Bullying and co-occurring psychological distress, self-harm and attempted suicide in adolescents – health inequalities by sexual identity

Sexual minority youth (bisexual, gay and lesbian individuals) consistently report worse mental health and higher levels of bullying compared to heterosexual peers. Studies have largely reported these associations with individual mental health problems. No study has examined associations between past experiences of bullying and co-occurring common mental health problems and whether these associations differ by sexual identity. In a nationally representative sample of adolescents aged 17 (N=9,767, female:51%, sexual minority:20%), we examined associations between sexual identity and risk for self-reported co-occurring mental-health (MH) problems (psychological distress, self-harm, and attempted suicide). We further examined whether sexual minority adolescents with past experiences of bullying (at ages 11/14) were more likely to report co-occurring-MH compared to peers without bullying. Bisexual (RRR: 9.42, 95% CI: 6.53-13.58) and gay/lesbian (RRR: 6.33, 3.52-11.47) adolescents had higher risk for co-occurring-MH than heterosexual peers. However, sexual minority adolescents (15%) with past bullying were more likely to have co-occurring-MH compared to sexual minority (4%) and heterosexual (2%) peers without bullying. Sexual minority youth with past experiences of bullying are 7-8 times more likely to report co-occurring-MH problems compared to heterosexual peers without bullying. More effective public health policies are required to reduce the deleterious impact of bullying on mental health.