On the occasion of the publication of a survey by the Jean-Jaurès foundation, carried out by Ifop, the professor of forensic medicine and legal expert at the Lyon Court of Appeal Michel Debout warns of the psychological consequences of the crisis. related to Covid-19.
The Jean-Jaurès foundation has just published a survey on the mental health of the inhabitants of six European countries, including France, carried out by Ifop.
Among the highlights of the study, 40% of French people feel more depressed since the arrival of Covid-19. Another striking fact: 62% of 18-24 year olds say they have had suicidal thoughts since September 2021compared to 34% in the total population.
Michel Debout, professor of medicine, psychiatrist and suicide specialist, warns of the increase in the risk of suicide in France and the inaction of the public authorities. He answers questions from Lyon Capitale.
Lyon Capital. Why is France one of the European countries where suicide mortality is the highest?
Michael Standing. This is a very old observation. For 40-50 years, we have known that France is in the wrong range of European countries with regard to the mortality rate.
For a very long time, suicide mortality was hidden in France, as in Catholic countries (Italy, France, Spain), whereas it was less so in Northern European countries. The Catholic religion has for a long time had a very critical attitude towards death by suicide. She refused to bury the bodies with a religious funeral. The consequence is that we didn’t talk about it. When someone died by suicide, we hid it.
We could not have an objective look at this human reality that is suicide. For years, we did not practice suicide prevention because we did not want to look the phenomenon in the face. We did not want to make it a health problem but only a moral problem. As we have not done any prevention, mortality by suicide is higher in France than in a number of northern European countries.
“We do not have a report to suicide which was a public health report, but a report of morals and religious taboos.”
Michel Debout, professor of medicine
The study highlights a gap between the prevalence of suicidal thoughts, lower in France than in other countries, and the risk of acting out, one of the highest in Europe. How to explain it?
Suicide prevention is not about preventing suicidal thoughts, but about preventing the risk of acting out, which results in either deaths by suicide or attempted suicide. The latter are fortunately much more frequent than death by suicide. ladle, there are 10 suicide attempts for every death by suicide.
But, even if he lets the person live, this acting out is nonetheless a serious act. There is often care, hospitalization. This also has consequences for the future of the subject. It is a traumatic event for the whole family. This is why it is absolutely necessary to prevent suicide; what we don’t do in France. We do not have a report to suicide which was a report of public health, but a report of morality and religious prohibition.
According to the study, 40% of French people feel more depressed since the arrival of Covid-19. What has been the impact of this crisis on the mental health of the population?
The Covid-19 crisis has had a clear impact on the French population. The health crisis initially caused concern and anxiety. For a period, every evening, the Director General of Health or the Minister of Health himself gave the number of dead and contaminated since the day before. We were in a very anxious climate.
“Economic and social crises result in an aggravation of the risk of suicide”
To which was added the economic crisis. Business in all countries was shut down for several months. Factories, businesses, workplaces have closed. However, we have known for more than a century that economic and social crises translate into an aggravation of the risk of suicide. Normally, a population must project itself into the future, here it was quite the opposite.
I said to the public authorities that they had to worry about this suicidal risk which was going to get worse. The authorities did nothing. From May 2020 to the end of November, the Minister of Health did not speak once about the mental health of the French.
Are there categories of French people who have been more affected than others?
In the study, we draw attention to two categories of population. First, the youth, who is particularly affected by this psychological crisis linked to Covid-19. There is a specific risk for young people, which can be understood in several ways. The youth had to confine themselves like the others. But young people need to have meeting places. Young people need young people, it’s an almost visceral need.
“The rate of suicidal acts has been particularly high among young people”
During periods of confinement, not only could they no longer find each other but, in addition, they had to isolate themselves. There are sometimes students who lived far from their families and who had to isolate themselves for long weeks alone in a student room or in a small space, sometimes without having significant financial means. This life context was very negative for this youth. The suicide rate has been particularly high among young people.
How to fight against this state of affairs?
I have long argued for two things. On the one hand, we should reorganize student health centers. 50 years ago, I ran a health center in Lyon, which was closed in the 1980s. At the time, I denounced the closure of this health center. We had provided many answers to the students’ health questions. I believe there is only one left in France, in Paris. In many college towns, there are no health centers for students.
The second answer is breaking the isolation and precarious living conditions of students. There are still too many students who have very precarious living conditions: they don’t have a scholarship or find it hard to get one, their parents may be in default, they can’t find odd jobs that supplement their means. to live. This part of the population is destitute, sometimes without support, and ends up despairing.
We must also consider the failure rate in studies. Now, the bac is obtained by 90% of young people, which means that 90% of young people can find themselves in higher education. Unfortunately, not everyone will be able to pass the same level of studies. Many will be faced with failure, and therefore with a feeling of not being up to the task. They will lose confidence in themselves, they will lose confidence in others, and there, the risk of suicide will be significant.
“There are more suicidal thoughts among employees who experience toxic situations at work”
And the second category of French people particularly affected by Covid-19?
Those are employees who experience toxic situations at work : moral or sexual harassment, burnout, situations of over-stress… In these situations, there are more suicidal thoughts. Above all, there is a greater risk of committing suicide. It is absolutely necessary that we lead a proactive policy for the prevention of psychosocial risks at work.
I have been asking for 20 years that the psychological consequences of moral or sexual harassment at work, of professional exhaustion, be recognized as an occupational disease. As long as they are not, there are no preventive measures in the company. There is no alert procedure to say that employees are at psychosocial risk in a company.
What are the public health policies in force in France and how can they be improved?
For a year and a half, a national telephone number has been set up. Before, there were non-national call numbers, which were often associative. SOS Amitiés is the first association which, in the 1960s, had developed a telephone number. We could call on them when we were in distress.
“We are doing the exact opposite of what should be done”
Substantial financial resources have been allocated to the establishment of this national telephone number. Whether you live in Brest, Marseille or in the center of Auvergne, you use the same number and you come across the same respondent, who may be hundreds of kilometers from your place of residence. A Breton will talk to a Marseillais, and vice versa.
These people certainly need a listening ear, but they first need a face-to-face hearing. The image is not worth the person. Admittedly, the image or even simply the sound of the voice can be useful. I’m not saying it’s useless. I am simply saying that if it is not supplemented by the possibility of a territorialized meeting, this telephone number is largely insufficient.
With the same financial means, it is therefore necessary to create meeting places. People who live in Lyon must be able to find a listening space in Lyon. A little over 20 years ago, we created a listening center in Saint-Etienne: Loire prevention suicide. For years, we received people in pain, families who had experienced the death of a loved one by suicide. Six months ago, the Regional Health Agency decided to remove the subsidies they gave to the association. We had to stop this activity.
We are doing the exact opposite of what should be done. Why not a national number, even if in my opinion it is expensive, but as long as it supplements and not replaces all actions in the field and in the vicinity.