team approach to bullying,” she said.

Almost 30% of U.S. adolescents are involved in bullying, which is linked to various mental health conditions, such as attention-deficit/hyperactivity disorder, anxiety, self-harming behaviors, suicidal thoughts, and suicide attempts, the researchers noted. Yet only one in five children who need mental health evaluations actually receive services.

To learn what factors are contributing to poor access to services, Dr. El Sherif and her associates conducted focus groups with bullying victims and their parents as well as interviews with teachers and community mental health providers. Based on the findings from these interviews and focus groups, the team developed a survey they administered to 440 middle school and high school students in Cumberland County, N.C. Among these students, 29% said they had been victims of bullying in the past.

All the students rated answers to questions on a Likert scale which assigned 5 points to the greatest potential barrier to receiving mental health services. Of the 28 barriers reported, students who had previously been bullied reported 11 more often.

“Our study showed that the biggest barriers to mental health care were the lack of screening and counseling about bullying by medical providers,” Dr. El Sherif said in the interview. “There were also school system challenges, including inaction by school personnel and poor enforcement of investigation procedures. Inadequate school follow-up and communication with parents were other major obstacles.”

Among barriers with the highest scores from adolescents who had been bullied were not having the school investigate the bullying incident, and the teen’s doctor not talking to the school or counseling the student.

Because the study was limited to one North Carolina county, it is not clear how generalizable the findings are, Dr. El Sherif said, indicating the need for larger, more nationally representative studies.

“We noted that girls were more likely to be bullied than boys,” Dr. El Sherif said. “Larger studies may be necessary to ascertain differences between racial/ethnic groups.”

In this study, 55% of respondents were male, but 44% of those who reported being bullied were male. Although girls made up 45% of the sample, they represented 56% of those who said they had been bullied. Among all the respondents, 18% were white, 65% were black, 5% were Latino, 1% were Asian, and 11% were of another race/ethnic group.

The implications of the study, however, still apply to children across the United States, Dr. El Sherif suggested.

“In general, all children should be screened for mental health concerns during their annual physicals, particularly children with risk factors for mental health sequelae such as bullying,” she said.

Parents also have an important role to play in helping their children if they have been bullied, Dr. El Sherif said.

“Parents are a child’s primary advocate both at home and out in the world,” she said. “They should provide support and advice to their child at home on how to handle bullying, report the incident to the school, and seek help from their pediatrician if they feel that bullying is affecting their child’s everyday life.”

No disclosures or external funding were reported.

One of the biggest barriers to mental health services for victims of bullying is the fact that too few medical providers are screening adolescents for bullying, according to a recent study.

“Efforts are needed to encourage medical providers to screen for bullying and to refer to mental health services when necessary,” said Dr. Amira El Sherif of KidzCare Pediatrics in Fayetteville, N.C. The study by Dr. El Sherif and her colleagues was presented at the annual meeting of the American Academy of Pediatrics.

©monkeybusinessimages/Thinkstock.com

“There is also a continuous need for school training programs to ensure staff respond appropriately to bullying incidents, and that investigation procedures are followed,” Dr. El Sherif said in an interview, echoing her research team’s conclusions. “Finally, it is critical to streamline a process of communication between medical providers, school officials, and parents to allow for a team approach to bullying,” she said.

Almost 30% of U.S. adolescents are involved in bullying, which is linked to various mental health conditions, such as attention-deficit/hyperactivity disorder, anxiety, self-harming behaviors, suicidal thoughts, and suicide attempts, the researchers noted. Yet only one in five children who need mental health evaluations actually receive services.

To learn what factors are contributing to poor access to services, Dr. El Sherif and her associates conducted focus groups with bullying victims and their parents as well as interviews with teachers and community mental health providers. Based on the findings from these interviews and focus groups, the team developed a survey they administered to 440 middle school and high school students in Cumberland County, N.C. Among these students, 29% said they had been victims of bullying in the past.

All the students rated answers to questions on a Likert scale which assigned 5 points to the greatest potential barrier to receiving mental health services. Of the 28 barriers reported, students who had previously been bullied reported 11 more often.

“Our study showed that the biggest barriers to mental health care were the lack of screening and counseling about bullying by medical providers,” Dr. El Sherif said in the interview. “There were also school system challenges, including inaction by school personnel and poor enforcement of investigation procedures. Inadequate school follow-up and communication with parents were other major obstacles.”

Among barriers with the highest scores from adolescents who had been bullied were not having the school investigate the bullying incident, and the teen’s doctor not talking to the school or counseling the student.

Because the study was limited to one North Carolina county, it is not clear how generalizable the findings are, Dr. El Sherif said, indicating the need for larger, more nationally representative studies.

“We noted that girls were more likely to be bullied than boys,” Dr. El Sherif said. “Larger studies may be necessary to ascertain differences between racial/ethnic groups.”

In this study, 55% of respondents were male, but 44% of those who reported being bullied were male. Although girls made up 45% of the sample, they represented 56% of those who said they had been bullied. Among all the respondents, 18% were white, 65% were black, 5% were Latino, 1% were Asian, and 11% were of another race/ethnic group.

The implications of the study, however, still apply to children across the United States, Dr. El Sherif suggested.

“In general, all children should be screened for mental health concerns during their annual physicals, particularly children with risk factors for mental health sequelae such as bullying,” she said.

Parents also have an important role to play in helping their children if they have been bullied, Dr. El Sherif said.

“Parents are a child’s primary advocate both at home and out in the world,” she said. “They should provide support and advice to their child at home on how to handle bullying, report the incident to the school, and seek help from their pediatrician if they feel that bullying is affecting their child’s everyday life.”

No disclosures or external funding were reported.