MENTAL HEALTH – From her office at the Pitié Salpêtrière hospital, Angèle Consoli is at the bedside of a France who is biting her nails. Between two consultations in the largest psychiatric service in France, this new recruit of the Scientific Council brings his expertise to Emmanuel Macron to spare the mental health of the French, battered by the coronavirus crisis.
While the coronavirus is already saturating hospitals, the Élysée is worried about the emergence of a new epidemic. In mid-February, 22.7% of French people surveyed by Public health France said they were victims of depressive or anxiety disorders. Psychological distress has never been so prevalent, even during the two national lockdowns.
>> Find our file “At the bottom of the wave”. After the health crisis, the moral crisis: looks and advice to overcome the great Covid depression.
Isolation, desocialization, uncertainty, inconsistency, contradiction, lack of leisure, loss of loved ones … The Covid-19 and its restrictions upset, offend, destabilize our psyche, to the point of making us sick. Lthe first shrink in France agreed to answer at HuffPost. Lie down.
The HuffPost: The French are doing badly. Depression, anxiety, hospitalizations after a suicide attempt … All indicators are red. Is the crisis exacerbating pre-existing psychological disorders or are we all at risk of developing mental illnesses?
Pr Angèle Consoli: The health crisis can worsen some mental illnesses or reveal new ones. Particularly vulnerable populations are the young and the elderly. In the child psychiatry service at Pitié Salpêtrière where I work, I see adolescents and children who are worse off when they were already followed for psychiatric pathologies (depressive disorders, anxiety disorders, developmental disorders). There are also people who are consulting for the first time.
There is a continuum between signs of lighter, more temporary emotional distress and decompensations (editor’s note: brutal degradation) psychiatric patients under specific care. The two situations are not opposed, they are part of a whole which is worrying.
Does the hospital have the means to face this psychiatric wave?
The Covid-19 crisis is worsening tensions in psychiatric services, especially those intended for the youngest patients. Before the pandemic, we were already refusing patients requiring full-time inpatient care. Since the second confinement, the number of hospitalizations after a suicide attempt or for suicidal ideation, anxiety disorders or depressive disorders increases sharply throughout France. The demand for consultations is also very strong.
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The sick go home without careAngèle Consoli, child psychiatrist, member of the Scientific Council
At Pitié Salpêtrière, we currently have around 40 patients on a waiting list for full-time hospital admissions, mainly due to suicide attacks. The sick go home without care, in a family unit worried about a new act. We must bring home adolescents under hospital care, and tell their worried and sometimes very poor families that we must wait for a place to become available … In the meantime, we continue to follow them in consultation.
What are the recommendations of the Scientific Council so that the country can respond to this epidemic of mental illness?
The measures recommended by the Scientific Council vary according to the degree of difficulties encountered. The psychiatric care system is very saturated, especially in child psychiatry. This deserves deep reflection beyond this health crisis, on the offer of care and the organization of mental health care (increasing the number of full-time beds, strengthening alternatives to hospitalizations). Psychiatry meetings must be held before the summer.
For people most at risk, we recommend in particular increasing the quota of school doctors and psychologists, psychologists in universities.
Finally, for the general population, we recommend that the government continue to support information campaigns on the impact on mental health of the health crisis, which accentuates the risk of suicide, addictive behavior, anxiety and depression.
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Consultation with a specialist is necessary if symptoms persist and become disablingAngèle Consoli, child psychiatrist, member of the Scientific Council
How to spot the signs of a discomfort that sets in at home?
It is important to identify in a child or adolescent a change in behavior, a break with his previous functioning. For example, he will show unusual irritability, even tantrums, or withdrawal, isolation, sad mood, or even unusual and frequent crying.
The first thing to do is to talk with your child or teenager and with the people who take care of them, teachers for example. It’s important to be able to get them to talk about what they feel, their worries, their feelings. A consultation with a specialist will be necessary if the symptoms set in, persist, become disabling and intense.
To get better, should we cling to the hopes aroused by vaccination and health protocols in restaurants and places of cultivation?
Vaccination is an undeniable hope. The curves reporting the number of COVID 19 infections in Île-de-France in the general population and among AP-HP caregivers were until now completely superimposable. Since 37% of caregivers are vaccinated versus 7% of the population of Île-de-France, the curve of COVID infections among caregivers has significantly decreased, which testifies to the effectiveness of vaccination. Getting vaccinated allows you to be an actor in a possible improvement.
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Let’s try to project ourselves. We will be able to resume activities that do us good.Angèle Consoli, child psychiatrist, member of the Scientific Council
This hope can be transmitted to the youngest who need to project themselves towards a better future. Thinking and imagining rediscovering activities that did good, such as sports or cultural activities, is essential. A teenager in consultation told me: “my little coffee when I left school with my friends was so important”. Cultural life and mental well-being are closely linked.
Are we going to get better once the crisis is over or stay home anxious?
Both movements are possible and it will be necessary to be attentive to them. We can expect moments of exhilaration with the temptation to forget and quickly move on. The challenge is to make people understand that resuming this life as “normal” as possible will also be accompanied by the continuation of gestures and barrier measures …
What will happen if certain serious psychological disorders take hold in the population?
The effects of the health crisis on mental health may well be prolonged for the most vulnerable people (the elderly, young people, precarious people, etc.), especially since economic difficulties are a well-known risk factor for mental disorders. The symptoms reported in the population (anxiety, depression, dark thoughts), insecurity, social isolation are also risk factors for committing suicide. The number of suicide attempts, a major indicator in terms of mental health, is observed very closely.
Perhaps the mobilization today concerning mental health will allow a de-stigmatization of mental pathologies. And finally, it is important to recall all the outbursts of solidarity, altruism and creativity that have developed and which can also make it possible to face adversity and get better.
See also on The HuffPost: These students at the end of their rope talk about their loneliness and precariousness
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