Intervening in primary care against childhood bullying: an increasingly pressing public health need

Childhood bullying is a major risk factor for physical and mental health, educational attainment and social relationships. Epidemiological evidence has highlighted that its adverse consequences continue into adulthood leading to substantial health and wider societal costs. With the advent of cyber bullying, childhood bullying is increasingly pervasive. Children can now be reached and subjected to systematic peer abuse at all times. Given the limited impact of school-based initiatives, there is increasing interest in developing the role of primary care services to support the early identification and response to childhood bullying, but evidence-based interventions are lacking. This paper considers the scale and health-related consequences of childhood bullying. It argues the need for greater awareness and responsiveness in primary care as part of a community-wide, integrated approach to stemming its harmful effects. Primary care is well-placed to identify affected children, provide support to children and their parents to help improve coping skills and mitigate the effects of bullying, where necessary making referrals to appropriate agencies for associated physical and mental health problems. However, evidence-based guidance on how best to achieve this is lacking. Effective interventions that can be delivered in primary care to identify affected children and intervene to minimise the consequences of being bullied are needed, and this paper suggests a number of research questions that need to be addressed.