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The impact of bullying on mental health

bullying and mental health essay

There has been a lot of conversation in the media lately about bullying and the damaging impact it can have on mental health.  Bullying is defined as the unwanted, aggressive behavior that presents in an engagement with another individual or individuals that involves a real or perceived power imbalance. Thinking back, most people can probably identify a time when they experienced bullying and how it made them feel. Bullying happens everywhere: schools, workplace, friend groups, online, and it’s important to remember it does not just happen to children.

With the technological world that we have moved in to, access to bullying has grown significantly. Cyberbullying, which refers to being bullied online or through digital devices and can happen through text messages, social media apps, gaming chats and platforms, and pretty much anywhere people view and share content. According to the Center for Disease Control and Prevention’s 2019 Youth Risk Behavior Surveillance System , data shows that an estimated 15.7% of high school students were electronically bullied in the 12 months prior to the survey.

Just because many of us are going to school or working from home doesn’t mean the bullying has stopped. The pandemic has led to youth being connected significantly more than before to their digital devices. For some, digital contact has been the only way they have communicated within the past year. L1ght , an organization that tracks online harassment, is reporting that cyberbullying has increased 70% in just the past few months.

The effects of bullying have serious and lasting negative impacts on our mental health and overall wellbeing. Bullying can cause feelings of rejection, exclusion, isolation, low self-esteem, and some individuals can develop depression and anxiety as a result. In some cases it can even develop into Acute Stress Disorder or Post Traumatic Stress Disorder.  Research has shown that being a victim of bullying can lead to longer term impacts including interpersonal violence, substance use, sexual violence, poor social functioning, and poor performance. Even witnessing bullying can impact one’s wellbeing.

Being bullied at a young age can affect someone well past childhood and can cause lifelong psychological damage. During these young years, children are identifying roles, developing personalities, and figuring out who they are. When a young person is bullied, it can lead to problems with trust in others, self-esteem, and anger. It can be hard to develop relationships with others at an older age when you may not have had any at a younger age. When we’re repeatedly presented with blows about who we are or what we are doing, we create a poor self-image and expect that others see us in the same light.

Bullying often leaves us with lingering feelings, turning into anger towards others or ourselves. When one goes through bullying over a long period of time, they may begin to blame themselves for being bullied. Thinking thoughts such as “If I wasn’t so ugly, people would leave me alone,” or “If I tried harder, people wouldn’t make fun of me.” The types of thoughts can change how we see and feel about ourselves and leave long-term impacts.

If you are a parent to a digital teen and you are working from home, you are spending more time than ever with your children. We have a great opportunity to be mindful of what our youth are doing online and how these interactions with others may be affecting them. Create rules on internet use that limits screen time. This can be challenging, since those of us working from home are stuck to screens all day, but these rules can help create a balance around positive, healthy social time and engaging in other activities that make them less likely to engage in cyberbullying. Allow youth to stay connected with others through positive engagement, such as Facetime or weekly Zoom chats that can help balance connectivity. It is very difficult for children and teens to not be connected to others, as these connections are necessary for growth and development. Have open communication and ensure your children know they can talk to you about what is going on in their lives.

If you are concerned that you or your child are experiencing lingering feelings from the results of bullying, it may be helpful to connect with a mental health professional to identify concerns and negative thinking patterns that may still be present. The STOMP Out Bullying HelpChat Line is a free confidential online chat that helps youth ages 13-24 with issues around bullying and cyberbullying. If you are interested in reading about bullying statistics here is a great resource: Pacer’s National Bullying Prevention Center

Written by: Meaghan Warner, LCSW-S

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  • Published: 14 December 2021

Bullying at school and mental health problems among adolescents: a repeated cross-sectional study

  • Håkan Källmén 1 &
  • Mats Hallgren   ORCID: orcid.org/0000-0002-0599-2403 2  

Child and Adolescent Psychiatry and Mental Health volume  15 , Article number:  74 ( 2021 ) Cite this article

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To examine recent trends in bullying and mental health problems among adolescents and the association between them.

A questionnaire measuring mental health problems, bullying at school, socio-economic status, and the school environment was distributed to all secondary school students aged 15 (school-year 9) and 18 (school-year 11) in Stockholm during 2014, 2018, and 2020 (n = 32,722). Associations between bullying and mental health problems were assessed using logistic regression analyses adjusting for relevant demographic, socio-economic, and school-related factors.

The prevalence of bullying remained stable and was highest among girls in year 9; range = 4.9% to 16.9%. Mental health problems increased; range = + 1.2% (year 9 boys) to + 4.6% (year 11 girls) and were consistently higher among girls (17.2% in year 11, 2020). In adjusted models, having been bullied was detrimentally associated with mental health (OR = 2.57 [2.24–2.96]). Reports of mental health problems were four times higher among boys who had been bullied compared to those not bullied. The corresponding figure for girls was 2.4 times higher.

Conclusions

Exposure to bullying at school was associated with higher odds of mental health problems. Boys appear to be more vulnerable to the deleterious effects of bullying than girls.

Introduction

Bullying involves repeated hurtful actions between peers where an imbalance of power exists [ 1 ]. Arseneault et al. [ 2 ] conducted a review of the mental health consequences of bullying for children and adolescents and found that bullying is associated with severe symptoms of mental health problems, including self-harm and suicidality. Bullying was shown to have detrimental effects that persist into late adolescence and contribute independently to mental health problems. Updated reviews have presented evidence indicating that bullying is causative of mental illness in many adolescents [ 3 , 4 ].

There are indications that mental health problems are increasing among adolescents in some Nordic countries. Hagquist et al. [ 5 ] examined trends in mental health among Scandinavian adolescents (n = 116, 531) aged 11–15 years between 1993 and 2014. Mental health problems were operationalized as difficulty concentrating, sleep disorders, headache, stomach pain, feeling tense, sad and/or dizzy. The study revealed increasing rates of adolescent mental health problems in all four counties (Finland, Sweden, Norway, and Denmark), with Sweden experiencing the sharpest increase among older adolescents, particularly girls. Worsening adolescent mental health has also been reported in the United Kingdom. A study of 28,100 school-aged adolescents in England found that two out of five young people scored above thresholds for emotional problems, conduct problems or hyperactivity [ 6 ]. Female gender, deprivation, high needs status (educational/social), ethnic background, and older age were all associated with higher odds of experiencing mental health difficulties.

Bullying is shown to increase the risk of poor mental health and may partly explain these detrimental changes. Le et al. [ 7 ] reported an inverse association between bullying and mental health among 11–16-year-olds in Vietnam. They also found that poor mental health can make some children and adolescents more vulnerable to bullying at school. Bayer et al. [ 8 ] examined links between bullying at school and mental health among 8–9-year-old children in Australia. Those who experienced bullying more than once a week had poorer mental health than children who experienced bullying less frequently. Friendships moderated this association, such that children with more friends experienced fewer mental health problems (protective effect). Hysing et al. [ 9 ] investigated the association between experiences of bullying (as a victim or perpetrator) and mental health, sleep disorders, and school performance among 16–19 year olds from Norway (n = 10,200). Participants were categorized as victims, bullies, or bully-victims (that is, victims who also bullied others). All three categories were associated with worse mental health, school performance, and sleeping difficulties. Those who had been bullied also reported more emotional problems, while those who bullied others reported more conduct disorders [ 9 ].

As most adolescents spend a considerable amount of time at school, the school environment has been a major focus of mental health research [ 10 , 11 ]. In a recent review, Saminathen et al. [ 12 ] concluded that school is a potential protective factor against mental health problems, as it provides a socially supportive context and prepares students for higher education and employment. However, it may also be the primary setting for protracted bullying and stress [ 13 ]. Another factor associated with adolescent mental health is parental socio-economic status (SES) [ 14 ]. A systematic review indicated that lower parental SES is associated with poorer adolescent mental health [ 15 ]. However, no previous studies have examined whether SES modifies or attenuates the association between bullying and mental health. Similarly, it remains unclear whether school related factors, such as school grades and the school environment, influence the relationship between bullying and mental health. This information could help to identify those adolescents most at risk of harm from bullying.

To address these issues, we investigated the prevalence of bullying at school and mental health problems among Swedish adolescents aged 15–18 years between 2014 and 2020 using a population-based school survey. We also examined associations between bullying at school and mental health problems adjusting for relevant demographic, socioeconomic, and school-related factors. We hypothesized that: (1) bullying and adolescent mental health problems have increased over time; (2) There is an association between bullying victimization and mental health, so that mental health problems are more prevalent among those who have been victims of bullying; and (3) that school-related factors would attenuate the association between bullying and mental health.

Participants

The Stockholm school survey is completed every other year by students in lower secondary school (year 9—compulsory) and upper secondary school (year 11). The survey is mandatory for public schools, but voluntary for private schools. The purpose of the survey is to help inform decision making by local authorities that will ultimately improve students’ wellbeing. The questions relate to life circumstances, including SES, schoolwork, bullying, drug use, health, and crime. Non-completers are those who were absent from school when the survey was completed (< 5%). Response rates vary from year to year but are typically around 75%. For the current study data were available for 2014, 2018 and 2020. In 2014; 5235 boys and 5761 girls responded, in 2018; 5017 boys and 5211 girls responded, and in 2020; 5633 boys and 5865 girls responded (total n = 32,722). Data for the exposure variable, bullied at school, were missing for 4159 students, leaving 28,563 participants in the crude model. The fully adjusted model (described below) included 15,985 participants. The mean age in grade 9 was 15.3 years (SD = 0.51) and in grade 11, 17.3 years (SD = 0.61). As the data are completely anonymous, the study was exempt from ethical approval according to an earlier decision from the Ethical Review Board in Stockholm (2010-241 31-5). Details of the survey are available via a website [ 16 ], and are described in a previous paper [ 17 ].

