As a pediatric emergency medicine physician for more than 20 years, seeing sick and injured kids in and out of your emergency department can be difficult, but a part of the job. Knowing you can help them, and being able to make them feel better is why we do what we do. Sadly, many of the children I was seeing with preventable injuries from fighting or assaults were a result of bullying or retaliatory behaviors. I needed to know what I could do to help, to turn the tide – and I have spent the last 10 years of my career focused on this issue. However, bullying still remains a bit of a mystery to many medical professionals.
In April of 2014, I presented at the Institute of Medicine (IOM) and National Research Council (NRC) working session, “Building Capacity to Reduce Bullying and Its Impact on Youth Across the Lifecourse,” sponsored by the Health Resources and Services Administration (HRSA). My presentation focused on the very important role that medical professionals play in bullying prevention, as they are often the first people to see the physical and/or emotional impacts of interpersonal violence among youth. Many medical professionals deal with children who are involved with bullying, but are unaware of its risk factors and, more importantly, its consequences. Bullying results from a complex interaction between individuals and their broader social environment, including their families, peers, school, and community.
Providers are obligated to understand the causes of intentional interpersonal injury and address the antecedents appropriately. However, in order to do this effectively, pediatricians and other medical professionals need to proactively confront childhood bullying by advocating for awareness by teachers, school administrators, parents and children. By making the case for new legislation and policies that could address bullying, coupled with encouraging adoption of evidence-based prevention programs, medical professionals can best activate their voice in the public health discourse around this issue.
The fact is, medical professionals are seen as leaders within their communities and hold tremendous potential to promote the health and well-being of children and youth. For example, families trust their pediatricians, in many cases more than any other adult outside of the home. We should be at the forefront of planning community prevention strategies and developing multidisciplinary partnerships with community leaders and professionals to promote the well-being of children and families beyond the ones we already have close relationships with. Bullying happens anywhere children and youth gather, learn and socialize. It is not confined to the playground or high school locker room. This is why pediatricians, physician assistants, nurses and public health officials alike need to engage a variety of stakeholders in bullying prevention.
Our society has normalized bullying as part of growing up. However, pediatricians recognize that bullying is not a developmental milestone, nor should it be addressed as such. Pediatricians in particular have a long-standing history of preventing violence among youth. In 1999, the American Academy of Pediatrics (AAP) released a detailed policy statement outlining the important role pediatricians play in preventing violence among children and youth. While awareness of youth violence has increased in recent years, largely due to tragic school shootings, AAP survey results show that pediatricians want more training and support when it comes to preventing youth violence, especially bullying.
AAP has begun to meet the needs the profession by issuing a 2009 policy statement encouraging pediatricians to address the threat of youth violence – including bullying –, and taking an active role in its prevention. The policy statement provides clear recommendations for pediatricians to address bullying within four domains: clinical practice, advocacy, education and research. Meanwhile, Connected Kids: Safe, Strong, Secure, a program launched by the AAP in 2005, helps pediatricians integrate violence prevention strategies into routine child health care check-ups and visits. Bright Futures, which is led by the AAP and supported by HRSA’s Maternal and Child Health Bureau, Health Resources and Services Administration is another great resource which helps medical professionals address children's health needs in the context of family and community.
I am holding out for the day when preventable injuries are actually prevented, and I don’t see these children coming through emergency departments for treatment anymore. Together, we can make that happen.
Joseph L. Wright, MD, MPH is the newly appointed Professor and Chairman of Pediatrics at the Howard University College of Medicine in Washington, DC. He most recently served as Senior Vice President for Community Affairs at Children's National Medical Center, where he provided strategic leadership for the organization's advocacy mission, public policy positions and community partnership initiatives. Dr. Wright is among the original cohort of board-certified pediatric emergency physicians in the United States with scholarly interests that include prehospital pediatrics, youth violence prevention and the needs of underserved communities. He has served as principal investigator of the federally-funded Emergency Medical Services for Children (EMSC) National Resource Center, as inaugural Chair of the American Academy of Pediatrics' Violence Prevention subcommittee, and as an expert contributor to the Institute of Medicine's 2014 workshop, "Building Capacity to Reduce Bullying".
- Want to learn more? Register for the July 28th webinar on the role of healthcare professionals in bullying prevention.