Predictors of Intention to Stay in Healthcare Among Healthcare Students and Professionals in Czechia and Slovakia.

The Lancet Psychiatry Commission on youth mental health calls the rising incidence of mental health problems in young people a global crisis and the “continuing neglect” of their needs “intolerable” []. The onset of most psychological disorders occurs before adulthood [], highlighting childhood and adolescence as critical developmental periods for prevention and early intervention in mental health care. Peer interactions strongly influence the development and well-being of children and especially adolescents []. Bullying is a frequent type of negative peer interaction characterised by a behavioural pattern of violence, harmful intention and power imbalance between those involved []. Recent large-scale studies report a bullying prevalence of 20% among 15-year-old students internationally (21% in Germany []) and 14% involvement in school bullying in 11-15-year-old students in Germany []. Bullying is considered a major risk factor for poor mental health and affected children and adolescents frequently rely on health care resources [–]. Bullying is not specifically listed as one of the stressors included in the A criterion for post-traumatic stress disorder, therefore, it does not meet the current definition of trauma. However, the debate on how this A criterion should be interpreted and if bullying constitutes one such stressor is still ongoing, as bullying has been identified as a significant risk factor for posttraumatic stress symptoms, such as intrusions [–]. A substantial body of research based on general populations demonstrates that active involvement in bullying is associated with increased risk for psychopathology [–]. There is a high risk of internalising disorders for former victims and of externalising disorders for former bullies; former bully-victims (i.e., those who experienced both victimisation and perpetration and who were oftentimes not distinguished from bullies in previous studies) are at risk for both internalising and externalising disorders in adulthood []. These findings suggest differential associations between bullying roles (victims/bully-victims/bullies) and mental health outcomes, arguing against the conceptualisation of bullying as an entirely unspecific risk factor. As most studies rely on school-based samples, it remains unclear whether these patterns also apply to treatment-seeking populations.