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Justice Minister Peter MacKay speaks as Steven Blaney, Minister of Public Safety and Emergency Preparedness, back right, Lianna McDonald, executive director of the Canadian Centre for Child Protection, join him in making an announcement on Parliament Hill in Ottawa on Nov. 20, 2013, as part of Bullying Awareness Week.

Sean kilpatrick/The Canadian Press

With one in three Canadian kids saying they have been a victim of cyberbullying, a prominent physician is calling on family doctors to do more to identify children battling depressive or suicidal thoughts and to intervene before they develop mental-health issues or attempt self-harm.

Dr. Matthew Stanbrook, deputy editor of the prestigious Canadian Medical Association Journal, says cyberbullying is an escalating crisis because of social media, and family doctors on the front lines need to intervene.

His call to physicians to step up their efforts in identifying kids battling mental-health issues comes on the heels of a medical research report earlier this month that found bullying and suicide are inextricably linked. Researchers from Leiden University in the Netherlands found that children who were cyberbullied were 3.2 times more likely to contemplate suicide than their peers, compared with children who experienced offline bullying, who were 2.2 times more likely to think about suicide.

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"We have to remember that it takes a broad societal effort to deal with this problem. Doctors have a big role in that, particularly because we treat young people. We see them regularly and we're trusted figures," Dr. Stanbrook wrote in an editorial published Monday in the CMAJ.

While he applauds the federal government's proposed new legislation to combat cyberbullying, specifically prohibiting the transmission of "intimate images" of an individual without his or her consent, he cautions that tougher laws alone are not enough to stop such a widespread societal problem.

In Canada, one in four kids surveyed recently admitted they have been "mean or cruel" to someone online. MediaSmarts, which polled 5,436 Canadian students in Grades 4 through 11 about online issues, also found that of the one in four who have been cruel to others online, more than one in three say they have been a victim.

"The federal law isn't going to fix everything," Dr. Stanbrook said in an interview. "We need to remind doctors – along with teachers and parents – what role they have and what the evidence says we can do about this. There are clues to behavioural changes in youth that may indicate the signs of bullying or cyberbullying … and if that is identified as occurring, to screen further for depression and suicidality.

"Traditional bullying may be confined to the schoolyard, but cyberbullying can follow its victims whererever they go, at any time of the day," says Dr. Stanbrook, who is a staff physician at Toronto Western Hospital and an assistant professor at the University of Toronto.

Dr. Sheila Wijayasinghe, a staff physician at St. Michael's Hospital and a lecturer with the University of Toronto's department of family and community medicine, agrees that physicians are uniquely positioned to help.

"Kids tend to have trust in their doctors and will disclose sensitive concerns that they may not feel comfortable sharing with others," she says.

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But she added that "the signs of bullying can be subtle and, with time constraints and large patient loads, unfortunately physicians can miss the opportunity to offer support."

To prevent the natural inclination to focus on acute issues or physical symptoms, she suggests that family doctors make it a practice to do a quick check-in about peer interactions and to ask specifically about bullying. "I find that even if a teenager denies bullying concerns when we first chat, it keeps the door open for this discussion if needed in the future," she noted.

Dr. Wendy Craig, a professor of psychology at Queen's University and scientific co-director of the healthy-relationships advocacy group PREVNet, says physicians with concerns about a particular child can download a letter from PREVNet to send to a school. It will soon be sent to all doctors' offices through the Canadian Medical Association.

The recent MediaSmarts study concluded that cyberbullying is not as rampant or serious as some parents believe. Dr. Stanbrook agrees that the majority of cases are not as dire as tragic situations that led to the suicides of Canadian teens Rehtaeh Parsons and Amanda Todd.

But he pointed out that "cyberbullying is on the rise. "I think it's fair to classify it as out of control when you have young people such as Parsons and Todd killing themselves," he said.

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