Students completed the questionnaire during a school lesson, placed it in a sealed envelope and handed it to their teacher. Student were permitted the entire lesson (about 40 min) to complete the questionnaire and were informed that participation was voluntary (and that they were free to cancel their participation at any time without consequences). Students were also informed that the Origo Group was responsible for collection of the data on behalf of the City of Stockholm.

Study outcome

Mental health problems were assessed by using a modified version of the Psychosomatic Problem Scale [ 18 ] shown to be appropriate for children and adolescents and invariant across gender and years. The scale was later modified [ 19 ]. In the modified version, items about difficulty concentrating and feeling giddy were deleted and an item about ‘life being great to live’ was added. Seven different symptoms or problems, such as headaches, depression, feeling fear, stomach problems, difficulty sleeping, believing it’s great to live (coded negatively as seldom or rarely) and poor appetite were used. Students who responded (on a 5-point scale) that any of these problems typically occurs ‘at least once a week’ were considered as having indicators of a mental health problem. Cronbach alpha was 0.69 across the whole sample. Adding these problem areas, a total index was created from 0 to 7 mental health symptoms. Those who scored between 0 and 4 points on the total symptoms index were considered to have a low indication of mental health problems (coded as 0); those who scored between 5 and 7 symptoms were considered as likely having mental health problems (coded as 1).

Primary exposure

Experiences of bullying were measured by the following two questions: Have you felt bullied or harassed during the past school year? Have you been involved in bullying or harassing other students during this school year? Alternatives for the first question were: yes or no with several options describing how the bullying had taken place (if yes). Alternatives indicating emotional bullying were feelings of being mocked, ridiculed, socially excluded, or teased. Alternatives indicating physical bullying were being beaten, kicked, forced to do something against their will, robbed, or locked away somewhere. The response alternatives for the second question gave an estimation of how often the respondent had participated in bullying others (from once to several times a week). Combining the answers to these two questions, five different categories of bullying were identified: (1) never been bullied and never bully others; (2) victims of emotional (verbal) bullying who have never bullied others; (3) victims of physical bullying who have never bullied others; (4) victims of bullying who have also bullied others; and (5) perpetrators of bullying, but not victims. As the number of positive cases in the last three categories was low (range = 3–15 cases) bully categories 2–4 were combined into one primary exposure variable: ‘bullied at school’.

Assessment year was operationalized as the year when data was collected: 2014, 2018, and 2020. Age was operationalized as school grade 9 (15–16 years) or 11 (17–18 years). Gender was self-reported (boy or girl). The school situation To assess experiences of the school situation, students responded to 18 statements about well-being in school, participation in important school matters, perceptions of their teachers, and teaching quality. Responses were given on a four-point Likert scale ranging from ‘do not agree at all’ to ‘fully agree’. To reduce the 18-items down to their essential factors, we performed a principal axis factor analysis. Results showed that the 18 statements formed five factors which, according to the Kaiser criterion (eigen values > 1) explained 56% of the covariance in the student’s experience of the school situation. The five factors identified were: (1) Participation in school; (2) Interesting and meaningful work; (3) Feeling well at school; (4) Structured school lessons; and (5) Praise for achievements. For each factor, an index was created that was dichotomised (poor versus good circumstance) using the median-split and dummy coded with ‘good circumstance’ as reference. A description of the items included in each factor is available as Additional file 1 . Socio-economic status (SES) was assessed with three questions about the education level of the student’s mother and father (dichotomized as university degree versus not), and the amount of spending money the student typically received for entertainment each month (> SEK 1000 [approximately $120] versus less). Higher parental education and more spending money were used as reference categories. School grades in Swedish, English, and mathematics were measured separately on a 7-point scale and dichotomized as high (grades A, B, and C) versus low (grades D, E, and F). High school grades were used as the reference category.

Statistical analyses

The prevalence of mental health problems and bullying at school are presented using descriptive statistics, stratified by survey year (2014, 2018, 2020), gender, and school year (9 versus 11). As noted, we reduced the 18-item questionnaire assessing school function down to five essential factors by conducting a principal axis factor analysis (see Additional file 1 ). We then calculated the association between bullying at school (defined above) and mental health problems using multivariable logistic regression. Results are presented as odds ratios (OR) with 95% confidence intervals (Cis). To assess the contribution of SES and school-related factors to this association, three models are presented: Crude, Model 1 adjusted for demographic factors: age, gender, and assessment year; Model 2 adjusted for Model 1 plus SES (parental education and student spending money), and Model 3 adjusted for Model 2 plus school-related factors (school grades and the five factors identified in the principal factor analysis). These covariates were entered into the regression models in three blocks, where the final model represents the fully adjusted analyses. In all models, the category ‘not bullied at school’ was used as the reference. Pseudo R-square was calculated to estimate what proportion of the variance in mental health problems was explained by each model. Unlike the R-square statistic derived from linear regression, the Pseudo R-square statistic derived from logistic regression gives an indicator of the explained variance, as opposed to an exact estimate, and is considered informative in identifying the relative contribution of each model to the outcome [ 20 ]. All analyses were performed using SPSS v. 26.0.

Prevalence of bullying at school and mental health problems

Estimates of the prevalence of bullying at school and mental health problems across the 12 strata of data (3 years × 2 school grades × 2 genders) are shown in Table 1 . The prevalence of bullying at school increased minimally (< 1%) between 2014 and 2020, except among girls in grade 11 (2.5% increase). Mental health problems increased between 2014 and 2020 (range = 1.2% [boys in year 11] to 4.6% [girls in year 11]); were three to four times more prevalent among girls (range = 11.6% to 17.2%) compared to boys (range = 2.6% to 4.9%); and were more prevalent among older adolescents compared to younger adolescents (range = 1% to 3.1% higher). Pooling all data, reports of mental health problems were four times more prevalent among boys who had been victims of bullying compared to those who reported no experiences with bullying. The corresponding figure for girls was two and a half times as prevalent.

Associations between bullying at school and mental health problems

Table 2 shows the association between bullying at school and mental health problems after adjustment for relevant covariates. Demographic factors, including female gender (OR = 3.87; CI 3.48–4.29), older age (OR = 1.38, CI 1.26–1.50), and more recent assessment year (OR = 1.18, CI 1.13–1.25) were associated with higher odds of mental health problems. In Model 2, none of the included SES variables (parental education and student spending money) were associated with mental health problems. In Model 3 (fully adjusted), the following school-related factors were associated with higher odds of mental health problems: lower grades in Swedish (OR = 1.42, CI 1.22–1.67); uninteresting or meaningless schoolwork (OR = 2.44, CI 2.13–2.78); feeling unwell at school (OR = 1.64, CI 1.34–1.85); unstructured school lessons (OR = 1.31, CI = 1.16–1.47); and no praise for achievements (OR = 1.19, CI 1.06–1.34). After adjustment for all covariates, being bullied at school remained associated with higher odds of mental health problems (OR = 2.57; CI 2.24–2.96). Demographic and school-related factors explained 12% and 6% of the variance in mental health problems, respectively (Pseudo R-Square). The inclusion of socioeconomic factors did not alter the variance explained.

Our findings indicate that mental health problems increased among Swedish adolescents between 2014 and 2020, while the prevalence of bullying at school remained stable (< 1% increase), except among girls in year 11, where the prevalence increased by 2.5%. As previously reported [ 5 , 6 ], mental health problems were more common among girls and older adolescents. These findings align with previous studies showing that adolescents who are bullied at school are more likely to experience mental health problems compared to those who are not bullied [ 3 , 4 , 9 ]. This detrimental relationship was observed after adjustment for school-related factors shown to be associated with adolescent mental health [ 10 ].

A novel finding was that boys who had been bullied at school reported a four-times higher prevalence of mental health problems compared to non-bullied boys. The corresponding figure for girls was 2.5 times higher for those who were bullied compared to non-bullied girls, which could indicate that boys are more vulnerable to the deleterious effects of bullying than girls. Alternatively, it may indicate that boys are (on average) bullied more frequently or more intensely than girls, leading to worse mental health. Social support could also play a role; adolescent girls often have stronger social networks than boys and could be more inclined to voice concerns about bullying to significant others, who in turn may offer supports which are protective [ 21 ]. Related studies partly confirm this speculative explanation. An Estonian study involving 2048 children and adolescents aged 10–16 years found that, compared to girls, boys who had been bullied were more likely to report severe distress, measured by poor mental health and feelings of hopelessness [ 22 ].

