The Relationship Between 

Bullying and Suicide: 

What We Know and What it Means for Schools

TM

National Center for Injury Prevention and Control

Division of Violence Prevention
2 The Relationship Between Bullying and Suicide

What We Know about Bullying and Suicide

In the past decade, headlines reporting the tragic stories of a 

young person’s suicide death linked in some way to bullying 

(physical, verbal, or online) have become regrettably common. 

There is so much pain and suffering associated with each of 

these events, affecting individuals, families, communities and our 

society as a whole and resulting in an increasing national outcry 

to “do something” about the problem of bullying and suicide. 

For this reason, the Centers for Disease Control and Prevention 

(CDC) and other violence prevention partners and researchers 

have invested in learning more about the relationship between 

these two serious public health problems with the goal of using 

this knowledge to save lives and prevent future bullying.

 As school administrators, teachers, and school staff in daily 

contact with young people, you are uniquely affected by these 

events and feel enormous pressure to help prevent them in the 

future. The purpose of this document is to provide concrete, 

action-oriented information based on the latest science to 

help you improve your schools’ understanding of and ability to 

prevent and respond to the problem of bullying and suiciderelated behavior. 

What We Know about Bullying

•	 Bullying is unwanted, aggressive behavior among school-aged children that involves a real or perceived

power imbalance. The behavior is repeated, or has the potential to be repeated, over time. Bullying 

includes actions such as making threats, spreading rumors, attacking someone physically or verbally, 

and excluding someone from a group on purpose. Bullying can occur in-person or through technology.

•	 Bullying has serious and lasting negative effects on the mental health and overall well-being of youth

involved in bullying in any way including: those who bully others, youth who are bullied, as well as those 

youth who both bully others and are bullied by others, sometimes referred to as bully-victims. 

•	 Even youth who have observed but not participated in bullying behavior report significantly more feelings 

of helplessness and less sense of connectedness and support from responsible adults (parents/schools) 

than youth who are have not witnessed bullying behavior.

•	 Negative outcomes of bullying (for youth who bully others, youth who are bullied, and youth who both

are bullied and bully others) may include: depression, anxiety, involvement in interpersonal violence or 

sexual violence, substance abuse, poor social functioning, and poor school performance, including lower 

grade point averages, standardized test scores, and poor attendance.

•	 Youth who report frequently bullying others and youth who report being frequently bullied are at

increased risk for suicide-related behavior. 

•	 Youth who report both bullying others and being bullied (bully-victims) have the highest risk for suiciderelated behavior of any groups that report involvement in bullying. 
What We Know and What it Means for Schools 3 

What We Know about Suicide

•	 Suicide-related behaviors include the following:

Suicide: Death caused by self-directed 

injurious behavior with any intent to die.

Suicide attempt: A non-fatal self-directed 

potentially injurious behavior with any intent 

to die as a result of the behavior. A suicide 

attempt may or may not result in injury.

Suicidal ideation: Thinking about, 

considering, or planning for suicide. 

•	 Suicide-related behavior is complicated and

rarely the result of a single source of trauma or 

stress.

•	 People who engage in suicide-related behavior

often experience overwhelming feelings of 

helplessness and hopelessness.

•	 ANY involvement with bullying behavior is one

stressor which may significantly contribute to 

feelings of helplessness and hopelessness that 

raise the risk of suicide. 

•	 Youth who are at increased risk for suiciderelated behavior are dealing with a complex 

interaction of multiple relationship (peer, 

family, or romantic), mental health, and school 

stressors.

What We Know about Bullying and Suicide Together

•	 We know that bullying behavior and suicide-related behavior are closely related. This means youth who

report any involvement with bullying behavior are more likely to report high levels of suicide-related 

behavior than youth who do not report any involvement with bullying behavior. 

•	 We know enough about the relationship between bullying and suicide-related behavior to make

evidence-based recommendations to improve prevention efforts. 

