«I refuse to go to that school» - A case report of Bullying

Abstract

Introduction: School violence is a public health problem with serious individual and social consequences. This case report aims to alert family doctors to the high prevalence of bullying and to emphasize the importance of their involvement in the pre- vention, diagnosis, and treatment of the possible consequences of bullying. Case description: A 15 year old male patient visited his family doctor and complained of aggression by his classmates. He also complained of insomnia, irritability, poor appetite and school refusal. School officials were not aware of the problem. The school principal reported the case to the child protection services but did not accept the family doctor's justification for school absences or the family's request to transfer the boy to another school. The case was discussed by the family doctor and the head of child protection services. They decided that the adolescent should be enrolled in another school. After integration in the new school, he began to reveal emotional maladjustment with aggres- sive behaviour against himself and others. He was referred to child psychiatry emergency services. The adolescent revealed de- pressive symptoms related to school violence. Comment: The management of bullying requires a multidisciplinary team. The family doctor is uniquely placed to identify risks, advise families, and follow psychiatric co-morbidity. The family doctor should consider bullying when there are unexplained psychosomatic symptoms, school problems, disruptive behaviors or suicidal thoughts. The emphasis should be placed on pri- mary prevention. Family doctors should improve and develop their skills related to the management of bullying.