Other studies suggest that heritable traits, such as the tendency to internalize problems and having low self-esteem are associated with being a bully-victim [ 23 ]. Genetics are understood to explain a large proportion of bullying-related behaviors among adolescents. A study from the Netherlands involving 8215 primary school children found that genetics explained approximately 65% of the risk of being a bully-victim [ 24 ]. This proportion was similar for boys and girls. Higher than average body mass index (BMI) is another recognized risk factor [ 25 ]. A recent Australian trial involving 13 schools and 1087 students (mean age = 13 years) targeted adolescents with high-risk personality traits (hopelessness, anxiety sensitivity, impulsivity, sensation seeking) to reduce bullying at school; both as victims and perpetrators [ 26 ]. There was no significant intervention effect for bullying victimization or perpetration in the total sample. In a secondary analysis, compared to the control schools, intervention school students showed greater reductions in victimization, suicidal ideation, and emotional symptoms. These findings potentially support targeting high-risk personality traits in bullying prevention [ 26 ].

The relative stability of bullying at school between 2014 and 2020 suggests that other factors may better explain the increase in mental health problems seen here. Many factors could be contributing to these changes, including the increasingly competitive labour market, higher demands for education, and the rapid expansion of social media [ 19 , 27 , 28 ]. A recent Swedish study involving 29,199 students aged between 11 and 16 years found that the effects of school stress on psychosomatic symptoms have become stronger over time (1993–2017) and have increased more among girls than among boys [ 10 ]. Research is needed examining possible gender differences in perceived school stress and how these differences moderate associations between bullying and mental health.

Strengths and limitations

Strengths of the current study include the large participant sample from diverse schools; public and private, theoretical and practical orientations. The survey included items measuring diverse aspects of the school environment; factors previously linked to adolescent mental health but rarely included as covariates in studies of bullying and mental health. Some limitations are also acknowledged. These data are cross-sectional which means that the direction of the associations cannot be determined. Moreover, all the variables measured were self-reported. Previous studies indicate that students tend to under-report bullying and mental health problems [ 29 ]; thus, our results may underestimate the prevalence of these behaviors.

In conclusion, consistent with our stated hypotheses, we observed an increase in self-reported mental health problems among Swedish adolescents, and a detrimental association between bullying at school and mental health problems. Although bullying at school does not appear to be the primary explanation for these changes, bullying was detrimentally associated with mental health after adjustment for relevant demographic, socio-economic, and school-related factors, confirming our third hypothesis. The finding that boys are potentially more vulnerable than girls to the deleterious effects of bullying should be replicated in future studies, and the mechanisms investigated. Future studies should examine the longitudinal association between bullying and mental health, including which factors mediate/moderate this relationship. Epigenetic studies are also required to better understand the complex interaction between environmental and biological risk factors for adolescent mental health [ 24 ].

Availability of data and materials

Data requests will be considered on a case-by-case basis; please email the corresponding author.

Code availability

Not applicable.

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Acknowledgements

Authors are grateful to the Department for Social Affairs, Stockholm, for permission to use data from the Stockholm School Survey.

Open access funding provided by Karolinska Institute. None to declare.

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Håkan Källmén

Epidemiology of Psychiatric Conditions, Substance Use and Social Environment (EPiCSS), Department of Global Public Health, Karolinska Institutet, Level 6, Solnavägen 1e, Solna, Sweden

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HK conceived the study and analyzed the data (with input from MH). HK and MH interpreted the data and jointly wrote the manuscript. All authors read and approved the final manuscript.

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Correspondence to Mats Hallgren .

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Källmén, H., Hallgren, M. Bullying at school and mental health problems among adolescents: a repeated cross-sectional study. Child Adolesc Psychiatry Ment Health 15 , 74 (2021). https://doi.org/10.1186/s13034-021-00425-y

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DOI : https://doi.org/10.1186/s13034-021-00425-y

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  • Mental health
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Child and Adolescent Psychiatry and Mental Health

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Bullying Increases Risk of Developing Mental Health Problems and Vice Versa

A new study by researchers at Columbia University Mailman School of Public Health suggests there is a two-way relationship between bullying perpetration and mental health problems among American youth. Bullying perpetration increased the risk of developing internalizing problems—such as depression, withdrawal, anxiety, and loneliness—and having internalizing problems increased the probability of bullying others. While previous research has focused on the causes and consequences of bullying victimization, this is the first study to comprehensively explore the time sequence between bullying perpetration and mental health problems. The results are published online in the Journal of Adolescent Health .

Bullying is defined as any unwanted aggressive behavior by youth or group of youths who are not siblings or dating partners that is repeated multiple times or highly likely to be repeated. In the U.S., it has been estimated that between 18-31 percent of youths are involved in bullying.

“While it is well documented that bullying victimization is associated with immediate and lifelong mental health problems, no studies to date have examined the hypothesis that the relationship between bullying perpetration and mental health problems may be bidirectional,” said Marine Azevedo Da Silva, PhD, a postdoctoral researcher at the Columbia Mailman School.

The researchers analyzed data from 13,200 youths aged 12 to 17 years in the nationally representative Population Assessment of Tobacco and Health survey to study the bidirectional association between bullying perpetration and internalizing problems. Among them, 79 percent reported that they never bullied others, 11 percent reported having bullied others over a year ago, and 10 percent reported having bullied others in the past year. When bullying perpetration was considered as a past month measure, 16 percent reported having bullied others over a month ago, and 5 percent reported having bullied others in the past month.

When the researchers examined the relationship between bullying perpetration as a predictor of internalizing problems, they found that youths who reported being the perpetrators of bullying were more likely to develop a moderate to high incidence of mental health problems compared to those who reported not perpetrating bullying. They also found that adolescents who experienced moderate to high internalizing problems had increased risk of bullying others compared to those who reported no or low incidence of having mental health problems.

“The study we designed allowed us to show that the association is likely to be bidirectional between bullying perpetration and internalizing problem. However, it is important to point out that the methods of assessment—including definitions, question-wording, and self-report—could overestimate or underestimate the prevalence of bullying and in turn, influence the strength of association between bullying perpetration and internalizing problems,” observed Azevedo Da Silva.

“Our findings provide an important extension to previous literature, and indicate that bullying behaviors prevention and intervention strategies among youth should consider how to take into account and handle negative feelings and mental health problems,” said Silvia Martins , MD, PhD, director of the Substance Abuse Epidemiology Unit of the Department of Epidemiology and senior author.

Co-authors are Jasmin Gonzalez, University of California, Berkeley; and Gregory Person, Xavier University of Louisiana.

The study was supported by NIDA-Inserm Drug Abuse Research Fellowship from the National Institute on Drug Abuse and the French National Institute of Health and Medical Research.

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How does bullying affect health and well-being?

Bullying can affect physical and emotional health, both in the short term and later in life. It can lead to physical injury, social problems, emotional problems, and even death. 1 Those who are bullied are at increased risk for mental health problems, headaches, and problems adjusting to school. 2 Bullying also can cause long-term damage to self-esteem. 3

Children and adolescents who are bullies are at increased risk for substance use, academic problems, and violence to others later in life. 2

Those who are both bullies and victims of bullying suffer the most serious effects of bullying and are at greater risk for mental and behavioral problems than those who are only bullied or who are only bullies. 2

NICHD research studies show that anyone involved with bullying—those who bully others, those who are bullied, and those who bully and are bullied—are at increased risk for depression. 4

NICHD-funded research studies also found that unlike traditional forms of bullying, youth who are bullied electronically—such as by computer or cell phone—are at higher risk for depression than the youth who bully them. 5 Even more surprising, the same studies found that cyber victims were at higher risk for depression than were cyberbullies or bully-victims (i.e., those who both bully others and are bullied themselves), which was not found in any other form of bullying. Read more about these findings in the NICHD news release: Depression High Among Youth Victims of School Cyberbullying, NIH Researchers Report .  

  • Centers for Disease Control and Prevention. (2015). Fact sheet: Understanding bullying . Retrieved June 17, 2016, from https://www.cdc.gov/violenceprevention/pdf/bullying-factsheet508.pdf (PDF - 356 KB).
  • Smokowski, P. R., & Kopasz, K. H. (2005). Bullying in school: An overview of types, effects, family characteristics, and intervention strategies. Children and Schools, 27, 101–109.

External Web Site Policy

  • Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2010). Taking a stand against bullying. Retrieved June 17, 2016, from http://www.nichd.nih.gov/news/resources/spotlight/092110-taking-stand-against-bullying
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2012). Focus on children's mental health research at the NICHD. Retrieved June 17, 2016, from http://www.nichd.nih.gov/news/resources/spotlight/060112-childrens-mental-health
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Youth Suicide and Bullying: Challenges and Strategies for Prevention and Intervention

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Youth Suicide and Bullying: Challenges and Strategies for Prevention and Intervention

4 Bullying and Mental Health

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Involvement in bullying in childhood and adolescence can have a significant impact on immediate and long-term mental health for individuals involved. In this chapter, the effects of bullying on social-emotional functioning, physical health, relationships, and school functioning are reviewed with respect to perpetrators, targets, bully-victims, and bystanders. The relationship between suicidality and bullying is highlighted, as are risk and protective factors. Consideration is given to the impact of bullying in multiple environments, including schools, the community, and the workplace, demonstrating both contextual and temporal implications for involvement. The chapter concludes with suggestions for parents and teachers, medical and mental health providers, and policy makers to help inform assessment and intervention efforts at multiple levels.

