New research shows that childhood bullying has a strong link to mental health service use throughout a person's life, putting additional strain on an "already overstretched" UK healthcare system.
A study by the London School of Economics and Political Science (LSE) and King's College London, tracking mental health service use among more than 9000 people over a 40-year-period using data from the 1958 British Birth Cohort, provides unequivocal evidence of the link.
The findings, published in Psychological Medicine, show that younger people who are bullied in their childhood are more likely to use mental health services long into adulthood, compared to those who weren't bullied.
More boys than girls use mental health services in childhood and adolescence, whereas more women than men use mental health services in adulthood.
Lead researcher Dr Sara Evans-Lacko, an Associate Professorial Research Fellow from LSE's Personal Social Services Research Unit, said: "The impact of childhood bullying on mental health services is most notable at an early age, but the association remains significant at 50."
"Individuals who were frequently bulled during childhood were more than twice as likely to use mental health services during childhood or adolescence and even at age 50, they were still 30% more likely to use mental health services compared to those who were not bullied.
"Half the adult population with a psychiatric disorder already show signs of poor mental health by the age of 15. If unnoticed or untreated, early onset of mental health problems could be the starting point of persistent disorders known to be associated with bullying, including depression and anxiety, self-harm and psychotic disorders.
"Bullying may also set the conditions for a cycle in which people are at risk of exposure to further victimisation in later life. Other outcomes associated with childhood bullying include relationship breakdowns and low employment."
The higher prevalence of boys who use mental health services may reflect the key role that adults play in recognising and referring boys, who show more outward signs of bullying than girls, the researchers say.
In contrast, the higher use of mental health services among women may be due to stigmas associated with mental health problems among men (who then don't want to seek support), or their inability to recognise feelings of distress.
Professor Louise Arseneault from King's College London, said: "In recent years, research has accumulated strong evidence to show that being bullied can be harmful for children and that problems can persist for a long time, up to midlife. This is the first time we are able to show the impact of childhood bullying victimisation on the health care system in the UK.
"Beyond the individuals, bullying affects the wider systems and societies. Findings from our study add to other research supporting early intervention aimed at stopping bullying or preventing mental health problems in the young victims."
The researchers say that early intervention to prevent childhood bullying is necessary to limit both individual distress and save thousands of pounds in healthcare over the course of a person's life.
Dr Evans-Lacko said: "Anti-bullying initiatives are relatively inexpensive, estimated at £15.50 per pupil per year, and offer good value for money. Given the current tremendous strain on the health system, policies and practices to prevent bullying should be a high priority."
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