On the occasion of the publication of a survey conducted by Ifop by the Jean Jaurès Foundation, Michel Debout, professor of forensic medicine and legal expert at the Court of Appeal of Lyon, warns of the psychological consequences of the crisis related to Covid-19.
The Jean Jaurès Foundation has just published a survey carried out by Ifop on the mental health of residents in six European countries, including France.
Highlights of the study include 40% of the French feel more depressed since the arrival of Covid-19. Another notable fact: 62% of 18-24 year olds say they have suicidal thoughts since September 2021compared to 34% in the general population.
Michel Debout, medical professor, psychiatrist and suicide specialist, warns of the increase in the risk of suicide in France and the inaction of the authorities. He answers questions from Lyon Capitale.
Lyon capital. Why is France one of the European countries with the highest suicide mortality rate?
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 in terms of mortality rate.
Suicide mortality has been concealed for a very long time in France as well as in the Catholic countries (Italy, France, Spain), while it was less the case in northern European countries. The Catholic religion has long been very critical of suicide. She refused to bury the bodies with a religious burial. The consequence is that we didn’t talk about it. If someone died by suicide, we hid it.
We could not look objectively at this human reality that is suicide. We didn’t practice suicide prevention for years because we didn’t want to face the phenomenon. We didn’t want to make this a health issue, just a moral issue. Because we have not taken any preventive measures, mortality from suicide is higher in France than in some northern European countries.
“We don’t have a suicide report, which was a public health report, but a report on morality and religious taboos.”
Michel Debout, professor of medicine
The study shows a discrepancy between the prevalence of suicidal ideation, which is lower in France than in other countries, and the risk of acting out, one of the highest in Europe. How do you explain it?
Suicide prevention is not about preventing suicidal thoughts, but about preventing the risk of acting out that leads to either death by suicide or suicide attempt. Fortunately, the latter is much more common than death by suicide. Trowel, For every suicide death there are 10 suicide attempts.
But even if he lets the person live, that acting out is still a serious act. There is often nursing, hospitalization. This also has consequences for the future of the subject. It is a traumatic event for the whole family. Therefore, it is absolutely necessary to prevent suicide; what we don’t do in France. We do not have a relationship with suicide, which was a public health relationship, but one of morality and religious taboos.
According to the study, 40% of French people feel more depressed since the arrival of Covid-19. What is the impact of this crisis on the mental health of the population?
The Covid-19 crisis is having a significant impact on the French population. The health crisis initially caused concern and apprehension. For a while, the director general of health or the health minister himself reported every evening the number of dead and infected since the previous day. We were in a very anxious climate.
“Economic and social crises lead to an increase in the risk of suicide”
Then came the economic crisis. Business in all countries was suspended for several months. Factories, shops, workplaces have closed. However, we have known this for more than a century economic and social crises lead to an increase in the risk of suicide. Normally a population has to project itself into the future, here it was the other way around.
I have told the authorities that they need to address this risk of suicide, which is only going to get worse. The authorities did nothing. From May 2020 to the end of November, The health minister never once spoke about the mental health of the French.
Are there categories of French people who are more affected than others?
In the study we draw attention to two population groups. First the youth, which is particularly affected by this psychological crisis related to Covid-19. There is a specific risk for young people that can be understood in different ways. The youth had to limit themselves like the others. But young people need meeting places. Young people need young people, it’s an almost instinctive need.
“The suicide rate was particularly high among young people”
During the detention periods, not only could they no longer find each other, but they also had to self-isolate. There are sometimes students who live far away from their families and have had to withdraw to a student room or a very small space for long weeks, sometimes without significant financial means. This life context was very negative for this young person. The suicide rate was particularly high among young people.
How to fight against this condition?
I have long argued for two things. On the one hand, we should reorganize the student health centers. 50 years ago I ran a health center in Lyon that closed in the 1980s and I denounced the closure of that health center at the time. We had given many answers to the students’ health questions. I think there is only one left in France, in Paris. Many college towns do not have student health centers.
The second answer is to break the isolation and the precarious living conditions of the students. There are still too many students in very precarious living conditions: They have no scholarship or only with difficulty, their parents may be in arrears, they cannot find odd jobs to supplement their livelihood. This part of the population is destitute, sometimes without support, and ends up in despair.
We also need to consider the failure rate in studies. Now 90% of young people get their high school diploma, which means that 90% of young people can find themselves in higher education. Unfortunately, not everyone will be able to complete the same degree. Many are confronted with failure and with it the feeling of not being up to the task. They will lose confidence in themselves, they will lose confidence in others, and that is where 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?
those are Employees who experience toxic situations at work : moral or sexual harassment, burnout, stressful situations… In these situations there are more suicidal thoughts. Above all, there is an increased risk of suicide. It is imperative that we conduct one proactive policy to prevent psychosocial risks at work.
For 20 years I have been demanding that the psychological consequences of bullying or sexual harassment at work, of occupational exhaustion, be recognized as an occupational disease. As long as this is not the case, there are no preventive measures in the company. There is no alert procedure for saying that employees in a company are at risk of psychosocial risks.
What are the public health policies in France and how can they be improved?
A national telephone number has been set up for a year and a half. There used to be foreign phone numbers that were often associative. SOS Amitiés is the first association to have developed a telephone number in the 1960s. We could call them when we were in need.
“We are doing exactly the opposite of what should be done”
Significant financial resources have been allocated to set up this national telephone number. Whether you live in Brest, Marseille or in the center of Auvergne, you use the same number and come across the same respondent, who may be hundreds of kilometers from where you live. A Breton talks to a Marseillais and vice versa.
These people certainly need a sympathetic ear, but they need a face-to-face conversation first. The picture is not worth the person. Granted, the image, or even just the sound of the voice, can be useful. I’m not saying it’s useless. I’m just saying that this phone number is largely inadequate if not complemented by the possibility of a territorialized meeting.
With the same financial resources, it is therefore necessary to create meeting places. People living in Lyon need to be able to find a listening room in Lyon. A little over 20 years ago, we created a hearing center in Saint-Etienne: Loire suicide prevention. For years we have welcomed people with pain, families who have witnessed the death of a loved one by suicide. Six months ago, the state health authority decided to cancel the subsidies granted to the association. We had to stop this activity.
We are doing the opposite of what should be done. Why not a national number, even if it is expensive in my opinion, but as long as it complements and does not replace all actions in the field and nearby.
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