What We DON’T Know about Bullying and Suicide

•	 We don’t know if bullying directly causes suicide-related behavior. We know that most youth who are

involved in bullying do NOT engage in suicide-related behavior. It is correct to say that involvement in

bullying, along with other risk factors, increases the chance that a young person will engage in suiciderelated behaviors.
4 The Relationship Between Bullying and Suicide

Recent attention focused on the relationship between bullying and suicide is positive and helpful because it:

1. Raises awareness about the serious harm that bullying does to all youth involved in bullying in any way.

2. Highlights the significant risk for our most vulnerable youth (e.g. youth with disabilities, youth with 

learning differences, LGBTQ youth).

3.	 Encourages conversation about the problem of bullying and suicide and promotes collaboration

around prevention locally and nationally.

However, framing the discussion of the issue as bullying being a single, direct cause of suicide is not helpful

and is potentially harmful because it could: 

1. Perpetuate the false notion that suicide is a natural response to being bullied which has the dangerous 

potential to normalize the response and thus create copycat behavior among youth.

2.	 Encourage sensationalized reporting and contradicts the Recommendations for Reporting on Suicide 

(http://reportingonsuicide.org) potentially encouraging copycat behavior that could lead to “suicide 

contagion.”

3. Focus the response on blame and punishment which misdirects the attention from getting the needed 

support and treatment to those who are bullied as well as those who bully others.

4. Take attention away from other important risk factors for suicidal behavior that need to be addressed 

(e.g. substance abuse, mental illnesses, problems coping with disease/disability, family dysfunction, etc.)

Still, a report of a young person who takes his/her own life and leaves a note pointing directly to the 

suffering and pain they have endured because of bullying is shocking and heartbreaking. While a 

young person’s death by suicide is a tragedy and both bullying and suicide-related behavior are serious 

public health problems, our response to such situations must reflect a balanced understanding of the 

issues informed by the best available research. 

It is particularly important to understand the difference between circumstances being related to an event versus 

being direct causes or effects of the event. To explore this idea, let’s look at a similar but much simpler example: 

In the case of drowning deaths among 

children, those who are not directly supervised 

by a competent adult while swimming are 

more likely to die by drowning than those 

children who are directly supervised. While 

the lack of adult supervision does not 

directly cause a child to drown, it is a critical 

circumstance that can affect the outcome of 

the situation.

Just as with preventing deaths by drowning, 

for bullying and suicide prevention, the more 

we understand about the relationship between 

circumstances and outcomes the better 

decisions we can make about what actions to 

take to prevent bullying and suicide-related 

behavior.

The Relationship Between Bullying and Suicide
What We Know and What it Means for Schools 5 

So, if bullying doesn’t directly cause suicide, what do we know about how bullying and suicide are related?

Bullying and suicide-related behavior are both complex public health problems. Circumstances that can affect 

a person’s vulnerability to either or both of these behaviors exist at a variety of levels of influence—individual, 

family, community, and society. These include:

•	 emotional distress

•	 exposure to violence

•	 family conflict

•	 relationship problems

•	 lack of connectedness to school/sense of supportive school environment

•	 alcohol and drug use

•	 physical disabilities/learning differences

•	 lack of access to resources/support.

If, however, students experience the opposite of some of the circumstances listed above (e.g. family support 

rather than family conflict; strong school connectedness rather than lack of connectedness), their risk for 

suicide-related behavior and/or bullying others—even if they experience bullying behavior—might be 

reduced. These types of circumstances/situations or behaviors are sometimes referred to as “protective factors.” 

In reality, most students have a combination of risk and 

protective factors for bullying behavior and suiciderelated behavior. This is one of the reasons that we 

emphasize that the relationship between the two 

behaviors and their health outcomes is not simple. The 

ultimate goal of our prevention efforts is to reduce 

risk factors and increase protective factors as much 

as possible.

The bottom-line of the most current research findings is 

that being involved in bullying in any way—as a person 

who bullies, a person who is bullied, or a person who 

both bullies and is bullied (bully-victim)—is ONE of

several important risk factors that appears to increase 

the risk of suicide among youth.

