Study finds higher risk of self-harm behaviours following bullying at school
Professor Ann John
Dr Sze Chim Lee
Senior Research Data Scientist
“Self-harm prevention interventions should reflect the fact that not all types of bullying are equally linked to self-harm, and focus their efforts on tackling in-person bullying at school.
Self-harm behaviour is common among children and young people, and there is a growing body of research on the relationship between bullying victimisation and self-harm. Unfortunately, most of these studies looked at data at a single point in time, relied on self-reported, unvalidated measures of self-harm, and failed to distinguish between the impacts of in-person bullying and cyberbullying. This study filled such gap by using routinely collected healthcare data as well as self-reported data to examine the relationship between bullying and subsequent self-harm, differentiating between in-person bullying at school and cyberbullying victimisation, and considering a range of other important factors such as mental health status.
The team used data from the Student Health and Wellbeing Survey in Wales obtained in 2017 for school pupils aged 11-16 years. This survey asked pupils about their bullying and cyberbullying experiences as well as other details of their life. At the same time, the team extracted self-harm and other mental health issues from routinely collected data from primary care, emergency departments and hospitals. These data were then linked to compare the risk of future self-harm for school pupils that are 1) not bullied 2) in-person bullied at school only, 3) cyberbullied only or 4) both in-person bullied at school and cyberbullied.
- Approx. 1 in 3 pupils reported being bullied, with the most common form of bullying being in person at school only, followed by both in-person and cyberbullying.
- We found that pupils who experienced in-person bullying at school were twice as likely to self-harm as those who did not, even after considering other risk factors for self-harm.
- When considering all other risk factors, cyberbullying did not seem to increase the risk of future self-harm.
- Like in-person bullying, loneliness also doubled the risk of future self-harm.
This study emphasises the impact of in-person school bullying and other risk factors like female sex and loneliness, on the risk of future self-harm in secondary school pupils. Schools and other professionals working with adolescents should be aware of these risk factors when offering mental health and wellbeing support.
The roles of bullying perpetrators and victims can be complicated and dynamic. The needs of both bullies and their victims should be taken into consideration in intervention programs and programmes aimed at preventing bullying.
Efforts to prevent loneliness, including during the summer months, are also necessary to prevent self-harm in adolescents and could be incorporated into a whole-school strategy. Pupils should also be encouraged to come forward and seek help especially in cases of cyberbullying, which may not yet be widely understood.
This study has some limitations, including: the lack of a standard measure of bullying; the potential relationship between bullying itself and the other included risk factors; the underrepresentation of self-harm in clinical data; and quality issues in routinely collected data. We designed our analysis plan with the aim of alleviating the effect of these limitations, but they should be kept in mind when interpreting the results.
“This study reaffirms that in-person bullying has a negative impact on self-harm. In comparison to their peers who were not bullied, students were twice as likely to self-harm after such incidents.
Strategies to reduce loneliness should also be included along with tackling in-person bulling in self-harm prevention interventions for young people.