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Bullying and Mental Health

  • First Online: 30 May 2019

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bullying and mental health essay

  • Violet Cox-Wingo 2 &
  • Sandra Poirier 3  

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The social worker perspective on bullying is that here is a strong link between bullies and their mental health. Bullying is a form of misplaced aggressive behavior often carried through by using intimidation, shaming, and profound hurtful comments. Young people who have experienced bullying are more likely to experience mental health issues, and those who have mental health issues are more likely to be bullied. Stress and anxiety caused by bullying and harassment can make it more difficult for kids to learn. This chapter illustrates the serious effects of childhood bullying on health, resulting in substantial costs for individuals, their families, and their communities. Recommendations for consideration on practices, research, and policies conclude this chapter.

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(Retired) Chief, Social Work Service, Department of Veterans Affairs, Tennessee Valley Healthcare System, Murfreesboro, TN, USA

Violet Cox-Wingo

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Sandra Poirier

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Cox-Wingo, V., Poirier, S. (2019). Bullying and Mental Health. In: Papa, R. (eds) School Violence in International Contexts. Springer, Cham. https://doi.org/10.1007/978-3-030-17482-8_8

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StopBullying.gov

Effects of Bullying

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Bullying can affect everyone—those who are bullied, those who bully, and those who witness bullying. Bullying is linked to many negative outcomes including impacts on mental health, substance use, and suicide. It is important to talk to kids to determine whether bullying—or something else—is a concern.

Kids Who are Bullied

Kids who are bullied can experience negative physical, social, emotional, academic, and mental health issues. Kids who are bullied are more likely to experience:

  • Depression and anxiety, increased feelings of sadness and loneliness, changes in sleep and eating patterns, and loss of interest in activities they used to enjoy. These issues may persist into adulthood.
  • Health complaints
  • Decreased academic achievement—GPA and standardized test scores—and school participation. They are more likely to miss, skip, or drop out of school.

A very small number of bullied children might retaliate through extremely violent measures. In 12 of 15 school shooting cases in the 1990s, the shooters had a history of being bullied.

Kids Who Bully Others

Kids who bully others can also engage in violent and other risky behaviors into adulthood. Kids who bully are more likely to:

  • Abuse alcohol and other drugs in adolescence and as adults
  • Get into fights, vandalize property, and drop out of school
  • Engage in early sexual activity
  • Have criminal convictions and traffic citations as adults 
  • Be abusive toward their romantic partners, spouses, or children as adults

Kids who witness bullying are more likely to:

  • Have increased use of tobacco, alcohol, or other drugs
  • Have increased mental health problems, including depression and anxiety
  • Miss or skip school

The Relationship between Bullying and Suicide

Media reports often link bullying with suicide. However, most youth who are bullied do not have thoughts of suicide or engage in suicidal behaviors. 

Although kids who are bullied are at risk of suicide, bullying alone is not the cause. Many issues contribute to suicide risk, including depression, problems at home, and trauma history. Additionally, specific groups have an increased risk of suicide, including American Indian and Alaskan Native, Asian American, lesbian, gay, bisexual, and transgender youth. This risk can be increased further when these kids are not supported by parents, peers, and schools. Bullying can make an unsupportive situation worse.

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Bullying Prevention and Mental Health Promotion Lab

The Bullying Prevention and Mental Health Promotion Lab conducts research on topics including bullying and bullying prevention, school-based mental health services and prevention of mental health problems, mental health literacy, help-seeking among culturally and linguistically diverse (CLD) students, parenting practices and family involvement. 

Some of our recent projects include:

  • Influences of the Coronavirus (COVID-19) Outbreak on Racial Discrimination, Identity Development and Socialization (funded by NSF)
  • Racial Discrimination, Identity, Socialization and Civic Engagement among Asian American Families during COVID-19 (funded by Russell Sage Foundation)
  • Examining the Feasibility and Effectiveness of a Novel Psychosocial Intervention for Asian American Parents and Youth during COVID-19 (funded by American Psychological Foundation 2020 Visionary Grant)
  • Promoting mental health literacy and positive help-seeking attitudes for school-based mental health services among minority adolescents
  • The impact of school (e.g., school climate) and family factors (e.g., parenting practice, parental ethnic racial socialization) on students’ involvement in bullying and psychosocial adjustment

If you are a prospective student interested in applying to Dr. Wang's lab, please send an e-mail expressing your interest to [email protected] .  You may also email the lab manager, Ami Patel, with any questions at [email protected] . Applicants with an interest in school-based mental health services, peer relationships, bullying prevention, parenting practice, working with culturally and linguistically diverse (CLD) students, and bridging the gap between research and practice are especially encouraged to apply. 

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bullying and mental health essay

When Prison and Mental Illness Amount to a Death Sentence

The downward spiral of one inmate, Markus Johnson, shows the larger failures of the nation’s prisons to care for the mentally ill.

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By Glenn Thrush

Photographs by Carlos Javier Ortiz

Glenn Thrush spent more than a year reporting this article, interviewing close to 50 people and reviewing court-obtained body-camera footage and more than 1,500 pages of documents.

  • Published May 5, 2024 Updated May 7, 2024

Markus Johnson slumped naked against the wall of his cell, skin flecked with pepper spray, his face a mask of puzzlement, exhaustion and resignation. Four men in black tactical gear pinned him, his face to the concrete, to cuff his hands behind his back.

He did not resist. He couldn’t. He was so gravely dehydrated he would be dead by their next shift change.

Listen to this article with reporter commentary

“I didn’t do anything,” Mr. Johnson moaned as they pressed a shield between his shoulders.

It was 1:19 p.m. on Sept. 6, 2019, in the Danville Correctional Center, a medium-security prison a few hours south of Chicago. Mr. Johnson, 21 and serving a short sentence for gun possession, was in the throes of a mental collapse that had gone largely untreated, but hardly unwatched.

He had entered in good health, with hopes of using the time to gain work skills. But for the previous three weeks, Mr. Johnson, who suffered from bipolar disorder and schizophrenia, had refused to eat or take his medication. Most dangerous of all, he had stealthily stopped drinking water, hastening the physical collapse that often accompanies full-scale mental crises.

Mr. Johnson’s horrific downward spiral, which has not been previously reported, represents the larger failures of the nation’s prisons to care for the mentally ill. Many seriously ill people receive no treatment . For those who do, the outcome is often determined by the vigilance and commitment of individual supervisors and frontline staff, which vary greatly from system to system, prison to prison, and even shift to shift.

The country’s jails and prisons have become its largest provider of inpatient mental health treatment, with 10 times as many seriously mentally ill people now held behind bars as in hospitals. Estimating the population of incarcerated people with major psychological problems is difficult, but the number is likely 200,000 to 300,000, experts say.

Many of these institutions remain ill-equipped to handle such a task, and the burden often falls on prison staff and health care personnel who struggle with the dual roles of jailer and caregiver in a high-stress, dangerous, often dehumanizing environment.

In 2021, Joshua McLemore , a 29-year-old with schizophrenia held for weeks in an isolation cell in Jackson County, Ind., died of organ failure resulting from a “refusal to eat or drink,” according to an autopsy. In April, New York City agreed to pay $28 million to settle a lawsuit filed by the family of Nicholas Feliciano, a young man with a history of mental illness who suffered severe brain damage after attempting to hang himself on Rikers Island — as correctional officers stood by.

Mr. Johnson’s mother has filed a wrongful-death suit against the state and Wexford Health Sources, a for-profit health care contractor in Illinois prisons. The New York Times reviewed more than 1,500 pages of reports, along with depositions taken from those involved. Together, they reveal a cascade of missteps, missed opportunities, potential breaches of protocol and, at times, lapses in common sense.

A woman wearing a jeans jacket sitting at a table showing photos of a young boy on her cellphone.

Prison officials and Wexford staff took few steps to intervene even after it became clear that Mr. Johnson, who had been hospitalized repeatedly for similar episodes and recovered, had refused to take medication. Most notably, they did not transfer him to a state prison facility that provides more intensive mental health treatment than is available at regular prisons, records show.

The quality of medical care was also questionable, said Mr. Johnson’s lawyers, Sarah Grady and Howard Kaplan, a married legal team in Chicago. Mr. Johnson lost 50 to 60 pounds during three weeks in solitary confinement, but officials did not initiate interventions like intravenous feedings or transfer him to a non-prison hospital.

And they did not take the most basic step — dialing 911 — until it was too late.

There have been many attempts to improve the quality of mental health treatment in jails and prisons by putting care on par with punishment — including a major effort in Chicago . But improvements have proved difficult to enact and harder to sustain, hampered by funding and staffing shortages.

Lawyers representing the state corrections department, Wexford and staff members who worked at Danville declined to comment on Mr. Johnson’s death, citing the unresolved litigation. In their interviews with state police investigators, and in depositions, employees defended their professionalism and adherence to procedure, while citing problems with high staff turnover, difficult work conditions, limited resources and shortcomings of co-workers.

But some expressed a sense of resignation about the fate of Mr. Johnson and others like him.

Prisoners have “much better chances in a hospital, but that’s not their situation,” said a senior member of Wexford’s health care team in a deposition.

“I didn’t put them in prison,” he added. “They are in there for a reason.”

Markus Mison Johnson was born on March 1, 1998, to a mother who believed she was not capable of caring for him.

