There may be a number of ways children and young people who are being bullied present to a GP. They may attend at the request of the school or advice of the school nurse, they may attend with an ‘unrelated’ condition, such as a physical health complaint or weight loss which a parent is concerned about, or they may attend with psychological consequences of bullying such as low mood or anxiety disorder.
A GP may see children who present regularly with unexplained stomach aches, headaches and other physical symptoms for which no organic cause can be found. It may be appropriate in this situation to explore whether bullying is a factor.
Supporting children to discuss bullying
Children may be very reticent to disclose experiences of bullying and it may require more than one visit to determine whether bullying is a factor. They may be concerned about how their parent or carer may react if they disclose bullying and it is therefore important to try and talk to the child or young person on their own, where possible. Further information about how to raise these issues sensitively, can be found in Safeguarding Children and Young People: The RCGP/NSPCC Safeguarding Children Toolkit for General Practice.
Finding out what support is currently in place
For the child or young person who has been directed to the GP via the school or school nursing, it is important to find out what the school has put in place and what support is available currently. Some school nurses and educational support services are already able to directly refer into CAMHS. Your role here is to support the child and family and to ensure co-ordination of services. You can also ensure that family members are directed to other sources of support, such as available parenting classes and national support services.
Supporting children and young people to access further support
If bullying is identified, then part of a GP’s role is to ensure that the school is responding appropriately, which may include discussion with the school nurse. It is critical that this is handled sensitively and in partnership with the child and their family as they may have concerns about how the school will respond and what the outcome of this will be. For children who are receiving support for bullying at school, they may still require additional support for mental and psychological health and a referral to psychological support such as counselling or CAMHS should be considered. It may be advisable to approach the CAMHS team for further advice and guidance. A GP may also want to signpost children, young people to the organisations listed in the guide for GPs below.