Knowledge is really most helpful if it informs action toward a positive change—in this case, prevention of 

bullying and suicide-related behavior. In your position—spending several hours a day with youth—you 

have the opportunity to put some of the best knowledge to work but little time to sift through reams of 

information. Hopefully, you will find the evidence-based suggestions in this document realistic and actionable 

in your specific settings. 

The following table highlights key research findings about the relationship between bullying and suiciderelated behavior, identifies the prevention action you can take based on this information, and suggests places 

to find supporting resources.

What Can We Do with What We Know?
What do we know from 

research?

What can school 

personnel do?

Where can I find 

more information?

Youth who feel connected

to their school are less likely 

to engage in suicide-related 

behaviors.

Help your students feel connected 

to you and their school. For example, 

greet them by name every day. 

Ask them how they are doing, etc. 

Encourage their extracurricular

interests and involvement.

A strong sense of connectedness to 

caring, responsible adults at school can 

provide invaluable support to youth 

who may be struggling socially and/or 

emotionally. 

CDC resources for fostering 

school connectedness: 

• www.cdc.gov/healthyyouth/

adolescenthealth/

connectedness.htm

CDC’s Applying Science, 

Advancing Practice: Preventing 

Suicide Through Connectedness: 

• www.cdc.gov/

ViolencePrevention/pdf/ASAP_

Suicide_Issue3-a.pdf

Youth who are able to cope

with problems in healthy ways 

and solve problems peacefully 

are less likely to engage in 

suicide and bullying related 

behaviors.

Teach youth coping/life skills. Focus on 

positive and empowering messages 

that build resilience and acceptance of 

differences in themselves and others.

Early training (even starting in

elementary school) for students to help 

them develop coping and problemsolving skills, build resilience, and 

increase their social intelligence and 

empathy is important to fostering 

positive mental health and pro-social 

behavior. 

Links to evidence-based, socialemotional learning approaches: 

Good Behavior Game

• www.air.org/focus-area/

education/?type=projects&id 

=127

Steps to Respect: Bullying Prevention 

for Elementary School

• www.cfchildren.org/steps-torespect.aspx

Youth with disabilities, learning

differences, sexual/gender 

identity differences or cultural 

differences are often most 

vulnerable to being bullied.

Provide better training for all school 

staff who work with youth. Teach 

personnel about vulnerable populations 

and appropriate ways to intervene in 

bullying situations. Understand that 

acknowledging risk factors is not the 

same as victim blaming.

There are power differences involved 

in bullying situations. For this reason, 

general conflict resolution methods are 

not appropriate or effective. Adopt and 

implement effective and inclusive antibullying policies.

Federal resources on responding 

to bullying:

• www.stopbullying.gov/

respond/index.html

• www.stopbullying.gov/

prevention/training-center/

index.html

Information on anti-bullying 

policy:

• www.afsp.org/advocacypublic-policy/state-policy/

anti-bullying-and-anticyberbullying-policies

6 The Relationship Between Bullying and Suicide
What do we know from 

research?

What can school 

personnel do?

Where can I find 

more information?

Youth who report frequently

bullying others are at high, 

long-term risk for suiciderelated behavior.

Youth who report both being

bullied and bullying others 

(sometimes referred to as 

bully-victims) have the highest 

rates of negative mental 

health outcomes, including 

depression, anxiety, and 

thinking about suicide.

Youth who report being

frequently bullied by others 

are at increased risk of suiciderelated behaviors, and negative 

physical and mental health 

outcomes.

Provide support and referrals for all 

youth involved. Include their families. 

Youth who act out through bullying

others may be trying to fit in and/or 

reacting to stress, abuse, or other issues 

at home or school. Bullying behavior 

may be an important signal that they 

need mental health services and 

additional support.

•	 While punishment and appropriate

consequences are often a necessary 

part of a school’s response, we 

must move beyond punishment 

and blame to set the tone for 

lasting prevention.

•	 The focus on blame, shame, and

criminalization is divisive and can 

be a roadblock to getting youth 

and families the professional 

support that is needed to make a 

positive change and prevent future 

suffering.

