Depression, school phobia: the mental health of young people still affected by Covid-19

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At the end of the first confinement linked to Covid-19, many specialists had warned about the psychological distress of children, adolescents and young adults. In the spring of 2022, the malaise is still present. In Toulouse, psychiatrists have identified up to 25% more suicide attempts.

Like other professionals in France, Pr Jean-Philippe Raynaud, psychiatrist, head of the department of child and adolescent psychiatry at the university hospital of Toulouse, confirms the significant solicitation of hospital services to address psychological distress.

Is hospital activity in child psychiatry still that important?

Unfortunately, we are witnessing a stability in the number of visits to pediatric emergencies. For suicide attempts we are, on average, 25% more than before Covid. But there are also requests for hospitalization, requests for consultations… Everything is overflowing!

Can we talk about the Covid effect?

There is obviously an effect linked to the Covid period: imprisonment, stress, instability or discontinuity at the school level have affected fragile and vulnerable children and adolescents who are decompensated and who may not have done so, or at least in a less violent way. without this context.

The confinement is gone, is the impact still so strong?

There is better on the side of eating disorders, but we have many cases of anxious school refusal, what we called school phobias. Interested students did not return to school in the traditional way. And then it cannot be said that the current school year has been classic with wearing the mask for a long period, the interruptions due to the absence of students or teachers, fatigue, tiredness, and an always stressful climate.

What do these young people express?

Their suffering is multifactorial, we now know that stressors pile up and add up. There is the malaise of the moment, sometimes a slightly older vulnerability, a sense of insecurity about the future, the school, the family environment, the social and political context. They say a lot that they have been robbed for two years, they feel like they don’t see the end of this period and they struggle to project themselves. Today it is the war in Ukraine that worries them. Some support Ukrainian children educated in the Upper Garonne, they see the reality of migration, of fear. Adolescence remains a great period of vulnerability, sensitivity and fragility.

“We must double the resources of public child psychiatry in France”

What resources do you have?

In December, we opened 6 crisis beds in the short-term care unit for adolescents (UHBA) for children aged 14 to 18. They allow young people to be welcomed during crises of agitation, attempted suicide, depressive collapse. This device is designed for 350-400 hospitalizations per year, but an additional 200 hospitalizations would be required. We also have a hard time recruiting. There is a lack of nurses but also social workers; for 85% of the young people received on these crisis beds there have been reports, what we call worrying information.
The Regional Health Agency (ARS Occitanie) has strengthened our consultations but it is not enough and we ask for sustainable means because we can see that it will not stop tomorrow. The characteristic of a teenager who is not well is that we do not follow him for 15 days, but for several months. “Teen counseling” was also overflowing, the specifications of which had to be able to respond within six days when a request was made by a doctor after a crisis episode. We have one month deadlines, which increases the risk of excessive morbidity, of going to the emergency room. We say it clearly, we must double the means of public child psychiatry in France.

Can liberal psychologists relieve you?

The “MonPsy” system is interesting because there are many psychologists competent to welcome these children and adolescents who do not all need psychiatric care, but are not well dimensioned in terms of remuneration. And then all territories are not equal in terms of access to care.

25% more suicide attempts

In the psychiatric emergency room of the pediatric hospital in Toulouse (CHU), Professor Isabelle Claudet confirms the impact of Covid-19 and its confinements. “We have been monitoring visits to the emergency room for psychiatric disorders among minors for over 20 years. We have gone from around 60 suicide attempts a year to 90-100 in the past two years. It is far above it and has had an impact on child psychiatry organizations that were already resisting small ends thanks to the great will and involvement of the teams “, underlines the head of the childcare center of the university hospital of Toulouse.

Food problems

“We were able to have up to 20 children under the age of 14 hospitalized at the same time, with extremely heavy lines and complicated family situations. We didn’t expect to see so many children with eating disorders. We have seen, in cases of anorexia, extremely low body mass indices, up to 12 “, continues Isabelle Claudet who hopes” that after these spring holidays, if there is not a new wave in the Covid epidemic, things will they will get up. These young people are fed up, they have suffered a form of stigmatization because we have long supported the idea that they were the engines of the epidemic, which is false. For the first time in the world we have closed schools to protect another group and that adolescents and adults have experienced it badly ”.

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