Few teens affected by bullying seek mental health services, according to a recent study.

Nearly one in three teens are affected by bullying, placing them at risk for health problems including attention deficit hyperactivity disorder, anxiety, depression and self-harm. Unfortunately, fewer than a quarter of these teens receive help.

"As a pediatrician, this study reminded me that we can always do more for our patients," researcher Dr. Amira El Sherif said in a statement. "Bullying should become a part of the normal conversation in the office. Doctors, parents and school officials should also work together to address bullying when it occurs and to make sure mental health services are accessible when needed."

For the study, researchers collected and analyzed data 440 students in high school and middle school in Cumberland County, North Carolina. Mirroring national trends, an average of 29 percent of the respondents reported being bullied in the past. Among 11- to 14-year-olds, 54 percent reported being bullied, compared with 46 percent of those 15 to 18 years old.

They found 28 barriers to mental health services in the study, 11 of which were specific to respondents who experienced prior bullying. Chief among these was a lack of adequate screening and counseling by medical providers. Other obstacles included school system barriers such as inaction by educators and poor enforcement of investigation procedures, and inadequate school follow-up and communication with parents.

Findings from the study, funded by an AAP Community Access and Child Health planning grant, have major implications for improving access to mental health services for victims of bullying, El Sherif said.

Schools also need training programs that include frequent evaluations to ensure quality standards are consistently met, El Sherif said. Overall, improving communication between medical providers, school officials and parents would allow for a team approach to bullying, which would improve mental health screening and access to services, she said.

The findings are detailed in the journal American Academy of Pediatrics.