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

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At the end of the first Covid-19 incarceration, 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 that hospital services are in high demand to deal with mental health problems.

Is hospital activity in child psychiatry still so important?

Unfortunately, we are seeing stability in pediatric emergency visits. For suicide attempts we are on average 25% more than before the Covid. But there are also hospital admissions, consultations… Everything is overflowing!

Can we speak of a Covid effect?

There is clearly an effect associated with the Covid period: incarceration, stress, instability or discontinuity at the school level has had an impact on vulnerable and vulnerable children and adolescents who have been decompensated and who may not have done so, or at least less violently without this context.

The incarceration is no longer there, is the impact still so strong?

There’s better on the eating disorders side, but we have a lot of cases of anxious school refusal, what we used to call school phobias. The students involved have not resumed education in the traditional way. And then we cannot say that the current school year has been classic with wearing the mask for a long period of time, the interruptions due to the absence of students or teachers, fatigue, fatigue and always a stressful atmosphere.

What are these young people expressing?

Their suffering is multifactorial, we now know that stressors pile up and add up. There is the malaise of the moment, sometimes a somewhat older vulnerability, a feeling of uncertainty about the future, about education, about the family environment, about the social and political context. They often say that they have been deprived of two years, have the impression that they do not see the end of this period and find it difficult to project themselves. Today it is the war in Ukraine that worries them. Some stand next to Ukrainian children schooled in Haute-Garonne, they see the reality of migration, of fear. Adolescence remains a great period of vulnerability, sensitivity and vulnerability.

‘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 Adolescent Short Hospitalization Unit (UHBA) for 14-18 year olds. They make it possible to welcome young people during crises of agitation, suicide attempts, depressive breakdowns. This device is designed for 350 to 400 hospital admissions per year, but would require an additional 200 hospital admissions. We also have trouble recruiting. We miss nurses but also social workers; for 85% of the young people who were taken care of on these crisis beds, there were reports, which we call disturbing information.
The Regional Health Service (ARS Occitanie) has strengthened our consultation but that is not enough and we ask for sustainable resources because we see that it will not stop tomorrow. The mark of a teenager who is not feeling well is that we follow him not for 15 days, but for several months. The ‘adolescent consultations’, the specifications of which had to be able to respond to a doctor’s request after a crisis period within six days, are also overflowing. We have one-month deadlines, which increases the risk of excessive morbidity, to go to the emergency room. We say it clearly, we need to double the resources of public child psychiatry in France.

Can Liberal Psychologists Relieve You?

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

25% more suicide attempts

In the psychiatric emergency department of the Children’s Hospital of Toulouse (CHU), Professor Isabelle Claudet confirms the impact of Covid-19 and related incarcerations. “We have been monitoring emergency departments for psychiatric disorders in minors for more than 20 years. We’ve gone from about 60 suicide attempts a year to 90-100 over the past two years. It is lofty and it has had an impact on child psychiatry organizations that have already held up with small ends thanks to the very great will and commitment of the teams ”, underlines the head of the children’s center of the University Hospital of Toulouse.

Eating Disorders

“We were able to hospitalize up to 20 children under 14 at the same time, with extremely heavy files and complicated family situations. We did not expect to see so many children with eating disorders. We have seen extremely low body mass indices in cases of anorexia, down to 12,” continues Isabelle Claudet who hopes “that after this spring break, if there is no new wave in the Covid epidemic, things will start to emerge. These young people are fed up, they have suffered a form of stigmatization because we have long maintained that they were the drivers of the epidemic, which is not true. For the first time in the world, we have closed schools to protect another group and that teenagers and adults have had a bad experience.”

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