Epidemiology expert witness discusses school bullying and suicide

An epidemiology expert witness discusses a case involving a teenager’s parents who sued their school district claiming that ignored bullying caused their daughter to commit suicide. The teenager was repeatedly harassed at school because she was overweight and disabled. She jumped to her death from a highway bridge. Students called her names on a daily basis, on the bus, in the lunch room, in classes and in the hallways. While also suing her bullying peers in juvenile court, her parents filed claims against the school district for violation of the Fourteenth Amendment substantive due process for the school board’s failure to prevent peer-on-peer bullying and violence, as well as claims under the Americans With Disabilities Act (ADA).

Question(s) For Expert Witness

1. Can school bullying cause suicide?

2. Did it cause the suicide in this case?

Expert Witness Response

Suicide is the third leading cause of death among youth between the ages of 10 and 24 in the United States, and for each of the 4,400 completed youth suicides each year, it is estimated that there are 100 to 200 suicide attempts. School bullying is one potential risk factor that has become a growing public health concern. Bullying behavior is highly prevalent among youth. In one study it was noted that approximately 30% of middle school-aged students reported having been involved in bullying in the last two months: 13% as bullies, 11% as victims, and 6% as both perpetrators and victims. This is largely due to the fact that the school environment provides opportunities for time and space without adult supervision.

Many prior publications have reported bullying behavior in youth to be associated with depression, suicidal ideation, and suicide attempts. Studies have shown that the odds of attempting suicide among youth who were threatened at school were nearly 4 times the odds of a suicide attempt among youth who were not threatened at school; the more frequent the involvement in bullying behavior, the more likely the student was depressed, had serious suicidal ideation, or had attempted suicide; the odds of a suicide attempt among those who were frequently bullied were 4.5 times the odds of a suicide attempt in a youth who was never bullied. A review of 31 studies from both inside and outside of the U.S. concluded that victims of bullying exhibit higher levels of suicidal ideation and are more likely to have attempted suicide in comparison with youth who have not experienced peer victimization.

It can be reasonably concluded that bullying is a plausible cause of suicidality.

Although recent research has shown an association between bullying behavior and adolescent suicidal ideation, in order to establish bullying as an independent risk factor for suicidal behavior, it is imperative to control for as many known risk factors as possible. Using data from multiple sources, my colleagues and I conducted an ad hoc epidemiologic study to evaluate a multivariate model of bullying and suicidal ideation and behavior that controlled for a larger variety of risk factors than what has been previously described in the literature.

The results show that, from an epidemiologic and biostatistics perspective, the bullying was the likely cause of the teen’s suicide in this case, to a reasonable degree of scientific certainty. This conclusion is meant to support rather than replace a psychological autopsy.

The expert is a university professor and widely published expert on forensic epidemiology.