Days after his birth, he was taken in by Lisa Barker Johnson, a foster mother in her 30s who lived in Zion, Ill., a working-class city halfway between Chicago and Milwaukee. Markus eventually became one of four children she adopted from different families.

The Johnson house is a lively split level, with nieces, nephews, grandchildren and neighbors’ children, family keepsakes, video screens and juice boxes. Ms. Johnson sits at its center on a kitchen chair, chin resting on her hand as children wander over to share their thoughts, or to tug on her T-shirt to ask her to be their bathroom buddy.

From the start, her bond with Markus was particularly powerful, in part because the two looked so much alike, with distinctive dimpled smiles. Many neighbors assumed he was her biological son. The middle name she chose for him was intended to convey that message.

“Mison is short for ‘my son,’” she said standing over his modest footstone grave last summer.

He was happy at home. School was different. His grades were good, but he was intensely shy and was diagnosed with attention deficit hyperactivity disorder in elementary school.

That was around the time the bullying began. His sisters were fierce defenders, but they could only do so much. He did the best he could, developing a quick, taunting tongue.

These experiences filled him with a powerful yearning to fit in.

It was not to be.

When he was around 15, he called 911 in a panic, telling the dispatcher he saw two men standing near the small park next to his house threatening to abduct children playing there. The officers who responded found nothing out of the ordinary, and rang the Johnsons’ doorbell.

He later told his mother he had heard a voice telling him to “protect the kids.”

He was hospitalized for the first time at 16, and given medications that stabilized him for stretches of time. But the crises would strike every six months or so, often triggered by his decision to stop taking his medication.

His family became adept at reading signs he was “getting sick.” He would put on his tan Timberlands and a heavy winter coat, no matter the season, and perch on the edge of his bed as if bracing for battle. Sometimes, he would cook his own food, paranoid that someone might poison him.

He graduated six months early, on the dean’s list, but was rudderless, and hanging out with younger boys, often paying their way.

His mother pointed out the perils of buying friendship.

“I don’t care,” he said. “At least I’ll be popular for a minute.”

Zion’s inviting green grid of Bible-named streets belies the reality that it is a rough, unforgiving place to grow up. Family members say Markus wanted desperately to prove he was tough, and emulated his younger, reckless group of friends.

Like many of them, he obtained a pistol. He used it to hold up a convenience store clerk for $425 in January 2017, according to police records. He cut a plea deal for two years of probation, and never explained to his family what had made him do it.

But he kept getting into violent confrontations. In late July 2018, he was arrested in a neighbor’s garage with a handgun he later admitted was his. He was still on probation for the robbery, and his public defender negotiated a plea deal that would send him to state prison until January 2020.

An inpatient mental health system

Around 40 percent of the about 1.8 million people in local, state and federal jails and prison suffer from at least one mental illness, and many of these people have concurrent issues with substance abuse, according to recent Justice Department estimates.

Psychological problems, often exacerbated by drug use, often lead to significant medical problems resulting from a lack of hygiene or access to good health care.

“When you suffer depression in the outside world, it’s hard to concentrate, you have reduced energy, your sleep is disrupted, you have a very gloomy outlook, so you stop taking care of yourself,” said Robert L. Trestman , a Virginia Tech medical school professor who has worked on state prison mental health reforms.

The paradox is that prison is often the only place where sick people have access to even minimal care.

But the harsh work environment, remote location of many prisons, and low pay have led to severe shortages of corrections staff and the unwillingness of doctors, nurses and counselors to work with the incarcerated mentally ill.

In the early 2000s, prisoners’ rights lawyers filed a class-action lawsuit against Illinois claiming “deliberate indifference” to the plight of about 5,000 mentally ill prisoners locked in segregated units and denied treatment and medication.

In 2014, the parties reached a settlement that included minimum staffing mandates, revamped screening protocols, restrictions on the use of solitary confinement and the allocation of about $100 million to double capacity in the system’s specialized mental health units.

Yet within six months of the deal, Pablo Stewart, an independent monitor chosen to oversee its enforcement, declared the system to be in a state of emergency.

Over the years, some significant improvements have been made. But Dr. Stewart’s final report , drafted in 2022, gave the system failing marks for its medication and staffing policies and reliance on solitary confinement “crisis watch” cells.

Ms. Grady, one of Mr. Johnson’s lawyers, cited an additional problem: a lack of coordination between corrections staff and Wexford’s professionals, beyond dutifully filling out dozens of mandated status reports.

“Markus Johnson was basically documented to death,” she said.

‘I’m just trying to keep my head up’

Mr. Johnson was not exactly looking forward to prison. But he saw it as an opportunity to learn a trade so he could start a family when he got out.

On Dec. 18, 2018, he arrived at a processing center in Joliet, where he sat for an intake interview. He was coherent and cooperative, well-groomed and maintained eye contact. He was taking his medication, not suicidal and had a hearty appetite. He was listed as 5 feet 6 inches tall and 256 pounds.

Mr. Johnson described his mood as “go with the flow.”

A few days later, after arriving in Danville, he offered a less settled assessment during a telehealth visit with a Wexford psychiatrist, Dr. Nitin Thapar. Mr. Johnson admitted to being plagued by feelings of worthlessness, hopelessness and “constant uncontrollable worrying” that affected his sleep.

He told Dr. Thapar he had heard voices in the past — but not now — telling him he was a failure, and warning that people were out to get him.

At the time he was incarcerated, the basic options for mentally ill people in Illinois prisons included placement in the general population or transfer to a special residential treatment program at the Dixon Correctional Center, west of Chicago. Mr. Johnson seemed out of immediate danger, so he was assigned to a standard two-man cell in the prison’s general population, with regular mental health counseling and medication.

Things started off well enough. “I’m just trying to keep my head up,” he wrote to his mother. “Every day I learn to be stronger & stronger.”

But his daily phone calls back home hinted at friction with other inmates. And there was not much for him to do after being turned down for a janitorial training program.

Then, in the spring of 2019, his grandmother died, sending him into a deep hole.

Dr. Thapar prescribed a new drug used to treat major depressive disorders. Its most common side effect is weight gain. Mr. Johnson stopped taking it.

On July 4, he told Dr. Thapar matter-of-factly during a telehealth check-in that he was no longer taking any of his medications. “I’ve been feeling normal, I guess,” he said. “I feel like I don’t need the medication anymore.”

Dr. Thapar said he thought that was a mistake, but accepted the decision and removed Mr. Johnson from his regular mental health caseload — instructing him to “reach out” if he needed help, records show.

The pace of calls back home slackened. Mr. Johnson spent more time in bed, and became more surly. At a group-therapy session, he sat stone silent, after showing up late.

By early August, he was telling guards he had stopped eating.

At some point, no one knows when, he had intermittently stopped drinking fluids.

‘I’m having a breakdown’

Then came the crash.

On Aug. 12, Mr. Johnson got into a fight with his older cellmate.

He was taken to a one-man disciplinary cell. A few hours later, Wexford’s on-site mental health counselor, Melanie Easton, was shocked by his disoriented condition. Mr. Johnson stared blankly, then burst into tears when asked if he had “suffered a loss in the previous six months.”

He was so unresponsive to her questions she could not finish the evaluation.

Ms. Easton ordered that he be moved to a 9-foot by 8-foot crisis cell — solitary confinement with enhanced monitoring. At this moment, a supervisor could have ticked the box for “residential treatment” on a form to transfer him to Dixon. That did not happen, according to records and depositions.

Around this time, he asked to be placed back on his medication but nothing seems to have come of it, records show.

By mid-August, he said he was visualizing “people that were not there,” according to case notes. At first, he was acting more aggressively, once flicking water at a guard through a hole in his cell door. But his energy ebbed, and he gradually migrated downward — from standing to bunk to floor.

“I’m having a breakdown,” he confided to a Wexford employee.

At the time, inmates in Illinois were required to declare an official hunger strike before prison officials would initiate protocols, including blood testing or forced feedings. But when a guard asked Mr. Johnson why he would not eat, he said he was “fasting,” as opposed to starving himself, and no action seems to have been taken.

‘Tell me this is OK!’

Lt. Matthew Morrison, one of the few people at Danville to take a personal interest in Mr. Johnson, reported seeing a white rind around his mouth in early September. He told other staff members the cell gave off “a death smell,” according to a deposition.

On Sept. 5, they moved Mr. Johnson to one of six cells adjacent to the prison’s small, bare-bones infirmary. Prison officials finally placed him on the official hunger strike protocol without his consent.

Mr. Morrison, in his deposition, said he was troubled by the inaction of the Wexford staff, and the lack of urgency exhibited by the medical director, Dr. Justin Young.

On Sept. 5, Mr. Morrison approached Dr. Young to express his concerns, and the doctor agreed to order blood and urine tests. But Dr. Young lived in Chicago, and was on site at the prison about four times a week, according to Mr. Kaplan. Friday, Sept. 6, 2019, was not one of those days.

Mr. Morrison arrived at work that morning, expecting to find Mr. Johnson’s testing underway. A Wexford nurse told him Dr. Young believed the tests could wait.

Mr. Morrison, stunned, asked her to call Dr. Young.

“He’s good till Monday,” Dr. Young responded, according to Mr. Morrison.

“Come on, come on, look at this guy! You tell me this is OK!” the officer responded.

