This is one of the consequences of the confinements due to Covid-19, which hospitals are still paying for today. Since 2020, pediatric emergency services have experienced “a worrying increase in the number of visits and hospitalizations of minors in psychiatry”, notes the Charles-Perrens hospital center in Bordeaux.
The pediatric emergencies at Bordeaux University Hospital thus noted a 70% increase in visits between 2020 and 2023. The same goes for the number of hospital stays for children. The crisis assessment and psychiatric orientation service (Secop) at Charles-Perrens hospital, for its part, recorded a 60% increase in minors’ visits during the same period. If school bullying takes a significant part of this increase, the consequences of isolation due to Covid-19 also have a lot to do with it.
“Do in five days what is done in two or three weeks in other services”
This massive influx to psychiatric care structures “causes congestion in hospitalization units and a deterioration in the clinical condition of adolescents,” continues the Charles-Perrens hospital. This is how the hospital center created the brief care unit for adolescents (USB-A) at the beginning of December, a brand new “post-emergency” structure, with the aim of streamlining the care pathway for minors. Equipped with eight beds, it welcomes adolescents aged 11 to 16 from throughout the Gironde department, for five-day stays.
“It is an intermediate period between emergencies, where children arrive at the time of an acute crisis, and where they will generally stay a few hours, and hospitalization, where they sometimes stay several weeks,” explains Professor Manuel Bouvard, head of the University Center for Child and Adolescent Psychiatry in Charles-Perrens. Five days is enough time to analyze what is going to happen, and adjust the direction, whereas in the emergency room, they arrive in a context of tension, where it is not just them to be treated, but in psychiatry, we need a little time. »
This still means being “very responsive to provide them with maximum help in a short time,” points out Mathias, caregiver at USB-A. “We try to do in five days what is done in two or three weeks in other departments,” adds Mathilde Degrave, one of the two child psychiatrists in the unit.
Scarifications
These adolescents “mostly come because of suicidal thoughts or for suicide attempts,” explains Mathilde Degrave. We also have some patients who arrive with severe anxiety disorders. » “Cases of scarification are quite common, Mathias also says, because it is the way that teenagers find to get out of their thoughts, to forget their suicidal thoughts. We then try to isolate them, to cut them from the outside to refocus them on them, so that when they exit, these scarifications stop, or at least lower. »
“When we dig a little deeper, behind all this, there is a lot of complex psychotrauma, and children who often have complex family dynamics,” analyzes Mathilde Degrave. This is why the family is placed at the heart of the USB-A therapeutic system. “The teenager is welcomed with his family, and we organize three interviews with them during the five-day stay, which is a lot,” explains the child psychiatrist. We don’t do much with a child without her family, and if we don’t work with her, the risk is that she won’t have the tools to support her child, and that the situation will deteriorate. »
After having passed medical interviews, meeting a social and psychological worker, work within the unit during these five days should allow them to “return home as quickly as possible, relying on outpatient structures such as centers psychological and liberal doctors,” continues the doctor. But in the most severe cases, hospitalization may still be necessary.
“We will be paying for the Covid crisis for a very long time”
A large part of the young people who have passed through the unit since December “are victims of school bullying, or have been in previous years,” points out Mathilde Degrave. But the doctor confirms that the Covid-19 crisis and its confinements in 2020-2021, “have accentuated a global phenomenon, because there was a lot of isolation of young people during this period”.
Our file on Covid-19
“The first moments when we spotted an increase in psychiatric care among adolescents in emergency rooms date back to 2015, then there was an influx with Covid, since the figures were multiplied by four in one year,” supports Manuel Bouvard.
“We still remain at a very high level today, it is far from over,” he continues, “and we will pay for the Covid crisis for a very long time, with these kids who have dropped out of school, and who have been victims or witnesses of family violence, during and after confinement. » The head of the University Center for Child and Adolescent Psychiatry even says he is “worried about what these young people will become in ten years”.