Federal resources on supporting 

youth involved in bullying:

• www.stopbullying.gov/whatis-bullying/roles-kids-play/

index.html

• www.stopbullying.gov/

respond/support-kidsinvolved/index.html#address

Involvement in bullying in any 

way—even as a witness—

has serious and long-lasting 

negative consequences for 

youth. 

Youth who reported witnessing

bullying had greater feelings 

of helplessness and less sense 

of connectedness to school 

than youth who did not report 

witnessing bullying.

Empower youth by providing concrete,

positive, and proactive ways they can 

influence the social norms of their peer 

group so that bullying is seen as an 

uncool behavior. 

Encourage more work on bystander

approaches to violence prevention in 

general.

Federal resources for empowering 

bystanders:

• www.stopbullying.gov/whatis-bullying/roles-kids-play/

index.html

• www.stopbullying.gov/

respond/be-more-than-abystander/index.html

CDC’s Applying Science, 

Advancing Practice: The BullySexual Violence Pathway in Early 

Adolescence

• www.cdc.gov/

violenceprevention/pdf/

asap_bullyingsv-a.pdf

What We Know and What it Means for Schools 7 
8 The Relationship Between Bullying and Suicide

Looking Ahead

There is a lot of concern, even panic, about the ongoing problem of bullying and suicide-related behavior 

among school-age youth. Much of the media coverage is focused on blame and criminal justice intervention 

rather than evidence-based, action-oriented prevention. Public health researchers are continually seeking a 

better understanding of the relationship between bullying and suicide-related behavior as well as the related 

risk and protective factors that affect young people. Increased awareness about what we do know, what we 

don’t know, and what information is most helpful and applicable to prevention is crucial to your schools’ 

efforts to protect students from harm. 

The good news is that we do have evidence-based, actionable information to help prevent bullying and 

suicide. As teachers, administrators, and school staff you have a vital and rewarding role to play by getting the 

word out and encouraging colleagues and communities to take action. 

Additional Reading

Borowsky IW, Taliaferro LA, McMorris BJ. Suicidal thinking and behavior among youth involved in verbal and 

social bullying: Risk and protective factors. Journal of Adolescent Health 2013; 53:S4-S12.

Copeland WE, Wolke D, Angold A, Costello EJ. Adult psychiatric outcomes of bullying and being bullied by

peers in childhood and adolescence. JAMA Psychiatry 2013; 70(4):419-426.

Cadarerelli, N. Bullying and Suicide: Unraveling the Link. A Presentation by the American Foundation for

Suicide Prevention. Retrieved October 21, 2012 from education.state.nm.us.

Centers for Disease Control and Prevention. Connectedness as a strategic direction for the prevention of 

suicidal behavior. Retrieved April 29, 2013 from http://www.cdc.gov/violenceprevention/pdf/suicide_

strategic_direction-one-pager-a.pdf.

Centers for Disease Control and Prevention. Youth risk behavior surveillance—United States, 2011. MMWR 

Surveillance Summaries 2012; 61(no. SS-4). Available from www.cdc.gov/mmwr/pdf/ss/ss6104.pdf.

Eisenberg ME, Neurnark-Sztainer D, Perry CL. Peer harassment, school connectedness, and academic

achievement. Journal of School Health 2003; 73(8): 311-316. 

Espelage DL, Holt MK. Suicidal ideation and school bullying experiences after controlling for depression and

delinquency. Journal of Adolescent Health 2013; 53:S27-S31.

Farrington DP, Ttofi MM. Bullying as a predictor of offending, violence and later life outcomes. Criminal 

Behaviour and Mental Health 2011; 21: 90–98.

Fekkes M, Pijpers F, Fredriks AM, Vogels T, Verloove-Vanhorick SP. Do bullied children get ill, or do ill children 

get bullied? A prospective cohort study on the relationship between bullying and health-related 

symptoms. Pediatrics 2006; 117:1568-1574.

