Take a moment and think back to some of the faces you remember from when you were at school. Those that really stand out. My guess is that at least a couple of those faces are people who you remember were unkind to you. Who you knew at the time, or look back now and realise, were ‘bullies’. Saying that, some of you might also look back and remember those who might look back on you in the same way.
Bullying has a long-lasting impact on the life of a child, echoing through the decades as we grow. As we’ve considered this, the evidence has shown us that, far from being a vital ‘right of passage’ to cope with the challenges of life, being bullied has a significant and lasting impact on our mental health and wellbeing, our future relationships, and even our economic opportunities. It is part of the fuel that means 10% of children and young people are living with a mental health disorder by the age of 16[1].
The evidence[2] shows us that “strong evidence exists for a causal relationship between bullying victimisation, mental health problems and substance use”. The population data also shows worrying association trends, with impacts on academic achievement and social functioning. Papers such as Goodman et al[3] look further into the life course impact of these triggered mental health conditions, suggesting by age 50, family income, hourly wage, probability of being employed, and being in a stable relationship can all be influenced by a childhood bullying experience.
We have very little local data on the true extent of bullying in Birmingham – how it varies by area, what kinds of adverse experiences children are having, and what people are doing about it. Nationally, the Department for Education found around 40% of children have been bullied in the last 12 months[4]. Six percent of young people had experienced daily bullying, and nine percent at least once a month. Name calling and exclusion from social groups were the most common forms. About a fifth of children who had been bullied had truanted or made themselves absent from school, at least three times the proportion of those who were not bullied, with one in four children who were regularly bullied being kept off school by their parents for a significant period of the year. There are worse outcomes for more vulnerable groups; a quarter of children with a special educational need experienced violence as part of their school year. When we look at the mental health of children and young people in our city, and the pre-determinants we can measure, it’s clear we are likely to have a major problem.
What is encouraging is that bullying is not inevitable, and that there is emerging consensus on high impact interventions that can alter this life course for children and young people. Whole school anti-bullying approaches were recently identified by Public Health England[5] has a highly cost effective approach, returning £1.58 to society for every £1 invested after only four years. In a cohort of 200 children, delivering the programme adds 15 ‘bullying free’ years of life. Not being bullied has been shown in some evidence to translate into wages that are between £39 and £116 per month higher in adulthood, layering a wider economic case on to the health, social and moral arguments.
The collaboration between Birmingham Women’s and Children’s NHS Foundation Trust and the Institute for Mental Health commits us to surface and respond to this truth. We’re working to tell the local story of bullying in Birmingham, and to bring effective interventions to parts of our city where it will matter most. With the recent University of Birmingham’s Mental Health policy commission[6] reporting that prevention is the only way to cope with rising poor child and young personal mental health, it’s time to rewrite the rules of the playground.
Dr Chris Chiswell is a Consultant in Public Health Medicine at Birmingham Women’s and Children’s NHS Foundation Trust.
[1] Public Health England. Children and Young People’s Mental Health and Wellbeing. [Online] https://fingertips.phe.org.uk/profile-group/mental-health/profile/cypmh [Accessed 10th November 2018]
[2] Moore et al. Consequences of bullying victimization in childhood and adolescence: A systematic review and meta-analysis. World J Psychiatry. 2017 7(1): 60–76.
[3] Goodman et al. The long shadow cast by childhood physical and mental problems on adult life. PNAS April 12, 2011 108 (15) 6032-6037
[4] Department for Education. Longitudinal study of young people in England cohort 2, wave 2. [Online] https://www.gov.uk/government/publications/longitudinal-study-of-young-people-in-england-cohort-2-wave-2 [Accessed 10th November 2018]
[5] Public Health England. Commissioning cost-effective services for promotion of mental health and wellbeing and prevention of mental ill health. 2017. PHE Publications.
[6] Burstow, P., Newbigging, K., Tew, J., and Costello, B., 2018. Investing in a Resilient Generation: Keys to a Mentally Prosperous Nation. Birmingham: University of Birmingham.