Last month, a study by the Josephson Institute of Ethics said half of all high school students in the United States admitted to bullying someone in the past year, and nearly half reported they had been victims of bullying. Sadly, says Antonia Alvarez, the results came as no surprise to her.

As director of the youth suicide and bullying prevention program at Mental Health America of Hawaii, Alvarez conducts workshops for students and adults to raise awareness of the issues and provide training in prevention and intervention.

"When I ask students, ‘How many of you have been bullied?’ maybe three-quarters will raise their hands," she says. "And then if I ask if they’ve ever bullied anyone, all of the hands go up."

Alvarez says what’s especially worrisome about the rise in bullying is the effect it could have on Hawaii’s rate of attempted suicide among young people, which already tops the nation.

"Hundreds of kids are attempting or planning or seriously considering suicide each year," she says. "We have a much smaller number who actually die by suicide, so that’s a good thing. In 2009 we had 27 deaths by suicide for people between the ages of 10 and 24, which is not a very high number.

"But for attempts, we’re one out of eight students. For planned, we have one out of six. And for seriously considering it, we’re like one out of four girls and one out of seven boys. We have twice the rate for attempts."

Question: When we talk about bullying in Hawaii, is there anything unique about it? Are we talking primarily issues of race, like we saw recently at Waianae High (where parent complaints led the U.S. Department of Education to broker a settlement in which school administrators and staff agreed to undergo racial and harassment training)?

Answer: Bullies are bullies. We hear about racial remarks at almost every school.

As far as local bullying issues, I hear a lot about military kids. There’s bullying within military kids’ groups. There’s bullying against military kids by non-military kids. There’s military kids bullying non-military kids. There are lots of cultural clashes because so many of our communities are divided but our kids attend the same high school.

I definitely hear a lot about LGBT (lesbian, gay, bisexual, transgender) kids, where a young person appears to be gay or maybe thinks that they’re gay and then starts getting a lot of hassling from their peers. And there’s also a lot of bullying in terms of peer pressure, especially among groups of girls. That’s one of the major avenues for bullying, peer-pressuring kids into doing things they might not want to do.

Q: Is bullying, for lack of a better word, evolving from the days when it was, "Give me your lunch money"?

A: Bullies have become very creative. And it is evolving because it’s matching the technology of our times. Nowadays you can bully someone without ever meeting them, and that’s very different from back in our day when you actually had to look somebody in the face and tell them what you wanted to say. Now you never ever have to do that.

Cyber-bullying is also very dangerous. Things can go viral very quickly. So you can post one nasty comment online and three hours later it can have 1,000 hits. I think we have to be very careful with the cyber stuff, and people have to move very quickly.

We’re encouraging students to talk to their parents or report it to the authorities. If you get text messages, you can call the company and they’ll block that stuff.

With bullying, and especially cyber-bullying, the key is to act quickly, because there’s a sense with this kind of stuff that things will either get better or they’ll never end.

Q: What defines a bully?

A: There are three basic rules, sort of defining characteristics.

One is the intent to do harm. It’s on purpose; it’s not an accidental thing. You’re trying to hurt someone, and this can be emotionally, physically, sexually, whatever.

The second is that there is an imbalance of power. So it can be many people versus one, or a bigger person versus a smaller one, or a louder person against a quiet person; they’re all playing with power.

And then it’s a repeat event. That’s it. All you need is a little bit of power and little bit of will.

So much of this is what happens in the home. Domestic violence is bullying. Bullying happens in our communities, when we accept racism … people talking about certain ethnic populations.

I think all of us as adults, parents, teachers … we definitely have a responsibility of showing a different behavior to our kids. Young people do pick it up. If they hear disparaging remarks about women and girls at home all the time or perceive certain roles, they’ll mimic it and they’ll take it back to school. Even the manini jokes about a certain religion or a certain race … a lot of students’ behaviors are being modeled for them.

Q: What do you hear from kids who are being bullied?

A: There are a lot of stages about what they feel. One is that they start to feel that maybe it’s all true, what the person is saying. So there’s self-doubt: Maybe they are the stupidest person … or the person that no one will ever love. They start to believe the things that are being said about them.

A lot of them get angry and don’t really have anywhere to express that anger. A lot of them go straight into depression, and that’s where we see a lot of suicide ideation, where they’re just starting to think that maybe it would be easier for them not to have to deal with this anymore. It’s not knowing when this will change, especially if they’ve been bullied the same way in elementary school, middle school and now high school. And especially if it’s the same set of peers, so the same kid who bullied them in first grade is now the varsity football player who’s still bullying them. There’s a certain sense of hopelessness for some of them.

Q: Why is the attempted suicide rate for teens so high in Hawaii?

A: We’re still trying to figure that out. I think we hear a lot about the fact that this is such a small place.

In many ways that’s a great thing because it provides a lot of support; we have a lot of multigenerational households with many people to turn to. But at the same time that can feel very isolating to young people if they don’t feel like they can talk to anyone in confidence.

Some say, "Oh, I talk to one person in my family and everyone knows." And especially with the stigma about suicide … if you say you’ve had thoughts about it, then all of a sudden you’re labeled the crazy kid, and how do you deal with that?

Q: So what are the solutions? What do you do if your child is being bullied?

A: Right now the state is working on an anti-bullying task force, so we’re trying to partner with the Board of Education and the Department of Education and the Department of Health to try to come up with some really good realistic ideas for students.

We have policies in place at the schools where they’re supposed to go up the chain of command — talk to the teacher, the principal, the superintendent — but how realistic is that for most kids? Not very realistic.

So we’re trying to develop on-the-ground techniques to keep yourself safe, which could mean just removing yourself from a situation. It’s about making safety plans for students, which can sometimes be as simple as don’t be alone, don’t go to the bathroom alone, don’t go where you know there might be conflict. I don’t think that’s a great long-term solution, you know, just avoiding the problem, but if it’s really a matter of safety, I think sometimes it does come down to that.

Q: Realistically, what can schools do to curb bullying?

A: I always ask the students if the zero-tolerance policy works, and they say no, because it would require enforcement. You can’t say "zero tolerance" and then not have enforcement, which doesn’t necessarily mean punishment or extreme discipline. It just means somebody has to be watching. And ideally the students have to be watching. I think people have to be holding each other accountable. There has to be a culture of safety and respect that’s created.

In schools where you see real tight-knit groups — not cliques necessarily, but more like a home room that’s very close or a sports team that’s very close — they tend to be more protective of each other … they’ll stand up for each other and help each. So really, just raising some of that in terms of a positive school environment and a positive culture in which students take pride in their school can help.

What also has to be said again is that bullying can have a tragic price, as we’ve seen nationally. Sometimes kids don’t understand the ramifications of what they’re doing. But they have to know that it could end up badly.