The effects of bullying and school violence on a child’s school performance have been well documented. The Journal of the American Medical Association declared that bullying is a public health issue. Studies show that repeated bullying can lead to depression, substance abuse, school violence, sexual promiscuity and suicide. Outside of school, in the community, sixty percent of boys identified as bullies in grades 6-9 had their first criminal offense by the age of 24; forty percent had three or more offenses. Among students, homicide perpetrators were more than twice as likely as homicide victims to have been bullied by peers.