Sexual minority, American Indian, Alaskan Native, non-Hispanic Multiracial, and female adolescents are at highest risk for suicide attempts from bullying victimization, according to a new study by researchers at Columbia University Mailman School of Public Health. The magnitude of these disparities was consistent over time from 2015 to 2019, except for increased bullying toward gay and lesbian adolescents when nearly half of gay and lesbian students faced bullying in 2019. The findings are published in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).

Examining 44,066 adolescents from the Youth Risk Behavior Survey (YRBS), the research addressed bullying victimization reflecting any experience of in-person bullying or cyberbullying and suicide attempts in the past year. The data of approximately 15,000 U.S. adolescents who were attending school grades 9 to 12 were collected biennially through nationally representative surveys across sex, race/ethnicity, and sexual identity.

Bullying disparities were particularly severe across sex and sexual identity. Female adolescents had nearly double the odds of being bullied compared to male adolescents. Adolescents who reported their sexual identity as bisexual, gay, lesbian, or “not sure” had similarly increased odds of being bullied compared to heterosexual peers. These disparities carried over to being bullied offline only, online-only, or both. American Indian/Alaskan Native and non-Hispanic Multiracial were the racial/ethnic groups with the highest rates of being bullied.



Patterns mirror the disparities in suicide attempts, which were most common for female, American Indian/Alaskan Native, non-Hispanic Multiracial, and sexual minority adolescents. These patterns also apply to suicidal ideation, plans, and injury.



“Our results reflect the ongoing marginalization of vulnerable young people,” says first author Noah T. Kreski, MPH, in the Department of Epidemiology at Columbia Mailman School. “Whether it’s due to sexism, racism, or homophobia, bullying persists as a mechanism by which groups are targeted and harmed.”



Disparities in bullying and suicide attempts were checked for shifts over time, with the only significant change being increasing bullying victimization for gay/lesbian adolescents. Bullying victimization among gay and lesbian adolescents went from 32 percent to 45 percent between 2015 and 2019. Further efforts should be made to support this group, as well as bisexual adolescents who had the highest overall rate of being bullied (42 percent) and having a past year suicide attempt (26.5 percent), according to Kreski.



“Schools, and other spaces for adolescents, need a strong, systematic approach to anti-bullying that directly addresses forms of bias. These spaces also need systems equipped to support the mental health of adolescents when problems arise,” noted Kreski. “Holding bullies accountable for their actions, covering social justice curricula, and ensuring that adolescents feel empowered to come forth when facing bullying or suicidality are just a few steps to actively support young people as they face these difficult experiences.”



Co-authors are Qixuan Chen, Mark Olfson, Silvia S. Martins, Pia M. Mauro, Deborah S. Hasin, and Katherine M. Keyes, Columbia Mailman School of Public Health; and Magdalena Cerda, NYU Grossman School of Medicine.



The study was supported by the National Institute on Drug Abuse (grant DA048853) and the National Center for Injury Prevention and Control through the Columbia Center for Injury Science and Prevention (grant R49-CE003094). 

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The disparity in America between those who suffer from physical ailments and mental ones is a yawning chasm. And it is only getting worse. In the past year amid the pandemic, the country has seen all-time highs in depression and anxiety. The number of American youth struggling with suicidal ideation and entering ERs in mental crisis have reached staggering heights.

As a health reporter for the Washington Post, I’ve written stories on the personal experiences and struggles of mental health patients seeking help. But when it comes to reporting on mental health the coverage — including my own stories — has so often been confined to anecdotal and sporadic reports. For years, I’ve been haunted by the staggering scope of the problem and the how little substantive attention or action it has received. In the coming year, I plan to unearth data from state regulators, hospital systems and lawsuits that illuminate systemic failures of our mental health care system. And I hope to focus especially on America’s rapidly worsening epidemic of suicide.

The data I am targeting will shed light on areas where the system is especially failing — in hospitals, jails, schools.

Even as suicide rates have fallen globally, they have increased 35% in the United States in the past two decades. Despite that alarming statistic, funding and prevention efforts for suicide lag far behind those for all other leading causes of death.

Hospitals, for example, are now overwhelmed by teens in mental crises. From March to October last year, the proportion of children coming to ERs with mental problems grew by almost 25% compared to the same period in 2019. Increasingly those children are being met with chronic shortages in beds, doctors and problematic wait times.

For years, the availability of psychiatric beds has been dwindling in hospitals. According to a 2016 report by the Treatment Advocacy Center, there are now roughly 11.7 psychiatric beds per 100,000 people in America, compared to 16.8 beds in 2005. And there are racial disparities to this problem as well. Studies show Hispanic children in mental crises are more than three times more likely to experience wait problems in ERs.

Another especially glaring problem area within the crisis of American suicides is prison and jails, where deaths are growing at an even higher rate than in the general population. From 2001 to 2018, suicides in state and federal prisons increased 85%. In local jails, it is now the single leading cause of death. People in jail are more than three times as likely to die from suicide as someone on the outside.

Many experts believe staffing shortages and degrading conditions amid the pandemic will only further worsen the problem. Despite this, health care in many prisons and jails is only worsening.

My vision for this project for the 2021 Data Fellowship is to combine the power of patients’ personal experiences with novel accountability and data reporting. My hope is such stories will not only to illuminate the problem, but to move readers and policy makers to action.

William Wan | Contributed

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