Morbidity among bystanders of bullying behavior at school: concepts, concerns, and clinical/research issues.

The role of the bystander is not one that is easily understood in the anti-bullying literature. Roles within the unofficial hierarchy of the school-yard and playground overlap considerably, and each role has its own social dynamic that brings with it a shifting behavioral landscape that affects every student. In this article, the mental health correlates of three categories of bystander are explored: the co-victim, the isolate, and the confederate. Each category of bystander has its own characterizations and mental health correlates. Reports of post-traumatic stress, internalized hostility, substance use, and suicide ideation are discussed with reference to studies involving witnesses of family abuse, community and school violence as well as bullying. It is argued that bystanders are the key to challenging bullying in schools, and their mental health and well-being is pivotal to the effectiveness of anti-bullying interventions.