Eventually, Justin Duprey, a licensed nurse practitioner and the most senior Wexford employee on duty that day, authorized the test himself.

Mr. Morrison, thinking he had averted a disaster, entered the cell and implored Mr. Johnson into taking the tests. He refused.

So prison officials obtained approval to remove him forcibly from his cell.

‘Oh, my God’

What happened next is documented in video taken from cameras held by officers on the extraction team and obtained by The Times through a court order.

Mr. Johnson is scarcely recognizable as the neatly groomed 21-year-old captured in a cellphone picture a few months earlier. His skin is ashen, eyes fixed on the middle distance. He might be 40. Or 60.

At first, he places his hands forward through the hole in his cell door to be cuffed. This is against procedure, the officers shout. His hands must be in back.

He will not, or cannot, comply. He wanders to the rear of his cell and falls hard. Two blasts of pepper spray barely elicit a reaction. The leader of the tactical team later said he found it unusual and unnerving.

The next video is in the medical unit. A shield is pressed to his chest. He is in agony, begging for them to stop, as two nurses attempt to insert a catheter.

Then they move him, half-conscious and limp, onto a wheelchair for the blood draw.

For the next 20 minutes, the Wexford nurse performing the procedure, Angelica Wachtor, jabs hands and arms to find a vessel that will hold shape. She winces with each puncture, tries to comfort him, and grows increasingly rattled.

“Oh, my God,” she mutters, and asks why help is not on the way.

She did not request assistance or discuss calling 911, records indicate.

“Can you please stop — it’s burning real bad,” Mr. Johnson said.

Soon after, a member of the tactical team reminds Ms. Wachtor to take Mr. Johnson’s vitals before taking him back to his cell. She would later tell Dr. Young she had been unable to able to obtain his blood pressure.

“You good?” one of the team members asks as they are preparing to leave.

“Yeah, I’ll have to be,” she replies in the recording.

Officers lifted him back onto his bunk, leaving him unconscious and naked except for a covering draped over his groin. His expressionless face is visible through the window on the cell door as it closes.

‘Cardiac arrest.’

Mr. Duprey, the nurse practitioner, had been sitting inside his office after corrections staff ordered him to shelter for his own protection, he said. When he emerged, he found Ms. Wachtor sobbing, and after a delay, he was let into the cell. Finding no pulse, Mr. Duprey asked a prison employee to call 911 so Mr. Johnson could be taken to a local emergency room.

The Wexford staff initiated CPR. It did not work.

At 3:38 p.m., the paramedics declared Markus Mison Johnson dead.

Afterward, a senior official at Danville called the Johnson family to say he had died of “cardiac arrest.”

Lisa Johnson pressed for more information, but none was initially forthcoming. She would soon receive a box hastily crammed with his possessions: uneaten snacks, notebooks, an inspirational memoir by a man who had served 20 years at Leavenworth.

Later, Shiping Bao, the coroner who examined his body, determined Mr. Johnson had died of severe dehydration. He told the state police it “was one of the driest bodies he had ever seen.”

For a long time, Ms. Johnson blamed herself. She says that her biggest mistake was assuming that the state, with all its resources, would provide a level of care comparable to what she had been able to provide her son.

She had stopped accepting foster care children while she was raising Markus and his siblings. But as the months dragged on, she decided her once-boisterous house had become oppressively still, and let local agencies know she was available again.

“It is good to have children around,” she said. “It was too quiet around here.”

Read by Glenn Thrush

Audio produced by Jack D’Isidoro .

Glenn Thrush covers the Department of Justice. He joined The Times in 2017 after working for Politico, Newsday, Bloomberg News, The New York Daily News, The Birmingham Post-Herald and City Limits. More about Glenn Thrush

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Teens and Video Games Today

85% of u.s. teens say they play video games, and about four-in-ten do so daily. teens see both positive and negative sides of video games – from problem-solving and making friends to harassment and sleep loss, table of contents.

  • Who plays video games?
  • How often do teens play video games?
  • What devices do teens play video games on?
  • Social media use among gamers
  • Teen views on how much they play video games and efforts to cut back
  • Are teens social with others through video games?
  • Do teens think video games positively or negatively impact their lives?
  • Why do teens play video games?
  • Bullying and violence in video games
  • Appendix A: Detailed charts
  • Acknowledgments
  • Methodology

An image of teens competing in a video game tournament at the Portland Public Library in Maine in 2018. (Ben McCanna/Portland Press Herald via Getty Images)

Pew Research Center conducted this analysis to better understand teens’ use of and experiences with video games.

The Center conducted an online survey of 1,453 U.S. teens from Sept. 26 to Oct. 23, 2023, through Ipsos. Ipsos recruited the teens via their parents, who were part of its KnowledgePanel . The KnowledgePanel is a probability-based web panel recruited primarily through national, random sampling of residential addresses. The survey was weighted to be representative of U.S. teens ages 13 to 17 who live with their parents by age, gender, race and ethnicity, household income, and other categories.

This research was reviewed and approved by an external institutional review board (IRB), Advarra, an independent committee of experts specializing in helping to protect the rights of research participants.

Here are the questions used for this analysis , along with responses, and  its methodology .

There are long-standing debates about the impact of video games on youth. Some credit them for helping young people form friendships and teaching them about teamwork and problem-solving . Others say video games expose teenagers to violent content, negatively impact their sleep and can even lead to addiction.

With this in mind, Pew Research Center surveyed 1,423 U.S. teens ages 13 to 17 about their own video game habits – from how often they play to the friends they’ve made and whether it gets in the way of them doing well in school or getting a good night’s sleep. 1

Key findings from the survey

  • Video games as a part of daily teen life: 85% of U.S. teens report playing video games, and 41% say they play them at least once a day. Four-in-ten identify as a gamer.
  • Gaming as a social experience: 72% of teens who play video games say that a reason why they play them is to spend time with others. And some have even made a friend online from playing them – 47% of teen video game players say they’ve done this.
  • Helpful with problem-solving, less so for sleep: Over half of teens who play video games say it has helped their problem-solving skills, but 41% also say it has hurt their sleep.
  • Bullying is a problem: 80% of all teens think harassment over video games is a problem for people their age. And 41% of those who play them say they’ve been called an offensive name when playing.
  • Boys’ and girls’ experiences differ: Most teen boys and girls play video games, but larger shares of boys identify as gamers (62% vs. 17%) and play every day (61% vs. 22%). Boys who play them are also more likely to experience positive things from it, like making friends, and more troubling things like harassment.

Jump to read about: Who plays video games | Socializing over video games | Views about video games’ impact | Harassment and violence in video games      

A bar chart showing that 85% of teens play video games, and 4 in 10 identify as gamers

Playing video games is widespread among teens. The vast majority of U.S. teens (85%) say they play them. Just 15% say they never do, according to the survey conducted Sept. 26-Oct. 23, 2023.

In addition to asking whether teens play video games, we also wanted to learn whether they consider themselves gamers. Overall, four-in-ten U.S. teens think of themselves as gamers. Just under half of teens (45%) play video games but do not think of themselves as gamers.

A bar chart showing that Most teen boys and girls play video games, but boys are far more likely to identify as gamers

Nearly all boys (97%) say they play video games, compared with about three-quarters of teen girls. There is a substantial gap by gender in whether teens identify as gamers: 62% of teen boys do, compared with 17% of girls. 2

By gender and age

Younger teen girls are more likely than older girls to say they play video games: 81% of girls ages 13 to 14 compared with 67% of those ages 15 to 17. But among boys, nearly all play video games regardless of age. 

Similar shares of teens play video games across different racial and ethnic groups and among those who live in households with different annual incomes. Go to Appendix A for more detail on which teens play video games and which teens identify as gamers.

A flow chart showing How we asked teens in our survey if they play video games and identify as gamers by first asking who plays video games and then who identifies as a gamer

We also asked teens how often they play video games. About four-in-ten U.S. teens say they play video games daily, including 23% who do so several times a day.

A bar chart showing that About 6 in 10 teen boys play video games daily

Another 22% say they play several times a week, while 21% play them about once a week or less.

Teen boys are far more likely than girls to say they play video games daily (61% vs. 22%). They are also much more likely to say they play them several times a day (36% vs. 11%).

By whether someone identifies as a gamer

About seven-in-ten teens who identify as gamers (71%) say they play video games daily. This drops to 30% among those who play them but aren’t gamers.

By household income

Roughly half of teens living in households with an annual income of less than $30,000 (53%) say they play video games at least daily. This is higher than those in households with an annual income of $30,000 to $74,999 (42%) and $75,000 or more (39%).

Go to Appendix A to see more details about who plays video games and identifies as a gamer by gender, age, race and ethnicity, and household income.

A bar chart showing that Most teens play video games on a console or smartphone, 24% do so on a virtual reality headset

Most teens play video games on a gaming console or a smartphone. When asked about five devices, most teens report playing video games on a gaming console (73%), such as PlayStation, Switch or Xbox. And 70% do so on a smartphone. Fewer – though still sizable shares – play them on each of the following:

  • 49% say they play them on a desktop or laptop computer
  • 33% do so on a tablet  
  • 24% play them on a virtual reality (VR) headset such as Oculus, Meta Quest or PlayStation VR

Many teens play video games on multiple devices. About a quarter of teens (27%) do so on at least four of the five devices asked about, and about half (49%) play on two or three of them. Just 8% play video games on one device.

