24 November 2023

Stella (all the children’s first names have been changed at their request) is a 13-year-old teenager with long blond hair. She is educated in 4e, in a college in Montpellier. In reality, she hasn’t been going to class since September 2022. The day after the start of the school year, she was in tears, impossible to go back. Stella had already experienced this situation. In the spring, on March 19, 2022, exactly, she recalls. ” I got up. I said “stop”. The day before, I had had a very bad headache. I was super stressed. I wanted to vomit”, says this extremely reserved young girl. The isolation at college, the fear of the gaze of others, of not being up to it, while this chess enthusiast is an excellent student, ended up paralyzing her.

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Stella suffers from what is commonly known as school phobia. A term that Hélène Denis, a child psychiatrist at the Montpellier University Hospital, rejects, who prefers that of anxious school refusal. “School phobia would be a phobia of school like the phobia of spiders, water… but it’s much more complex, she says. When we talk about anxious school refusal, we are talking about young people who have one or more prominent anxiety disorders that prevent them from functioning. Particularity of these young people: they are generally good students, like to learn. They really want to go back to school, but they’re in so much pain that they can’t. »

How many children are affected? In the absence of precise data from national education, it is difficult to quantify the phenomenon. But they would be more numerous from year to year. This disorder occurs particularly at ages when there are changes in school level. These children are so anxious about going to school that they develop somatic symptoms: stomach aches in the morning, the day before school starts, when everything was fine during the holidays, vomiting, but also panic attacks . Sometimes they fall into depression.

A teenager received in the anxious school refusal unit of the Montpellier University Hospital Center, January 31, 2023.

Problem: if they are not supported, “this absenteeism will continue, they risk developing other psychiatric pathologies, having difficulty finding their place in society, with a risk of desocialization”, says Hélène Denis.

Destitute parents

About ten years ago, this child psychiatrist decided to set up an unprecedented day care unit for college students, whose care is based on behavioral and cognitive therapies (CBT). Stella entered it in November 2022. The unit welcomes around ten middle school students from 6e at the 3e. They suffer from social anxiety, like Stella – the fear of judgment from others is such that they can’t look people in the face, go out in the street, go to a store –; separation anxiety, like Mei, 12, who is afraid of being away from her parents; performance anxiety, like Thomas, an 11-year-old boy in grade 6e who puts pressure on himself even when he has no controls and for whom a 15 is a bad mark. Some suffer from generalized anxiety, they are afraid of everything. Others have a phobia, like Emma, ​​15, who is emetophobic (fear of vomiting). “This anxiety has generated other anxieties, I’m afraid to go out, to eat…”, she confides.

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