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On the occasion of the publication of a survey of the Jean-Jaurès foundation, carried out by Ifop, the professor of forensic medicine and jurist of the Court of Appeal of Lyon Michel Debout warns about 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% of the total population.
Michel Debout, professor of medicine, psychiatrist and suicide specialist, warns of the increased risk of suicide in France and the inaction of public authorities. He answers questions from Lyon Capitale.
Leon Capital. Why is France one of the European countries where mortality from suicide is 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 regarding the mortality rate.
For a long time, suicide mortality was hidden in France, as in Catholic countries (Italy, France, Spain), while in northern European countries it was less so. The Catholic religion has long had a very critical attitude towards death by suicide. She refused to bury the bodies with a religious funeral. The consequence is that we don’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 didn’t practice suicide prevention because we didn’t want to look the phenomenon in the face. We didn’t want to make it a health problem but only a moral problem. Since we have not done any prevention, mortality from suicide is higher in France than in several northern European countries.
“We don’t have a suicide report that was a public health report, but a report of moral 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?
Suicide prevention is not about preventing suicidal thoughts, but about preventing the risk of acting out, resulting in 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 suicide death.
But, even if he lets the person live, this performance is nonetheless a serious act. Often there is care, hospitalization. This also has consequences for the subject’s future. 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 suicide report that was a public health report, but a morality and religious prohibition report..
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 time, every afternoon, the General Director of Health or the Minister of Health himself gave the number of dead and contaminated since the previous day. We were in a very anxious climate.
“The economic and social crises translate into an aggravation of the risk of suicide”
To which was added the economic crisis. Business in all countries was closed for several months. Factories, companies, workplaces have closed. However, we have known for more than a century that The economic and social crises translate into an aggravation of the risk of suicide. Normally, a population must be projected into the future, here it was the opposite.
I told the public authorities that they had to worry about this suicidal risk that 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 that have been more affected than others?
In the study, we draw attention to two categories of population. First the youth, who is especially affected by this psychological crisis linked to Covid-19. There is a specific risk for young people, which can be understood in various ways. The young man had to confine himself like the others. But young people need to have meeting places. Young people need young people, it is 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 be found, but they also had to isolate themselves. Sometimes there are students who lived far from their families and had to isolate themselves for long weeks alone in a student room or in a small space, sometimes without significant financial means. This context of life was very negative for this young man.. The suicide rate has been particularly high among young people.
How to fight against this state of affairs?
For a long time I have defended two things. On the one hand, we should reorganize the student health centers. 50 years ago, I ran a health center in Lyon, which was closed in the 1980s. At that time, I denounced the closure of this health center. We had provided many answers to student health questions. I think there is only one left in France, in Paris. In many college towns, there are no student health centers.
The second answer is break the isolation and precarious living conditions of students. Il ya encore trop d’étudiants qui ont des conditions de vie très précaires: ils n’ont pas de bourse ou ont du mal à l’avoir, les parents peuvent être défaillants, ils ne trouvent pas de petits boulots qui complètent leurs moyens de to live. This part of the population is destitute, sometimes without support, and ends up desperate.
The rate of failure in the studies must also be considered. Now, the bac is obtained by 90% of young people, which means that 90% of young people can be found in higher education. Unfortunately, not everyone will be able to pass the same level of studies. Many will face failure and therefore 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 particularly affected by Covid-19?
Are employees experiencing 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 an increased risk of committing suicide. It is absolutely necessary that we carry out 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 current public health policies in France and how can they be improved?
A national telephone number has been enabled for a year and a half. Before there were non-national call numbers, which were often associative. SOS Amitiés is the first association that, in the 1960s, developed a telephone number. We could call them when we were in trouble.
“We are doing the exact opposite of what should be done”
Significant financial resources have been allocated to the establishment of this national telephone number. Whether you live in Brest, Marseille or central Auvergne, you use the same number and meet the same respondent, who may be hundreds of kilometers from where you live. A Breton will speak to a Marseillais and vice versa.
These people certainly need a listening ear, but they need a face-to-face audience first. The image is not worth the person. It is true that the image or even just the sound of the voice can be useful. I’m not saying it’s useless. I am simply saying that if it is not complemented by the possibility of a territorialized meeting, this telephone number is largely insufficient.
Therefore, with the same financial means, it is necessary to create meeting places. People who live in Lyon must be able to find a listening space in Lyon. Just over 20 years ago, we created a listening center in Saint-Etienne: Loire suicide prevention. 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 cancel the subsidies it granted 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, although in my opinion it is expensive, but as long as it complements and does not replace all the actions in the field and in the vicinity?