The figures are more than alarming. According to a study published Monday February 5 by Public Health France, based on a survey conducted by telephone in 2021 among more than 24,000 people, 7.2% of 18-24 year olds surveyed said they had already had suicidal thoughts. – compared to 3.3% in 2014, an increase of more than 50% in ten years. The mental health of young women seems particularly affected: 4.8% of them admitted to having thought about suicide in 2021, compared to 3.5% of men of the same age. Actual suicide attempts have also increased sharply in this age group: in 2017, 6.1% of 18-24 year olds declared having already attempted to end their lives, compared to 10.8% in 2021.
At the same time, comparable figures affect young adolescents. The third edition of adolescent barometer, published on January 29 by Ipsos and the structure “Our common future”, illustrates a persistent malaise among 11-15 year olds, 49% of whom say they are affected by anxiety disorders, and 13% admit to having ever had suicidal thoughts. Priscille Gérardin, child psychiatrist and head of the child and adolescent psychiatry unit at Rouen University Hospital and Rouvray Hospital, evokes an “extremely worrying” situation for adolescents and young adults, whose anxiety disorders she sees “exploding” since Covid.
L’Express: The figures presented by Public Health France and the latest adolescent barometer are impressive. Do you observe such an increase in distress among adolescents and young adults on the ground in Rouen?
Priscille Gérardin: I confirm the magnitude of these figures, which are extremely worrying. The number of young people who we see “landing” in the emergency room in a situation of total helplessness is only increasing, and these pathologies last over time. Before the pandemic, it was already not possible to sufficiently provide psychiatric care to adolescents, and this situation continues to deteriorate – leading to the figures published by Public Health France on the situation of young adults. For example, between 2019 and 2023, we observed a doubling of the number of visits to pediatric emergencies for “mental health” reasons in my establishment.
What do these disorders result in?
Some young people report their difficulties themselves, others are put in contact by their families, their high school, or child welfare via homes. We have seen an explosion in anxiety and depressive disorders, but also in suicidal ideas, suicide attempts, and eating disorders. [TCA], situations of violence or mistreatment. When they arrive at the emergency room, these young people are most of the time in a real dead end situation, with more often on the boys side, externalized problems such as running away, scarification, behavioral problems, among others, and on the girls side, more depression , suicide attempts…
How do you explain such an increase in these disorders?
Obviously, the health crisis and the societal crisis that followed have exacerbated these problems. Something directly impacted the developmental trajectory of adolescents and young adults, at the very moment when they most needed to leave the family circle and gain confidence in their abilities and their future. They were forcibly brought back into this family circle, with all the social isolation that this implies. We wrongly thought that this age group would not be affected by the mental difficulties linked to Covid, that they would not really suffer from isolation, in particular thanks to social networks. We quickly realized that this was not the case: nothing replaces social and relational experiences in reality, and the pandemic has permanently hampered this dynamic of adolescent development, which needs to discover experiences other than those lived within the family. At the same time, some young people were singled out and made to feel guilty when they tried to go out, for example, as if the world had forgotten that adolescence is also about transgression.
And then we must not underestimate the violence of reopening to the world, both on a health and societal level, with this diffuse and ambient anxiety – which adults also carry – regarding the war in Ukraine and in the Middle East, the climate crisis, the economic crisis. This violence, widely highlighted by the media and on social networks, creates a feeling of insecurity linked to major questions about the future, which can be dangerous for the most fragile young people.
Do social networks aggravate this discomfort among young people?
Everything is not black or white. Social networks have made isolation a little more bearable, and have probably kept many adolescents in a certain social exchange. But there have also been negative effects. The increase in eating disorders during the Covid period, for example, and which continues, can be explained in particular by social networks: some Internet users have been very active on the subject, calling on young people about the risk of weight gain, the consequences of stopping sport, the relationship with food, which found itself at the center of family discussions. Through what the adolescents tell us, we clearly see that there was a protective aspect of networks on social relationships, but also a highlighting of certain risks.
Do you fear an increase in addictions among younger people since Covid?
The crisis has in any case increased the number of false remedies for anxiety, in particular through the taking of toxic substances, and their availability. We can entirely assume that the worse young people get, the more they will tend to find solutions by taking medication, drugs or alcohol, or even restrictive diets, which initially provide relief. Some teenagers were able to tell us: “Luckily I had shit, otherwise I would have screwed myself up”. These are a type of gap-filling, which are a trap, and can lead to very harmful escalation for these young people. This should not make us forget, however, that many young people are doing well, and that the overall figures for the use of toxic substances are improving on a certain number of parameters.
According to Public Health France, young women are the most affected by these disorders. For what ?
These figures must be taken with a grain of salt, because the expressions of the disorders are not the same in men and women. For eating behavior, for example, a young girl beginning an episode of anorexia nervosa will at one point worry those close to her, which leads to a consultation in the emergency room due to malnutrition. A boy, on the other hand, will be more likely to build muscle in the gym, by hyper-investing in physical activity, which does not alert anyone to his level of anxiety and the development of the disease, whereas boys risks can be the same if it is a pathological overinvestment. The same goes for suicide attempts, which in fact mainly affect girls, while suicides mainly affect boys – particularly because girls are more likely to use medication, while boys are more likely to use firearms. Finally, there are sociological aspects that must be taken into account: young girls, and this is a very good thing, will be more likely to alert themselves and seek help in the event of suicidal thoughts, when boys communicate much less on the subject, and will have different modes of expression and taking action.
What do you think we need to work on so that French psychiatry can keep up with this increase in unease among young people?
We must invest massively in this generation which is our future, via, for those who are in difficulty, prevention, research in psychiatry and mental health, and in care. We must ensure that in all regions, there are support systems with all the links in the chain, ranging from places of reception and support such as adolescent centers, to places of hospitalization, through intermediate places such as “care-studies” or “therapeutic boarding schools”, which make it possible to combine schooling and care for adolescents and young adults. Too many are currently out of school or down on their dynamic post-baccalaureate. We hope that the announced priority on the mental health of young people will result in this regional coverage throughout France.
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