Glew GM, Fan M, Katon W, Rivara FP, Kernic MA. Bullying, psychosocial adjustment, and academic performance 

in elementary school. Archives of Pediatric Adolescent Medicine 2005; 159:1026-1031.

Hatzenbuehler ML, Keyes KM. Inclusive anti-bullying policies and reduced risk of suicide attempts in lesbian 

and gay youth. Journal of Adolescent Health 2013; 53:S21-S26. 
What We Know and What it Means for Schools 9 

Juvonen, J. Nishina, A. and Graham, S. Peer harassment, psychological adjustment, and school functioning in

early adolescence. Journal of Educational Psychology 2000; 92(2): 349-359.

Karch DL, Logan J, McDaniel DD, Floyd CF, Vagi KJ. Precipitating circumstances of suicide among youth aged 

10–17 years by sex: Data from the National Violent Death Reporting System, 16 States, 2005–2008. Journal 

of Adolescent Health 2013; 53:S51-S53.

Kim YS, Leventhal B. Suicide and bullying. A review. International Journal of Adolescent Medicine and Health

2008; 20:133-154.

King CA, Horwitz A, Berona J, Jiang Q. Acutely suicidal adolescents who engage in bullying behavior: One-year

trajectories. Journal of Adolescent Health 2013; 53:S43-S50.

Klomek AB, Kleinman M, Altschuler E, Marrocco F, Amakawa L, Gould MS. Suicidal adolescents’experiences

with bullying perpetration and victimization during high school as risk factors for later depression and 

suicidality. Journal of Adolescent Health 2013; 53:S37-S42.

Klomek AB, Sourander A, Gould A. The association of suicide and bullying in childhood to young adulthood: A 

review of cross-sectional and longitudinal research findings. Canadian Journal of Psychiatry 2010; 55:282–

288.

Klomek AB, Sourander A, Niemela S, Kumpulainen K, Piha J, Tamminen T, Almqvist F, Gould MS. Childhood

bullying behaviors as a risk for suicide attempts and completed suicides: A population-based birth cohort 

study. Journal of the American Academy of Child and Adolescent Psychiatry 2009; 48:254-261.

Kowalski RM, Limber SP. Psychological, physical, and academic correlates of cyberbullying and traditional 

bullying. Journal of Adolescent Health 2013; 53:S13-20.

Lubell KM, Vetter JB. Suicide and youth violence prevention: The promise of an integrated approach. 

Aggression and Violent Behavior 2006; 11:167– 175.

McKenna M, Hawk E, Mullen J, Hertz M. The association between bullying behavior and health risks among

middle school and high school students in Massachusetts, 2009. Morbidity and Mortality Weekly Report 

2011; 60:465-471.

Nansel TR, Overpeck M, Pilla M, et al. Bullying behavior among US youth: prevalence and association with

psychosocial adjustment. Journal of the American Medical Association 2001; 285:2094 –100.

Rivers I, Noret N. Potential suicide ideation and its association with observing bullying at school. Journal of 

Adolescent Health 2013; 53:S32-S36.

Vreeman RC, Carroll AE. A systematic review of school-based interventions to prevent bullying. Archives of 

Pediatric Adolescent Medicine 2007; 161:78-88.

Waasdorp TE, Bradshaw CP, Leaf PJ. The impact of school wide positive behavioral interventions and supports

on bullying and peer rejection: A randomized controlled effectiveness trial. Archives of Pediatric Adolescent 

Medicine 2012; 166:149-156.

Williams KR, Guerra NG. Prevalence and predictors of internet bullying. Journal of Adolescent Health 2007; 

41:S14–21.

www.cdc.gov/violenceprevention/suicide/definitions.html

www.stopbullying.gov/what-is-bullying/index.html
For more information please contact:

 Centers for Disease Control and Prevention 

National Center for Injury Prevention and Control

Division of Violence Prevention

4770 Buford Hwy NE, MS F-64

Chamblee, GA 30341 

1-800-CDC-INFO • www.cdc.gov/violenceprevention

04/2014