A teenage girl comes down the stairs, her face wet. Another waits for her consultation without moving, her eyes glued to her smartphone, while her mother bites her nails and taps her foot. It’s like this every day at the Strasbourg Teenagers’ House, a place dedicated to young people: since the end of the health crisis, more and more young girls are knocking on the door, their heads in disarray, hope. which takes water.
Girls, sometimes alone, sometimes barely out of childhood, but girls, always more girls, rarely boys. Although equal before Covid-19, attendance at these reception structures located in each department continues to increase in women. Now, nationally, more than two thirds of young people in care are female. The figures can climb up to 99%, depending on the departments and the monitoring methods. Delphine Rideau, national president of the Maisons des adolescents, saw the tidal wave in her office, long before the studies came out. The last, that of the Directorate of Research, Studies, Evaluation and Statistics (Drees), the statistics service of the Ministry of Health, reports a “sudden” jump: hospital admissions for attempted suicide among girls under 14 have increased by 71% since the health crisis. “There’s something going on, that’s for sure. But what?” asks the manager, the protocol to follow in the event of a child in danger nailed to the wall behind her.
The question obsesses anyone who has witnessed this sad parade of pigtails, braids and buns, broken before leaving the age of carelessness: “What is happening to these girls? We would all like to know”, sighs Guillaume Corduan, the structure’s psychiatrist. He hangs up with a patient, his mind too stormy to come. She couldn’t fall asleep and went to bed at dawn, he said. Guillaume also works at the neighboring university hospital. There, not a day goes by without them seeing girls with stomachs stuffed with sleeping pills or with sliced forearms.
If the phenomenon has suddenly worsened, it is in reality not new: “There have always been many more girls who attempt to kill themselves and report anxiety or depression. They express suffering differently “, explains Professor Richard Delorme, psychiatrist and head of department at the Robert-Debré hospital in Paris. When boys get annoyed and become impulsive, put themselves in danger, young ladies ruminate, doubt, worry. They “internalize” their suffering, we say in the jargon.
The role of biology
The result of a different education – “don’t cry my son” – but also of biology. Brain development, hormonal changes at puberty and neural circuits of stress follow different logics depending on the sexes, as shown by several scientific studies recently published in journals like Science Advances Or Translational Psychiatry. Certain genetic variations associated with depression are also more common in women.
Faced with the current context, made up of wars, epidemics and climatic, social and energy crises, all causes of deterioration of mental health, girls therefore have a greater probability of developing these disorders. Boys, for their part, fall more easily into addictive substances or risky behavior, such as driving at full speed, fighting, etc. Except that, as Drees points out, hospitalizations for this type of behavior have remained stable. As if evil only befalls girls. In reality, nothing is less certain: boys can suffer without it being seen, because they generally require much less care. “No one comes saying ‘I’m violent because I’m sad'”, illustrates Delphine Rideau.
It is also possible that certain elements specifically affect adolescent girls: this is indeed the case for physical, and especially sexual, attacks, including rape or incest, which are devastating for the psyche. It’s the elephant in the room, experts say. If we rely on police records, this violence seems more common since Covid-19, but the situation is more complex: “There are not necessarily more attacks. It is very likely that these are in reality only more often reported to the authorities But it is still a risk factor, especially since we talk about it a lot, which is not without consequences”, explains psychiatrist Guillaume Corduan, at the House. teenagers from Strasbourg.
If the current liberation of speech soothes, it can also bring back trauma. “Many of my patients tell me about this form of asymmetry between general awareness and the attention paid by loved ones. When they are not inclined to help while in the media or in politics the taboo has been broken, the patients feel even more alone, abandoned,” explains the specialist.
School stress
Lisa, real blonde and fake leather on her shoulders, never found anyone to talk to about her rape. The young Parisian, who wished to remain anonymous, had not even made the connection with her sudden consumption of alcohol and drugs, and all these ill-intentioned men she began to associate with. Until his psychiatrist told him: “A boy, twice your age, an adult, sleeping with you when you were barely in middle school, that’s not normal.” Since then, Lisa has learned to put into words what weighs on her. “I have always been out of step with people my age,” she says, playing with her thumbs to avoid feeling anxious. One of his parents is disabled. Very quickly, she had to do the shopping, the cleaning, even the taxes. “I was small, but tall. But now, I play with it,” she laughs, ordering a half of beer with a confident attitude.
It is often the accumulation that causes a dive. “In these pathologies, the causes are multiple, which complicates research,” underlines Judith van der Waerden, epidemiologist and researcher at Inserm. Too many responsibilities at home – they are still delegated to the girls. A lack of friends, relationship problems, the eternal drama of the teenager trying to wean himself from his parents. And on top of that, problems at school. Here’s another avenue: between 2018 and 2022, the level of stress linked to school work doubled among girls, according to the declarative study In class of Public Health France. For the boys, nothing is moving. The school, its increasingly harmful climate and all the cases of harassment it harbors could fuel unhappiness. But the data does not say whether it is the cause or the indicator. Difficult to study unhappy.
The fact remains that “school rejection”, which affects girls much more, has exploded in recent years. One of Guillaume Corduan’s patients no longer wants to return to college. She locks herself in her room and secretly waits for someone to knock. No one’s coming. This annoys him: “Parents disengage very early. In an era that only reacts to noise, suicide is seen as a means of capturing attention,” laments the specialist. The little girl the psychiatrist is talking about is fascinated by anorexia. A morbid escape, but one that makes him feel part of a group. The algorithms understand: they only show him that. Social networks, ideal culprits? In reality, their role is ambiguous: “They can degrade girls’ self-esteem and lock them up, isolate them, but they sometimes also help raise awareness of psychological hygiene”, explains Charles-Edouard Notredame, psychiatrist at Lille University Hospital.
“We need to do more to understand and respond to this crisis,” insists Professor Antoine Pelissolo, psychiatrist at CHU Henri-Mondor (AP-HP), in Créteil. The demands of caregivers are numerous: fund research and increase psychiatric capacity, which is totally overwhelmed. But also develop places of reception and discussion, and “equip” the French on mental functioning. So many elements mentioned in the framing report pediatrics conference which will be held on May 24. A crucial meeting.
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