The pandemic, a detonator for adolescents in difficulty

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“These drugs, I took them for one purpose: to die.” From the top of her 14 years, Clara * evokes with a certain detachment the nightmare she went through during semi-confinement in March 2020. For this Genevan teenager in crisis, who was then cumulating difficulties at school and bad associates, the pandemic acted as a detonator. Stuck at home with her mother who brings her up alone, the young girl “goes crazy”. Now out of school, she is followed on an outpatient basis at the Child and Adolescent Psychiatry Service (SPEA) of the Geneva University Hospitals (HUG). A decompression chamber where professionals help him to put his suffering into words and channel his emotions.

Clara has been dragging his discomfort for years. Sitting on a bench alongside her mother, she verbalizes it in snatches without always measuring its seriousness. Behind his outspokenness, the modesty of childhood shines through in his battered journey. Harassed since elementary school, the young girl suffers mockery and insults on her physique, her mixed origins, her modest social background. “I came home every day in tears,” says Clara who, every morning, invents imaginary illnesses so as not to go to school. Her school results are affected, she can no longer keep up and repeats a year. At home, the situation becomes conflictual to the point that she makes several trips back and forth between her mother’s home and that of her father, with the intervention of the protection of minors who suspects parental negligence. At the age of 12, her relationship with an older youngster she met on social media got out of hand. Again violence, insults and an unwanted sexual intercourse which finishes crushing her self-esteem.

Increase in demand

Anxiety, dark thoughts, sleep disorders or even depression: the consequences of the pandemic on the psychological health of adolescents are manifold. In Lausanne, the CHUV has recorded 50% of additional hospitalization requests since the summer. In Geneva, the Medico-Pedagogical Office has a longer than usual waiting list, proof of growing concern in the network. The specialized consultations of the SPEA are also recording an increase in requests. “Distraught parents ask for help and have trouble finding it,” notes Rémy Barbe, assistant doctor, head of the Hospitalization unit at the HUG Child and Adolescent Psychiatry Service. If the Covid-19 revealed vulnerabilities in young people without history, it accentuated the pathologies of those who were already ill. “

When the pandemic breaks out, Clara is on the phone. “As a person at risk [ndlr: elle souffre de diabète], I was afraid that the virus would land in Geneva, I started to panic at the idea of ​​being stuck at home, ”says the teenager. On March 16, the sentence falls, the schools close. An event that disrupts the already fragile balance of the young girl. “Clara had a very bad experience of confinement, she would get angry when I told her that she should not go out, refused to wear the mask, it was war,” says her mother, distraught. Clara expresses her discomfort through aggressiveness and tears. Holed up in her room, she isolates herself and grinds in the dark. At the start of September, the situation deteriorates. The young girl skips class and hangs out in the trams, “as far as possible from home”, taking medication and scarification, until hospitalization last fall.

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“A click”

Since then, Clara has been attending the day hospital three days a week alongside a dozen other young people. Managed by a multidisciplinary team, the structure operates in therapeutic groups. “The goal is to allow these young people to work on themselves and their relationships with others, to help them understand how they function,” explains Anelise Fredenrich, coordinating psychologist. To do this, different mediums are used: art, culture or sport. Very far from the obsolete image of face-to-face therapy, handkerchief in hand. “Speaking is not always what works best with adolescents,” emphasizes the psychologist. Many find it difficult to put words to their distress. ”

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Often recommended after hospitalization, the place acts as a transition to help the young person to reintegrate into his family and social world. “For one reason or another, the teenagers we receive here have gone outside the box, we help them find benchmarks, a schedule, a listening.” To avoid rooting, which can prove to be counterproductive, the duration of attendance is three months renewable. As for medication, it is used to facilitate communication when symptoms take too much place.

For Clara, the day hospital, with its shared meals and activities, was a radical change of environment. “At first I didn’t want to go,” she says. I don’t like being in a group and talking to strangers about my problems. ” Looking back, her mother views the pandemic with philosophy. “It is an ordeal which brought back a lot of suffering, but which also allowed me to burst an abscess with my daughter. It was in free fall, seeing it so badly alerted me, I was able to take the necessary steps. ” Today, Clara can begin to envision the future. She is expected to resume her studies in a private school soon and dreams of becoming a mechanic or esthetician.

“I was sad, angry”

Alex * doesn’t see a way out for the moment. “A blocked tunnel, closed in on itself.” This is how the 14-year-old describes his daily life without being able to put words into his discomfort. Followed since November in the day hospital, he says he was in the past a “little ball of joy”. But for two or three years, it is the black hole. Wanting nothing, a stalled motivation even for the drawing he loves, the desire to end it just so that the pain stops. Where is she from? Impossible to tell. When the pandemic breaks out, the situation deteriorates. “Before, I already missed a lot of lessons, but with distance school, I completely dropped out,” says Alex. I slept all day or was on my phone, sad, angry, it was a mixture of a lot of things. ” Folded in on himself, the young person hurts himself several times, talks about it to his mother, herself in a bad personal and professional position, who directs him to a psychologist.

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The return to school in September is going badly. “I missed more and more, I started to hate school”, confides the teenager, convinced that nobody can help him to get better, simply “to accompany him”. Not even his sister whom he trusts. Today Alex is required to go to school one day a week. An absurdity according to him. “The goal is to get me back into class, but just going on Wednesdays, I can’t keep up, I’m completely dumped, the teenager blurted out, bitter. I will obviously have to repeat. I would like to quit now and start again in September. The system is not very comprehensive. ” A dead end in which he feels stuck.

A weakened family and social framework

Beyond the story of Clara and Alex, how to explain such distress? “Among vulnerable young people, changes in organization or lifestyle linked to the pandemic, but also stressful elements, semi-confinement, distance school or even the anxiety-provoking climate, have represented factors of aggravation, ”says Rémy Barbe.

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In the emergency room, there was an upsurge in consultations at the time of the recovery this fall with more frequent hospitalizations. On the other hand, the increase in requests took place with a certain delay at the day hospital. “During the fall, we recorded fewer requests than usual, it is only since January that the demand has exploded”, notes Anelise Fredenrich, stressing that ten young people are waiting for a place. As if, at first, all other problems, psychic or somatic, had taken a back seat in the face of covid. “The situations we treat are not necessarily more serious than before,” continues the psychologist. On the other hand, we see that adult networks around young people have been very affected by the crisis and are unable to contain the difficulties. This is often one of the triggers for hospitalization. ”

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In addition to weakening the family and social environment, the pandemic has also removed the pressure relief valves, travel, social ties, and leisure. “Deprivation particularly hard to live in adolescence, a time when young people have a strong need for affiliation”, notes Rémy Barbe. For the specialist, the sequelae of the crisis will multiply. “Today, it is easier not to go to school without this being noticed,” underlines Rémy Barbe. We can imagine that currently, young people have dropped out but have not yet been identified. ” Especially since the suffering visible at the HUG is only the tip of the iceberg. “The cases that arrive at the emergency room are the most glaring, with the loudest behavior, from suicide attempts to running away from home. Certain young people whose state of health is very worrying nevertheless remain outside the network, invisible. ”

* Names known to the editorial staff