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Covid-19: “16–25 year olds are the most psychologically fragile”

Bruno Falissard
Bruno Falissard
Child psychiatrist and professor of public health at Paris-Sud Faculty of Medicine

What do we cur­rent­ly know about the impact of the Covid-19 cri­sis on the men­tal health of young people?

Bruno Falis­sard. Noth­ing too supris­ing, actu­al­ly. The data regard­ing the “morale of the French” pro­duced by San­té Publique France come to log­i­cal con­clu­sions: in Jan­u­ary 2021, near­ly 23% of peo­ple suf­fered from anx­i­ety and/or depres­sion, against 13.5% and 10% respec­tive­ly in 2017 1.

How­ev­er, this glob­al obser­va­tion remains rather super­fi­cial, because not every­one has the same reac­tion to the pan­dem­ic. Young peo­ple, because less psy­cho­log­i­cal­ly “crys­tallised” than old­er peo­ple, vary more in terms of men­tal health. For exam­ple, they were more dis­traught than aver­age dur­ing the lock­down, but were bet­ter off than oth­ers dur­ing the Sum­mer period.

In the case of chil­dren, it is even hard­er to pro­duce sci­en­tif­ic data. First of all, because epi­demi­o­log­i­cal stud­ies in psy­chi­a­try are almost nev­er done on minors. But also because they tend to expe­ri­ence the epi­dem­ic through the eyes of their par­ents. A four-year-old child con­fined with par­ents who were not dis­tressed by the sit­u­a­tion could eas­i­ly not notice any­thing par­tic­u­lar differences.

So, it’s not all doom and gloom?

No. One of the numer­i­cal mea­sures we have is the num­ber of hos­pi­tal­i­sa­tions for sui­cide attempts [all ages includ­ed]. We see that between Jan­u­ary and August 2020, the num­ber of patients was ~8.5% low­er than the same peri­od in 2019 2. There is no unequiv­o­cal expla­na­tion for this decline, but it is a reoc­cur­ring trend: dur­ing crises or wars, there are few­er sui­cides. We call this an “exter­nal organ­is­er”: our atten­tion is fixed on this event so much so that we for­get all the oth­er, more per­son­al, rea­sons for our anx­i­ety. This is very human, and para­dox­i­cal­ly, hav­ing a con­crete object to project your feel­ings on can make you feel bet­ter about them.

For chil­dren, and if their fam­i­ly envi­ron­ment was healthy, the con­fine­ment was some­times even pos­i­tive. I noticed that autis­tic or hyper­ac­tive chil­dren in my care were bet­ter dur­ing this peri­od, in par­tic­u­lar because school is a big source of anx­i­ety for them. We also noticed that the par­ents spent more time with their chil­dren: doing home­work, play­ing board games, etc.

How­ev­er, this obser­va­tion is much more nuanced for young adults. We keep repeat­ing that we must act to pro­tect the most vul­ner­a­ble, but we must recog­nise who they are. We don’t yet have any fig­ures on the sit­u­a­tion post-Sep­tem­ber 2020, but the clin­i­cal feed­back is clear: the most psy­cho­log­i­cal­ly frag­ile are 16 to 25-year-olds.

Stu­dents and young work­ers are con­front­ed with a sat­u­rat­ed labour mar­ket, which offers them no prospects.

Why, specif­i­cal­ly, the 16 to 25-year-olds? 

Because they are the most exposed. Chil­dren con­tin­ue to go to school and receive sup­port from their par­ents. On the con­trary, stu­dents and young work­ers are con­front­ed with a sat­u­rat­ed job mar­ket, which offers them no prospects, and they are also deprived of the social and sex­u­al life that is absolute­ly nec­es­sary for the con­struc­tion of their iden­ti­ty at their age. And no one says that! The sex­u­al­i­ty of young peo­ple is not a neg­li­gi­ble para­me­ter, it is a dis­rup­tive fac­tor, some­times at the ori­gin of eat­ing dis­or­ders and sui­cide attempts.

The main prob­lem for this age group is the total lack of recog­ni­tion of their sac­ri­fices. The lock­down has been an extreme­ly bru­tal sit­u­a­tion psy­cho­log­i­cal­ly, and it was intend­ed to pro­tect a very spe­cif­ic seg­ment of the pop­u­la­tion: the very old. And no one admit­ted it. No one thanked young peo­ple for play­ing along when Covid-19 is not even real­ly dan­ger­ous for them. In addi­tion, liv­ing con­di­tions of young adults tend to be far infe­ri­or than most retired peo­ple and the gov­ern­ment has not made any ges­ture, such as addi­tion­al social wel­fare to them.

On the con­trary, they are con­stant­ly chas­tised in the media. They are reproached for par­ty­ing and tak­ing risks result­ing in a fla­grant dou­ble pun­ish­ment. Con­trary to what is often stat­ed, I don’t think that there is a “bash­ing” of the elder­ly: they are pro­tect­ed much more than the young.

Do you fear that this sit­u­a­tion will fuel an inter­gen­er­a­tional conflict?

Gen­er­a­tional ten­sions are anthro­po­log­i­cal invari­ants; they will always be there. But the cur­rent sit­u­a­tion is par­tic­u­lar­ly harm­ful. In my job as a psy­chi­a­trist, half of my work is to put a name to a prob­lem: by refus­ing to recog­nise the efforts of young peo­ple as well as mak­ing them feel guilty, we are feed­ing a resent­ment that is wor­ry­ing. And that comes on top of oth­er issues like glob­al warm­ing, the weight of which is under­es­ti­mat­ed in the minds of young peo­ple. A sur­vey by Le Monde 3 revealed that 56% of respon­dents fear a gen­er­a­tion con­flict, and that 81% believe that “young peo­ple and stu­dents are the most poor­ly tak­en into account in gov­ern­ment deci­sions”. It might be time to make a ges­ture to thank them. 

Interview by Juliette Parmentier
2« Hos­pi­tal­iza­tion for self-harm dur­ing the ear­ly months of the Covid-19 pan­dem­ic in France: a nation­wide study », Fab­rice Jol­lant, Adrien Rous­sot, Emmanuelle Cor­ru­ble, Jean-Christophe Chau­vet-Gelin­ier, Bruno Falis­sard, Yann Mikaeloff, Cather­ine Quan­tin https://​www​.medrx​iv​.org/​c​o​n​t​e​n​t​/​1​0​.​1​1​0​1​/​2​0​2​0​.​1​2​.​1​8​.​2​0​2​4​8​4​8​0​v​1​.​f​u​l​l​-text


Bruno Falissard

Bruno Falissard

Child psychiatrist and professor of public health at Paris-Sud Faculty of Medicine

A graduate of the École Polytechnique, Bruno Falissard is director of the CESP (INSERM centre for research in epidemiology and population health). He has also been a member of the French National Academy of Medicine and was president of the IACAPAP (International association of child and adolescent psychiatry and allied professions).

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