Bullying and Suicide Risk Behaviors in High School
By Terese Blakeslee
News reports demonstrate that students continue to experience bullying at an alarming rate. According to the Centers for Disease Control and Prevention (CDC), from 2011 to 2017, one in five students across the United States in grades 9-12 reported they have been bullied (CDC, 2018; Kann et al., 2018). Researchers define bullying as an imbalance of power between the victim and perpetrator intending to harm the victim. Bullying, which may be experienced one time or repeatedly, is harmful, and may occur at school, online, or both. Although many prevention strategies have been tried in schools, examination of bullying over time shows that students continue to suffer this form of violence from their more powerful peers.
We conducted a secondary analysis of the Youth Risk Behavior Survey 2011–2017 to identify relationships between adolescent demographic characteristics, suicide risk behavior, and experiences of bullying. We defined suicide risk behaviors as feeling sad or hopeless for more than two weeks, having a plan, seriously considered, and number of times suicide was attempted. Experiencing bullying was operationalized as being carried out on school property, online, or a combination thereof. We found that males and females in grades 9 through 12, as well as White and Non-white students, reported that they had been bullied. In fact, 23% of high school students in our study reported they had been bullied at school or online, or both. Female students were more likely to be bullied on school property and online compared to their male peers. High-school students who reported suicidal risk behaviors were almost five times more likely to have experienced bullying electronically. However, students in ninth grade and female students were more likely than their peers to report suicide risk behaviors and having experienced bullying.
Call to Action for School Nurses
Promoting safe school environments is within the school nurses scope of practice (National Association of School Nurses, 2018). Several strategies have been identified for school nurses to aid in prevention of bullying and suicide:
1. School nurses form therapeutic relationships with students and may be able to identify students who are experiencing bullying (Kvarme et al., 2013) and who exhibit suicide risk behaviors (Bohnenkamp et al., 2015). School nurses typically see a variety of students throughout the day, many of whom may be victims of bullying (Salmeron & Christian, 2016). School nurses should routinely ask students about their well-being when they present to the health room, including asking about bullying (National Academy of Sciences, Engineering, and Medicine, 2016; Perron, 2015).
2. It is important for bullied students to connect with their school nurse (Kvarme et al., 2020). Nurses in schools can be the early-identifiers of students at risk and ensure they receive the appropriate support. School health data can be used to inform policy and decision makers about the prevalence of bullying (Basch, 2011), thereby contributing to early identification and prevention.
3. School nurses have an integral role on the multidisciplinary team working on prevention and early identification of students experiencing bullying (Limber, 2014). On a school community and systems level, school nurses may actively engage in bullying prevention through the development of policies that support students through anti-bullying strategies (Anderson et al., 2018; Kub & Feldman, 2015) and suicide prevention programs (Bohnenkamp et al., 2015). School nurses should have a key role in facilitating support for students and ensuring resources are available (Kim et al., 2020) to prevent bullying and suicide risk behaviors. Positive connections between students and the school staff may reduce the impact of being bullied. Whole school programs such as Link Crew, Problem Behavioral Interventions and Support, and the Olweus Bullying Prevention Program are among the strategies in which school nurses may build supportive relationships with students, staff, and the community.
Findings from our study indicate students in categories across all demographic characteristics experience bullying and suicide risk behaviors. Our search of the literature revealed many ways school nurses can aid in prevention of bullying and suicide risk behaviors at the individual and school community levels. Forming relationships with students and linking them to supportive resources are valuable steps school nurses can take to enhance strategies for early identification and prevention.
Article Details
Adolescent Characteristics, Suicide, and Bullying in High School
Terese Blakeslee, Julia Snethen, Rachel F. Schiffman, Seok Hyun Gwon, Marty Sapp, and Sheryl Kelber
First published online August 16, 2021
DOI: 10.1177/10598405211038235
The Journal of School Nursing
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