Children’s plight associated with Covid-19: a psychiatrist sounds the alarm in Toulouse

The main hospital stays for psychiatric reasons are increasing among people under the age of 18.

Many professionals warn of the mental health of children, adolescents and young adults. Are we experiencing an epidemic of mental stress amid the Covid-19 epidemic?

Absolutely yes. I am very impressed with the numbers. The number of young people coming to the emergency room for psychiatric reasons has quadrupled. Among them are large numbers of young people whom we have to hospitalize and for whom we have difficulty finding places. We currently have about 20 teenagers in the children’s hospital in the hospital … that never happens, we usually have a maximum of 6 or 10 patients. We have about thirty places in the department, which is not enough, and there are 25 young people waiting for hospitalization. Our consultations for young people in our three sectors (Marchant Hospital, Child Counseling and CHU) are overwhelmed.

How do the disorders of these children and adolescents manifest themselves?

Then, during the first phase of the epidemic, we observed a lot of anxiety disorders, early school leavers and rejections related to first childbirth, school closings, a return to school disrupted by health protocols that changed often … all that it was Was caused a lot of discontinuities and breaks … But what surprised us very much was a huge wave of eating disorders, especially anorexia in girls. They come in numbers through emergencies with very significant weight loss conditions. A few days ago we had 15 of the 15-year-olds hospitalized at the CHU, this is unknown. And for a few months now we’ve had psychotic disorders, things that look like the beginnings of schizophrenia. These problems certainly existed and were contained. They occur in this time of destabilization and the fear-inducing atmosphere of the moment.

How do you explain it?

These young people we see today were already fragile. I don’t think the Covid epidemic invented A to Z psychiatric pathology. Those who were fragile but followed do not end up doing so badly. Anyone who had not been discovered was decompensated because the parents were not doing well either, because there were initially contradicting messages that indicated that they should not come to the hospital because they sometimes grieve in their families or the very sick People had … All of this created a mixture of post-traumatic stress and anxiety. There was also a lot more domestic violence, more alcohol, etc.

Prof. Jean-Philippe Raynaud is a psychiatrist and head of the Department of Child and Adolescent Psychiatry at Toulouse University Hospital. Toulouse University Hospital

What do these children say to you, what do they express?

They act more than they speak by acting: food restrictions for anorexics, suicide attempts. They express what looks like burnout, a kind of exhaustion, tiredness. I find that there are many young people out there who have thoughts of suicide and the problem is that we cannot protect them all because we cannot find a place to stay in hospital. We take significant risks, it’s difficult for these children, for their families, and for health professionals. We also note much testimony of anxiety and many sleep disorders that may be related to a disorder that arose with excessive screen consumption during first delivery.

“These children are sadly serious”

Do you feel isolated?

Yes, they often express a loss of bond with some of their comrades. Of course they manage to have contacts, but they say “it’s not like before”, they have less activities, they go home straight after school. The mask also transforms relationships, but surprisingly, they integrated it well. I am quite surprised and even concerned that some children are so concerned that they wear the mask at home on weekends. It hurts me incredibly to see how sad and serious these children are.

What can you do?

We are waiting for the opening of crisis beds until the summer, but it is complicated because we too lack staff and it is very difficult to find nurses who are in demand in all specialties, especially in the intensive care unit. We are also increasing our consultations for adolescents with psychologists, but again, recruiting is complicated as they are not all familiar with child psychiatry. All of these measures will be in place for a few months, but I fear that our active queues will be saturated for much longer.

Note for families: Pay attention to the changed setting

“I think we have to tell parents first to take good care of themselves in order to do the best they can in context. Then, to be very attentive, to keep in touch with their children, especially teenagers, without standing on your back every five minutes To ask them if they are okay, the first thing to do is observe what goes wrong: eating, sleeping, communicating. The main warning indicator is the change in duration when a parent says, “My child is not like before “, also because he smiles less, is more withdrawn or, on the contrary, is in an unusual state of excitement. You have to have a dialogue with your child and, if necessary, so-called first-line specialists, attending physicians, paediatricians, psychologists or call in professionals who are already doing this You know the child, intervener in the school setting, or even in the youth department house, you must negotiate with a teenager, him tell about your concerns I am studying and I propose that he visit someone together, “explains Professor Jean-Philippe Raynaud, psychiatrist, head of the Department of Child and Adolescent Psychiatry at Toulouse University Hospital.