Bullying victimisation seemed to be a major antecedent of self harm in our cohort of 12 year olds; more than half of self harmers had been bullied frequently. Although more effective programmes to prevent bullying occurring in schools are needed,49 our findings suggest that efforts should also focus on improving the ways in which children cope with emotional distress arising from bullying victimisation. Although only a small proportion of bullied children in this sample engaged in self harm, this is clearly too many and victims need to be provided with alternative coping strategies from a young age. The effectiveness of such interventions would also need to be investigated. Furthermore, our results suggest that, when tested, these interventions should be aimed initially at bullied children who also have additional indicators of concern (a family member who has attempted/completed suicide, history of physical abuse, or concurrent mental health problems), as these children need the most immediate intervention. This will require schools and health professionals who come into contact with bullied children to assess these indicators of concern and also to ascertain whether the help a child has is sufficient.
