He would have heard the day before “a small voice” which would have suggested to him to commit an assassination. This is what emerges from the hearing by the police of the teenager who stabbed his Spanish teacher on Wednesday in Saint-Jean-de-Luz (Pyrénées-Atlantiques). A drama that puts back on the table the question of the detection and support of students suffering from psychological problems or psychiatric disorders in schools, even if this teenager was followed by a psychiatrist outside high school. 20 minutes review this case.
What is the state of school medicine in public establishments?
According to a 2020 report by the Court of Auditors, there was one school nurse for 1,300 students in 2018, and one school doctor for 12,572 students. And according to a National Education report from 2021, there is 1 PsyEN (guidance counsellor-psychologists) for around 1,500 students. Knowing that the latter’s mission is not only to intervene with students in psychological distress, because they must also help middle and high school students to develop their orientation project and work to prevent school dropout.
Affirming that “school health is an important issue”, the Minister of Education, Pap Ndiaye, recalled on France Bleu this Thursday that 20% of psychologists – currently in training – had been recruited more in 2022 and that 50 school nursing posts had been created the same year.
Why is the role of school nurses so important?
“For students, families and educational teams, school health is above all embodied by nursing staff: they are the most numerous, most available health professionals (…)”, underline the Elders of rue Cambon. “In colleges, the nurse is in charge of the compulsory visit of 12-year-old students, which makes it possible to assess the state of health of the students and to identify those who are not doing well”, describes Gwenaëlle Durand, general secretary of the union. national of nurses and nurse educators of health (Snies).
In colleges and high schools, the nurse is also there to provide first aid in the event of illness or injury. Its role is also to detect psychic problems or mental disorders. “Students come to us when they feel anxious. Some teachers also report to us middle or high school students who accumulate absences, are withdrawn, often cry, hear voices…”, she continues. After an interview, the school nurses inform the parents of their child’s condition if he or she is considered to be worrying. “We can also call 15 to find out which medical structure to direct the student to. »
Why is the lack of health personnel a problem?
According to Gwenaëlle Durand, “nurses sometimes work in several establishments, due to a shortage of staff. In college, they are often only there two and a half days a week, which is very insufficient, especially to spot signs of psychological distress. Because for the students to come and consult us, they have to identify us, they have to trust us”.
And the pace of work of these professionals is often very sustained: “We often have between 20 and 50 student visits per day,” she says. Finally, the medical visits for 12-year-old students mentioned above, although compulsory, are not carried out systematically, due to a lack of resources.
What about private establishments?
Private establishments – this is the case of the high school where the tragedy took place on Wednesday – receive funds from the State to ensure their operation, but they are not obliged to have a health service established within their walls. However, it is extremely rare that they recruit school doctors and nurses, except in large structures. And again, they are only employed there part-time. “The financial balance of our establishments does not allow us to recruit them. Otherwise, we should greatly increase the financial contribution of the families”, explains Yann Diraison, deputy to the Secretary General of Catholic Education.
In the private sector, the identification of students in psychological distress is therefore the responsibility of teachers: “In these cases, they report these students to the head of the establishment, who alerts the family”, he continues. And it is extremely rare that they have received training to detect weak signals…