Connecting ACEs to in-patient behavioral health treatment associated with bullying/cyberbullying
Depression, Smart Phone Dependence, and Social Media Cyberbullying Among Youth and Young Adults Wyatt Meriwether, PhD, Quality, Safety, & Value, Kansas City VA Medical Center, Independence, MO APHA's 2019 Annual Meeting and Expo (Nov. 2 - Nov. 6)
Abstract: Connecting ACEs to in-patient behavioral health treatment associated with bullying/cyberbullying.
Bullying/cyberbullying are pervasive for today’s youth – 28% report being bullied and 30% report having been a bully themselves. Involvement with cyberbullying is linked to depression, suicidal ideation, and attempted or completed suicide. In addition to bullying/cyberbullying, adverse childhood experiences (ACEs) impact future violence victimization and perpetration. The CDC estimates that 64% of the population have at least one adverse child experience, with 12.5% having four or more. To understand the impacts of these issues within our health system, the inpatient behavioral health unit changed its standard of care to include a bullying/cyberbullying survey at intake and discharge to identify the depth of this problem in the youth patient population. This survey assesses aspects of perceived safety, how the bullying took place, the impact on the patient, and if bullying/cyberbullying contributed to their admission. This project evaluates the outcomes of the surveys. The dataset is comprised of patients who were admitted between June 2018 and January 2019. In addition to the survey data, for each patient we collected specific health data including: diagnosis, reason for admission, admission/discharge notes, and duration of stay. We utilized diagnoses and admission/discharge notes to retroactively screen patients for aspects related to ACEs. These include abuse (emotional, physical, sexual) and household issues (substance abuse, mental illness, incarceration, parental separation/divorce). Initial data analysis indicates that out of 733 patients, 31.1% indicated that bullying/cyberbullying contributed to their admission or was found in their chart. Of this subset, 45.8% had an indication of an ACE within their diagnosis or admission comments, compared to 31.8% for patients with no indication of bullying/cyberbullying. Of the personal ACEs, 18.9% indicated abuse and 3.9% neglect. From the household perspective, 11.4% indicated substance abuse, 14.0% divorce/separation, 5.3% incarceration and 4.4% mental illness. Our analysis shows that ACEs are prevalent in patients who indicated that bullying/cyberbullying contributed to their admission. In addition to the need for increased education for our patients, their families and the community-at-large about ACEs, bullying/cyberbullying and how to address them, further research is needed to understand the deeper connections between ACEs and bullying/cyberbullying from a clinical perspective.
Pfafman, Rachel; Pater, Jessica; Reining, Lauren; Drouin, Michelle; Kerrigan, Connie; and Kardys, Kelley, "Connecting ACEs to in-patient behavioral health treatment associated with bullying/cyberbullying" (2019). Health Services and Informatics Research. 124.