Millions of children and adolescents across Latin America and the Caribbean face the persistent harm of bullying and cyberbullying, a pervasive form of peer violence that leaves lasting damage to physical, mental and emotional well-being. To address this growing public health crisis, the Pan American Health Organization (PAHO) has introduced a groundbreaking new resource: the *What Works to Prevent Bullying and Cyberbullying of Children and Adolescents in the Americas* toolkit. This comprehensive guide consolidates verified research, actionable policy recommendations, and practical on-the-ground tools to help stakeholders across sectors prevent these forms of violence and deliver targeted support to affected young people.
The toolkit opens by mapping the scope of the crisis across the region, laying out the profound harm bullying inflicts on young populations, and detailing evidence-backed intervention strategies that have been proven effective. Drawing on cross-sector research from public health, education, and social protection systems, the resource specifically highlights the underrecognized critical role that health services play in early detection, holistic care, and ongoing support for youth impacted by bullying and cyberbullying.
“Bullying during childhood and adolescence is a form of peer violence that can have significant consequences for physical, sexual, mental, and emotional health,” explained Britta Baer, PAHO Regional Advisor on Violence and Injury Prevention and co-author of the new toolkit. “The good news is that it can be prevented. We have evidence on what works, and this toolkit aims to make that evidence accessible to decision-makers, people who work with adolescents, and those who support their development.”
Regional data compiled in the toolkit underscores the scale of the problem: roughly one in four 13 to 17-year-olds across Latin America and the Caribbean report experiencing in-person bullying at school in the past 30 days, with prevalence varying across subregions. Central America records a 23% bullying prevalence rate among students, while South America sees that rate climb to 30%.
Bullying manifests in multiple overlapping forms, including physical, verbal, sexual, and social aggression, with distinct patterns by gender. Physical bullying is more commonly reported among boys, while girls are disproportionately impacted by social and sexual bullying, with differing associated harms and rates of help-seeking.
Cyberbullying, the digital variant of the violence, affects between 7% and 27% of children and adolescents across the region over a 12-month period, with higher rates recorded among girls. Unlike traditional in-person bullying, cyberbullying can invade a young person’s space at any time of day, spread to massive online audiences in seconds, and leave permanent digital traces. The anonymity afforded to perpetrators online also amplifies harm and makes the abuse far harder to regulate and stop.
PAHO stresses that cyberbullying rarely exists in a vacuum. It often mirrors, amplifies, or extends patterns of violence that already occur offline, most frequently in school settings. It also commonly overlaps with other forms of digital abuse, including non-consensual sharing of private information, identity theft, image-based harassment, and other forms of coercive online control.
Recognized as a core public health priority, bullying in all its forms is a major determinant of long-term health and well-being for young people. Both in-person and online bullying severely disrupt healthy development, and are linked to sharply increased risks of depression, anxiety, traumatic stress, social isolation, sleep disorders, self-harm, suicidal ideation, and suicide attempts, alongside negative outcomes for academic performance and social integration. Research compiled in the toolkit confirms that young people who experience bullying are far more likely to report loneliness, sleep disruption, and suicidal thoughts than peers who have not faced abuse.
Bullying also damages physical, sexual, and reproductive health, causing everything from acute injuries and chronic psychosomatic pain to increased risk of sexual coercion. These far-reaching harms demonstrate that addressing bullying cannot be left solely to school systems; coordinated engagement from public health systems is essential to meet the full scope of young people’s needs.
The toolkit further warns that different forms of violence often overlap and reinforce one another: abuse may begin online before moving to in-person interactions, or start offline and be amplified through digital platforms. This makes early intervention critical to breaking cycles of violence and reducing the risk of long-term harm across a young person’s life.
To support early detection, the guide outlines key warning signs that caregivers and health providers can watch for: sudden shifts in behavior, increased anxiety or irritability, social withdrawal, unexplained injuries, and new reluctance to attend school. For cyberbullying specifically, additional red flags include abrupt changes in behavior during or immediately after digital device use, quickly closing screens when adults approach, and refusal to discuss online activities.
PAHO identifies health services as a critical first point of contact for recognizing these warning signs, delivering initial support, and connecting young people to specialized care when needed. The toolkit recommends that health care workers integrate questions about school climate and digital experiences into routine youth check-ups, proactively identify warning signs, assess potential mental health impacts, and provide immediate support to affected youth. It also emphasizes the importance of supporting families to foster safe digital habits and coordinating closely with schools and other sectors to deliver a cohesive, comprehensive response.
“The most important thing is for children and adolescents to know that bullying and cyberbullying are never acceptable and that they do not have to face them alone,” Baer noted. “Seeking help from a trusted adult and using available reporting mechanisms can make a real difference.”
Addressing bullying effectively requires coordinated action across multiple sectors and stakeholder groups, with meaningful youth participation at the center of successful strategies, PAHO emphasizes. The toolkit highlights the value of strengthening peer support networks and building young people’s social and emotional skills as key protective factors. It also encourages parents and caregivers to maintain open lines of communication with their children, stay alert for warning signs of abuse, coordinate with schools when concerns arise, and set clear, collaborative agreements for safe and responsible internet and mobile device use.
Public health, education, and government agencies at all levels are called on to collaborate to develop and roll out evidence-based violence prevention responses. The guide also underscores the critical responsibility of the private sector, particularly digital platform operators, to work alongside governments and communities to embed safety and protection into product design from the earliest stages.
The new toolkit is part of PAHO’s longstanding ongoing work to strengthen prevention of violence against children and adolescents, and to support member states in breaking intergenerational cycles of violence through accessible, evidence-driven resources.