A dot plot showing that Teen boys are more likely than girls to play video games on all devices except tablets

Teen boys are more likely than girls to play video games on four of the five devices asked about – all expect tablets. For instance, roughly nine-in-ten teen boys say they ever play video games on a gaming console, compared with 57% of girls. Equal shares of teen boys and girls play them on tablets.  

Teens who consider themselves gamers are more likely than those who play video games but aren’t gamers to play on a gaming console (95% vs. 78%), desktop or laptop computer (72% vs. 45%) or a virtual reality (VR) headset (39% vs. 19%). Similar shares of both groups play them on smartphones and tablets.

A dot plot showing that Teen gamers are far more likely to use Discord and Twitch than other teens

One way that teens engage with others about video games is through online platforms. And our survey findings show that teen gamers stand out for their use of two online platforms that are known for their gaming communities – Discord and Twitch :

  • 44% of teen gamers say they use Discord, far higher than video game players who don’t identify as gamers or those who use the platform but do not play video games at all. About three-in-ten teens overall (28%) use Discord.
  • 30% of teens gamers say they use Twitch. About one-in-ten other teens or fewer say the same; 17% of teens overall use the platform.

Previous Center research shows that U.S. teens use online platforms at high rates .

A bar chart showing that Teens most commonly say they spend the right amount of time playing video games

Teens largely say they spend the right amount of time playing video games. When asked about how much time they spend playing them, the largest share of teens (58%) say they spend the right amount of time. Far fewer feel they spend too much (14%) or too little (13%) time playing them.

Teen boys are more likely than girls to say they spend too much time playing video games (22% vs. 6%).

By race and ethnicity

Black (17%) and Hispanic (18%) teens are about twice as likely than White teens (8%) to say they spend too little time playing video games. 3

A quarter of teens who consider themselves gamers say they spend too much time playing video games, compared with 9% of those who play video games but don’t identify as gamers. Teen gamers are also less likely to think they spend too little time playing them (19% vs. 10%).

A bar chart showing that About 4 in 10 teens have cut back on how much they play video games

Fewer than half of teens have reduced how much they play video games. About four-in-ten (38%) say they have ever chosen to cut back on the amount of time they spend playing them. A majority (61%) report that they have not cut back at all.

This share is on par with findings about whether teenagers have cut back with their screen time – on social media or their smartphone.

Although boys are more likely to say they play video games too much, boys and girls are on par for whether they have ever cut back. About four-in-ten teen boys (39%) and girls (38%) say that they have ever cut back.

And gamers are as likely to say they have cut back as those who play video games but don’t identify as gamers (39% and 41%).

A chart showing that 89% of teens who play video games do so with others; about half or 47% made a friend through them

A main goal of our survey was to ask teens about their own experiences playing video games. For this section of the report, we focus on teens who say they play video games.

Socializing with others is a key part of the video game experience. Most teens who play video games do so with others, and some have developed friendships through them.

About nine-in-ten teen video game players (89%) say they play them with other people, in person or online. Far fewer (11%) play them only on their own.

Additionally, about half (47%) report that they have ever made a friend online because of a video game they both play. This equals 40% of all U.S. teens who have made a friend online because of a video game.

These experiences vary by:  

A bar chart showing that Teen boys who play video games are more likely than girls to make friends over video games

  • Gender: Most teen boy and girl video game players play them with others, though it’s more common among boys (94% vs. 82%). Boys who play video games are much more likely to say they have made a friend online because of a video game (56% vs. 35%).
  • Race and ethnicity: Black (55%) and Hispanic (53%) teen video game players are more likely than White teen video game players (43%) to say they have made a friend online because of them.
  • Whether someone identifies as a gamer: Nearly all teen gamers report playing video games with others (98%). Fewer – though still most – of those who play video games but aren’t gamers (81%) also play them with others. And about seven-in-ten (68%) say they have made a friend online because of a video game, compared with 29% of those who play them but don’t identify as gamers.

A bar chart showing that More than half of teens who play video games say it helps their problem-solving skills, but many say it negatively impacts the amount of sleep they get

Teens who play video games are particularly likely to say video games help their problem-solving skills. More than half of teens who play video games (56%) say this.

Additionally, more think that video games help, rather than hurt, three other parts of their lives that the survey asked about. Among teens who play video games:

  • Roughly half (47%) say it has helped their friendships
  • 41% say it has helped how they work with others
  • 32% say it has helped their mental health

No more than 7% say playing video games has hurt any of these.

More teens who play video games say it hurts, rather than helps, their sleep. Among these teens, 41% say it has hurt how much sleep they get, while just 5% say it helps. And small shares say playing video games has impacted how well they do in school in either a positive or a negative way.

Still, many teens who play video games think playing them doesn’t have much an impact in any of these areas. For instance, at least six-in-ten teens who play video games say it has neither a positive nor a negative impact on their mental health (60%) or their school performance (72%). Fewer (41%) say this of their problem-solving skills.

A dot plot showing that Boys who play video games are more likely than girls to think it helps friendships, problem-solving, ability to work with others

Teen boys who play video games are more likely than girls to think playing them has helped their problem-solving skills, friendships and ability to work with others. For instance, 55% of teen boys who play video games say this has helped their friendships, compared with 35% of teen girls.

As for ways that it may hurt their lives, boys who play them are more likely than girls to say that it has hurt the amount of sleep they get (45% vs. 37%) and how well they do in school (21% vs. 11%). 

Teens who consider themselves gamers are more likely than those who aren’t gamers but play video games to say video games have helped their friendships (60% vs. 35%), ability to work with others (52% vs. 32%), problem-solving skills (66% vs. 47%) and mental health (41% vs. 24%).

Gamers, though, are somewhat more likely to say playing them hurt their sleep (48% vs. 36%) and how well they do in school (20% vs. 14%).

By whether teens play too much, too little or the right amount

Teens who report playing video games too much stand out for thinking video games have hurt their sleep and school performance. Two-thirds of these teens say it has hurt the amount of sleep they get, and 39% say it hurt their schoolwork. Far fewer of those who say they play the right amount (38%) or too little (32%) say it has hurt their sleep, or say it hurt their schoolwork (12% and 16%).

A bar chart showing that Most common reason teens play video games is entertainment

Teens who play video games say they largely do so to be entertained. And many also play them to be social with and interact with others. Teens who play video games were asked about four reasons why they play video games. Among those who play video games:

  • Nearly all say fun or entertainment is a major or minor reason why they play video games – with a large majority (87%) saying it’s a major reason.
  • Roughly three-quarters say spending time with others is a reason, and two-thirds say this of competing with others. Roughly three-in-ten say each is a major reason.
  • Fewer – 50% – see learning something as a reason, with just 13% saying it’s a major reason.

While entertainment is by far the most common reason given by teens who play video games, differences emerge across groups in why they play video games.

A bar chart showing that Teen gamers are especially likely to say spending time and competing with others are reasons why they play

Teens who identify as gamers are particularly likely to say each is major reason, especially when it comes to competing against others. About four-in-ten gamers (43%) say this is a major reason, compared with 13% of those who play video games but aren’t gamers.

Teen boys who play video games are more likely than girls to say competing (36% vs. 15%), spending time with others (36% vs. 27%) and entertainment (90% vs. 83%) are major reasons they play video games.

Black and Hispanic teens who play video games are more likely than White teens to say that learning new things and competing against others are major reasons they play them. For instance, 29% of Black teen video game players say learning something new is a major reason, higher than 17% of Hispanic teen video game players. Both are higher than the 7% of White teen video game players who say the same.

Teens who play video games and live in lower-income households are especially likely to say competing against others and learning new things are major reasons. For instance, four-in-ten teen video game players who live in households with an annual income of less than $30,000 say competing against others is a major reason they play. This is higher than among those in households with annual incomes of $30,000 to $74,999 (29%) and $75,000 or more (23%).

Cyberbullying can happen in many online environments, but many teens encounter this in the video game world.

Our survey finds that name-calling is a relatively common feature of video game life – especially for boys. Roughly four-in-ten teen video game players (43%) say they have been harassed or bullied while playing a video game in one of three ways: 

A bar chart showing that About half of teen boys who play video games say they have been called an offensive name while playing

  • 41% have been called an offensive name
  • 12% have been physically threatened
  • 8% have been sent unwanted sexually explicit things

Teen boys are particularly likely to say they have been called an offensive name. About half of teen boys who play video games (48%) say this has happened while playing them, compared with about a third of girls (32%). And they are somewhat more likely than girls to have been physically threatened (15% vs. 9%).

Teen gamers are more likely than those who play video games but aren’t gamers to say they been called and offensive name (53% vs. 30%), been physically threatened (17% vs. 8%) and sent unwanted sexually explicit things (10% vs. 6%).

A pie chart showing that Most teens say that bullying while playing video games is a problem for people their age

Teens – regardless of whether they’ve had these experiences – think bullying is a problem in gaming. Eight-in-ten U.S. teens say that when it comes to video games, harassment and bullying is a problem for people their age. This includes 29% who say it is a major problem.

It’s common for teens to think harassment while playing video games is a problem, but girls are somewhat more likely than boys to say it’s a major problem (33% vs. 25%).

