October 4, 2023

Suicide in children and adolescents: a reality surely undervalued

"When we see that four million adults consume psychotropic drugs on a regular basis, we can think that this malaise has slipped to the youngest," commented Jeannette Bougrab, Secretary of State for Youth. Last winter, the latter asked for a report to the neuropsychiatrist, Boris Cyrulnik, following the suicide of a nine-year-old diabetic girl near Lyon and an 11-year-old boy in Seine-Saint-Denis. He has just submitted his report, published by Odile Jacob under the title "When a child gives himself 'death'". 

For neuropsychiatrist Boris Cyrulnik, the prevention of child suicide begins before birth. It emphasizes the need to provide the child with emotional and sensory stability from the moment of conception, and also recommends the fight against maternal stress during pregnancy, "especially in the last weeks" and advocates long parental leave - (at least ten months) for the father and the mother. "The emotional isolation of a newborn gives the brain a cerebral trace that prevents it from controlling the drive." Then the emotional isolation of the child or the child.teenager trigger the drive for just a flick that can be enough to act, he explained. A hurtful sentence, a little frustration, a bad note to theschool or moving a buddy can cause an exceptional explosion.

Suicidal act or accident ???

The latter also believes that the phenomenon is underestimated: "Successful suicides are rare in 5-12 years," he says but he added immediately "They are certainly more common because the figures speak only of obvious suicides. There are so many unhappy children who will bend over the window, cross the street without looking or get off the bus on the move ... For him, it's "a cascade of invisible tears" that leads to the passage to the 'act, while children begin to understand death between six and nine years.

What are the causes ?

Early bereavement, family conflict, abuse, sexual assault, emotional isolation, malaise, harassmentschool, a bad grade. All of these causes are among those fatal "tears". In 2009, 37 suicides of children under 14 were recorded in metropolitan France (26 boys, 11 girls, mostly by hanging, strangulation or asphyxiation), 526 among 15-24 year olds (404 boys, 122 girls), age group where suicide is the second leading cause of death, according to figures from Inserm CépiDc.

How to spot warning signals

In teens, it can be difficult to distinguish psychic suffering from age-related malaise. "What makes prevention difficult is that suicide attempts are very often impulsive, the delay between warning signs (sleep, appetite, mood, alcohol consumption, running away), and the acts can be very, very short, "says Dr. Bochereau. In children, "it is less known so we have even fewer signals" and the impulsivity is more marked, "more related to their mode of operation" and their "relationship to time more instantaneous".

However, anxiety or academic decline may be stronger indicators than for teens, according to professionals who note that humiliation in front of the class, a bad note or a derogatory remark can be triggers. Theschool, where not much is done according to Thérèse Hannier, president of the National Union for the Prevention of Suicide, must therefore work towards early prevention of ill-being. There is a shortage of nurses, school doctors and "the teachers are in total limbo, even if their human capabilities still allow them to detect disorders," she says.

Boris Cyrulnik agrees! It advocates to develop the trades of the small childhood and invites to stop "overinvesting" theschool, "factor of anxiety and suicide". Revisiting French school rhythms would be a major step in this regard, he says. "The children of Northern Europe are half as stimulated as the children of Southern Europe and these children are first in the international rankings of school assessments" he explained on France Info."In less than ten years, Finland and the countries of Northern Europe have achieved a 40% decrease in suicides," he noted.

Do not burn the steps

"All psychopathological problems are rejuvenating: we see mental anorexia, behavioral disorders, depressions more and more young.The suicidal act rejuvenates too" explains Marie-France Le Heuzey, child psychiatrist at Robert Debré Hospital in Paris . According to the doctors, the child becomes aware around 7-8 years of the irreversibility of death, or earlier if he has experienced deaths in his entourage or the loss of a pet. The suicidal act can, however, be dictated more by a desire for change than a real desire to die.

"The living conditions in our society can be extremely difficult, more than in the past," says Dr. Le Heuzey, citing "families exploded "generating a feeling of insecurity or guilt in the child." There is a general climate of stress, competition, which crystallizes on schooling "according to Denis Bochereau, child psychiatrist at the mutualist Institute Montsouris (Paris) "Children are more adultified than before, with laptops from CM1, and, while they are still latency, they are offered a kind of pseudo-responsibility or identity ofteenagerhe said.

The national plan for the prevention of suicide 2011-2014 provides a guide for professionals of care and social action, to identify mental suffering and developmental disorders in children and adolescents. Awareness-raising and training actions should also be offered to the various professionals in National Education.

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