A recent study of U.S. 10th-grade adolescents at the University of Washington, Seattle, showed a positive association between victimization by bullies and substance use. Are these findings plausible?

The Olweus program consists of five steps:

▸ Every adult in the school, from the principal to the janitor, must sign on to participate in antibullying efforts.

▸ Assemblies announcing that the school is an antibullying school must take place, in addition to other kinds of marketing to the children–such as signs on the walls–about this designation.

▸ Whenever an adult interrupts a bullying event, the teacher must stop the lesson and take 5–10 minutes to lead a discussion about the incident.

▸ The bully must be made into an antihero.

▸ Parents must become involved.

The last two ideas are the most difficult to implement. Generally, the other children make the bully into a hero by backing him so they, themselves, will not be victimized and/or join the bully in the victimization. Teachers and administrators have to continue to remind the children that bullying will not be tolerated.

Although it is difficult to get parents to come into school for instruction on this issue, parent involvement is key.

Cyberbullying is relatively new horror. After all, it is easier to hurt someone when you do not have to look in their face and can remain anonymous. In one case, an 8th grade girl saw a 7th grade girl talking to the 8th grader's boyfriend. She and several of her friends sent the 7th grader 500 e-mails that were hostile and filled with threats of exclusion. The child hanged herself soon after the harassment. Other cases share similar themes.

Psychiatrists have a huge role to play in getting communities to respond to this problem. Child psychiatrists, in particular, have to make sure to ask about bullying to find out whether it is among the etiological factors in the development of depression and/or substance abuse in a child. Psychiatrists must promote prevention of mental illnesses and sociocultural factors that contribute to the development of mental illness.

The current trend to help patients seek mental wellness is a part of this. We should be the leaders in these events to create healthier communities. It is our duty to help parents to know more about raising children, and helping children deal with traumas and abuses.