There have also been decades-long debates about how violent video games can influence youth behavior , if at all – such as by encouraging or desensitizing them to violence. We wanted to get a sense of how commonly violence shows up in the video games teens are playing.

A bar chart showing that About 7 in 10 teen boys who play video games say there is violence in at least some of the games they play

Just over half of teens who play video games (56%) say at least some of the games they play contain violence. This includes 16% who say it’s in all or most of the games they play.

Teen boys who play video games are far more likely than girls to say that at least some of the games they play contain violence (69% vs. 37%).

About three-quarters of teen gamers (73%) say that at least some of the games they play contain violence, compared with 40% among video game players who aren’t gamers.   

  • Throughout this report, “teens” refers to those ages 13 to 17. ↩
  • Previous Center research of U.S. adults shows that men are more likely than women to identify as gamers – especially the youngest adults. ↩
  • There were not enough Asian American respondents in the sample to be broken out into a separate analysis. As always, their responses are incorporated into the general population figures throughout the report. ↩

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Elektrostal , Moscow Oblast, Russia

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    Research shows that young adults who are bullied as a child have an increased risk of mental health difficulties, including: Generalized anxiety. ‌ Panic disorder. ‌ Agoraphobia. ‌Depression ...

  4. Bullying in children: impact on child health

    Bullying in childhood is a global public health problem that impacts on child, adolescent and adult health. Bullying exists in its traditional, sexual and cyber forms, all of which impact on the physical, mental and social health of victims, bullies and bully-victims. Children perceived as 'different' in any way are at greater risk of ...

  5. Bullying at school and mental health problems among adolescents: a

    To examine recent trends in bullying and mental health problems among adolescents and the association between them. A questionnaire measuring mental health problems, bullying at school, socio-economic status, and the school environment was distributed to all secondary school students aged 15 (school-year 9) and 18 (school-year 11) in Stockholm during 2014, 2018, and 2020 (n = 32,722).

  6. Bullying at school and mental health problems among adolescents: a

    Introduction. Bullying involves repeated hurtful actions between peers where an imbalance of power exists [].Arseneault et al. [] conducted a review of the mental health consequences of bullying for children and adolescents and found that bullying is associated with severe symptoms of mental health problems, including self-harm and suicidality.. Bullying was shown to have detrimental effects ...

  7. Effects of Bullying Forms on Adolescent Mental Health and Protective

    In Model 1, with bullying frequency as the core explanatory variable, the regression results showed that bullying frequency negatively affected adolescent mental health, with the largest negative effect on mental health for adolescents who had been bullied for more than 20 days in the past 30 days, with a 7.53 decrease in mental health (p < 0. ...

  8. Effects of Bullying on Mental Health

    Bystanders to bullying may also experience mental health effects. The same study showed that students who witness bullying at school experienced increased anxiety and depression regardless of whether they supported the bully or the person being bullied. Bystanders may experience stress related to fears of retaliation or because they wanted to ...

  9. Bullying Increases Risk of Developing Mental Health Problems and Vice

    "While it is well documented that bullying victimization is associated with immediate and lifelong mental health problems, no studies to date have examined the hypothesis that the relationship between bullying perpetration and mental health problems may be bidirectional," said Marine Azevedo Da Silva, PhD, a postdoctoral researcher at the ...

  10. How does bullying affect health and well-being?

    Bullying can affect physical and emotional health, both in the short term and later in life. It can lead to physical injury, social problems, emotional problems, and even death.1 Those who are bullied are at increased risk for mental health problems, headaches, and problems adjusting to school.2 Bullying also can cause long-term damage to self-esteem.3

  11. 4 Bullying and Mental Health

    Bullying, once regarded as a rite of passage, is now recognized as a serious mental health and public health issue. Bullying is a form of aggressive behavior that includes an intention to cause physical or psychological harm, a power imbalance that makes it difficult for the target to defend himself or herself, and repeated occurrence (Nansel et al., 2001; Olweus, 1993).

  12. Preventing Bullying: Consequences, Prevention, and Intervention

    mental health problems, cognitive function, self- regulation, and other physical hea lth problems. The long-term consequences of being bullied extend into adulthood. Consequences for Youth Who ...

  13. Bullying and Mental Health

    According to the Anti-Bullying Alliance ( 2017 ), there is a strong link between mental health and bullying . Young people who have experienced bullying are more likely to experience mental health issues, and those who have mental health issues are more likely to be bullied. In 2015, the Anti-Bullying Alliance teamed up with YoungMinds (a ...

  14. Bullying and Its Impact on Mental Health

    In this essay, readers can expect to delve into the pervasive issue of bullying and its detrimental consequences on mental health and well-being. The essay explores how bullying not only affects individuals but also has ripple effects on families and communities.

  15. Effects of Bullying

    Bullying is linked to many negative outcomes including impacts on mental health, substance use, and suicide. It is important to talk to kids to determine whether bullying—or something else—is a concern. Kids Who are Bullied. Kids who are bullied can experience negative physical, social, emotional, academic, and mental health issues.

  16. The Mental Health Impact of Bullying on Kids and Teens

    If you would like to learn more about bullying or need help managing the mental health effects of bullying, there are resources available. If you or someone you care for is feeling hopeless or helpless, you can call the 988 Suicide & Crisis Lifeline at 1.800.273.8255 or 988 at any time for support from a counselor.

  17. Cyberbullying and its impact on young people's emotional health and

    The nature of cyberbullying. Traditional face-to-face bullying has long been identified as a risk factor for the social and emotional adjustment of perpetrators, targets and bully victims during childhood and adolescence; Reference Almeida, Caurcel and Machado 1-Reference Sourander, Brunstein, Ikomen, Lindroos, Luntamo and Koskelainen 6 bystanders are also known to be negatively affected.

  18. The Impact of Cyberbullying on Mental Health

    Please use one of the following formats to cite this article in your essay, paper or report: APA. Greenwood, Michael. (2023, January 05). The Impact of Cyberbullying on Mental Health.

  19. Chains of tragedy: The impact of bullying victimization on mental

    Maladaptive behavior of bullying victims could produce mental health issues. Bullying victims scored higher on hostile interpretation, anger, retaliation, and ease of aggression than the other children (Camodeca and Goossens, 2005), and aggressive acts that would occur as impulsive behavior to cause harm to the source of frustration and defend ...

  20. Bullying Prevention and Mental Health Promotion Lab

    The Bullying Prevention and Mental Health Promotion Lab conducts research on topics including bullying and bullying prevention, school-based mental health services and prevention of mental health problems, mental health literacy, help-seeking among culturally and linguistically diverse (CLD) students, parenting practices and family involvement ...

  21. What are the effects of bullying on children's mental health?

    Children who experience bullying are at greater risk of physical and mental health challenges that can continue into adulthood. It can also impact their academic performance, ability to make friends, and self-esteem . Fortunately, bullying is preventable. By speaking up, offering support, and advocating for change, you can help break the cycle ...

  22. Dehumanization and mental health

    The burgeoning literature on dehumanization offers three key insights. First, dehumanization ranges from blatant and verbalized to subtle and unconscious: people can be explicitly likened to animals, but also implicitly denied fundamental human qualities such as rationality, self-control and complex emotions. Second, dehumanization takes varied ...

  23. When Prison and Mental Illness Amount to a Death Sentence

    It was 1:19 p.m. on Sept. 6, 2019, in the Danville Correctional Center, a medium-security prison a few hours south of Chicago. Mr. Johnson, 21 and serving a short sentence for gun possession, was ...

  24. Teens and Video Games Today

    Teens - regardless of whether they've had these experiences - think bullying is a problem in gaming. Eight-in-ten U.S. teens say that when it comes to video games, harassment and bullying is a problem for people their age. This includes 29% who say it is a major problem.

  25. Elektrostal Map

    Elektrostal is a city in Moscow Oblast, Russia, located 58 kilometers east of Moscow. Elektrostal has about 158,000 residents. Mapcarta, the open map.

  26. Elektrostal

    Elektrostal , lit: Electric and Сталь , lit: Steel) is a city in Moscow Oblast, Russia, located 58 kilometers east of Moscow. Population: 155,196 ; 146,294 ...

  27. Two Wisconsin high school seniors receive prestigious national award

    MADISON — Two Wisconsin students have been named U.S. Presidential Scholars by the U.S. Department of Education, one of the nation's highest honors for high school students. The students received the recognition for achievement in academics, arts, and career and technical education. Anica Tipkemper-Wolfe (Cedarburg Senior High School - Cedarburg School District) and Ezra M. Linnan ...

  28. Geographic coordinates of Elektrostal, Moscow Oblast, Russia

    Geographic coordinates of Elektrostal, Moscow Oblast, Russia in WGS 84 coordinate system which is a standard in cartography, geodesy, and navigation, including Global Positioning System (GPS). Latitude of Elektrostal, longitude of Elektrostal, elevation above sea level of Elektrostal.

  29. Elektrostal, Moscow Oblast, Russia

    Elektrostal Geography. Geographic Information regarding City of Elektrostal. Elektrostal Geographical coordinates. Latitude: 55.8, Longitude: 38.45. 55° 48′ 0″ North, 38° 27′ 0″ East. Elektrostal Area. 4,951 hectares. 49.51 km² (19.12 sq mi) Elektrostal Altitude.