Public Health France publishes new results from Enabee and EnCLASS, two key studies to decipher the mental health of children aged 6 to 11 years old in school from CP to CM2, and of adolescents in middle and high school. These results confirm the importance of promoting behaviors and environments favorable to mental health, and of developing psychosocial skills programs, particularly in schools. They also call for strengthening awareness-raising actions among parents, teachers and educational staff.. Communiqué.
Child mental health: understanding contexts of vulnerability to take better action
The first results of Enabee, a national epidemiological survey on the mental health of children attending kindergarten and elementary school in mainland France, were published in 2023. By combining the points of view of parents, teachers and children, these unprecedented results showed that 13% of children in elementary school (6 to 11 years old) present at least one probable mental health disorder (emotional disorder, oppositional disorder or attention deficit disorder with or without hyperactivity).
Public Health France is therefore publishing new analyzes which describe the individual and contextual characteristics (family, relational, environmental) associated with these probable mental health disorders in children aged 6 to 11. These new results could help identify situations of vulnerability, where the child is more likely to suffer from mental health disorders, without it being possible to establish causal links.
• The study shows that, in this age group: boys, children whose mothers have reported pregnancy complications as well as children suffering from chronic illnessesare more frequently affected by probable mental health disorders.
• In addition, children experiencing academic difficulties (according to the parent and/or teacher), or having experienced difficult events (bereavement, aggression, placement in child welfare) also more often present with a probable mental health disorder.
• Furthermore, the study once again confirms the impact of the Covid-19 health crisis on the mental health of children. Indeed, significant hardship of confinement or significant worry within the household during the pandemic are associated with a more frequent presence of at least one probable mental health disorder in the child.
• The family environment (separated parents, existence of conflicts between separated parents, financial situation of the household perceived as difficult, presence of an anxiety disorder in the responding parent) also constitutes a context of fragility for the child, more associated with the existence of mental health disorders.
• Finally, being likely to be bullied by other children or spending a significant amount of time at the recreation center on non-school days are also factors associated with at least one mental health disorder in children. But it should be remembered that these associations should not be interpreted as causal and deterministic relationships, the study specifies.
Adolescent mental health and well-being : signs of improvement, but continued pain
Public Health France also publishes new results on mental health from the national survey in middle and high schools among adolescents on health and substances (EnCLASS), carried out in partnership with the School of Advanced Studies in Public Health (EHESP) and the French Observatory of Drugs and Addictive Tendencies (OFDT).
The data, collected in 2024 from 11,400 secondary school students, reveals a contrasting situation in the well-being and mental health of middle and high school students. After a marked deterioration in all well-being and mental health indicators between 2018 and 2022, some indicators show an improvement, while others indicate a downward trend. We also note that adolescent girls have systematically less favorable mental health indicators than boys, with gaps increasing during secondary school.
– In 2024, the majority of middle school students (82%) and high school students (78%) perceive themselves to be in good or excellent health and are satisfied with their current life (respectively 80% and 72%), despite a downward trend in these indicators since 2018.
–In addition, 70% of middle school students and 63% of high school students report a good level of mental well-being, with a respective increase of 11 and 12 points compared to 2022, observed in both boys and girls. We also observe a decrease in the share of young people who say they feel a feeling of loneliness most of the time during the year (this concerns 15% of middle school students and 20% of high school students in 2024).
However, these indicators coexist with persistent signals of psychological suffering among young people:
- 45% of middle school students (6th, 5th and 4th grade) report psychological complaints more than once a week for at least 6 months (-4 points compared to 2022). Nervousness is most frequently reported (32%), followed by irritability (29%) and feeling depressed (21%). These manifestations become more pronounced with class level and are more frequent among girls.
- Furthermore, 19% of high school students have a significant risk of depression, more marked among girls. (+3.5 points compared to 2022). The most frequently reported symptoms are: lack of energy (58%), difficulty concentrating (44%) and feeling discouraged (42%).
- Finally, 20% of high school students report having had suicidal thoughts in the last 12 months; a figure down compared to 2022 (-4 points). If this reduction is an encouraging signal, the increase in suicide attempts declared over the course of life (15% of high school students, or +2 points compared to 2022) reminds us that the most severe forms of psychological suffering persist among some adolescents.
- Whatever the level of education, boys are more likely than girls to perceive their health as good or excellent, with the gap becoming more significant from 4th grade onwards. Thus the proportion of girls declaring themselves in good or excellent health decreases from 83.1% in 6th grade to 69.5% in 4th grade and 72.3% in 3rd grade.while that of boys remains at an equivalent level (86.6% in 6th grade and 89.0% in 3rd grade). In high school, this proportion remains stable between class levels for both sexes. Whatever the level of education, girls are proportionally more likely than boys to express a feeling of loneliness (22,3 % vs. 8.6% in college and 25.1% vs. 13.6% in high school). For girls, a break is observed between the start of middle school (17.3% in 6th grade and 19.4% in 5th grade) and the following classes, reaching an average of 25.1% of students concerned in high school. Among boys, the proportion of students expressing a feeling of loneliness is lower with 8.6% on average in middle school compared to 13.6% in high school.
These results confirm the importance of promoting behaviors and environments favorable to mental health, and of developing psychosocial skills programs, particularly in schools. These results also call for strengthening awareness-raising actions among parents, teachers and educational staff. early identification of signs of adolescent discomfort and referral to listening and support spaces, particularly in the event of suicidal thoughts. Prevention strategies that take into account gender inequalities must also be developed.
What tools and levers for action?
Faced with these findings, it is appropriate to continue and strengthen actions to prevent and promote the mental health of children and adolescents. Public Health France is committed to the deployment of psychosocial skills (CPS) in schools, a lever to mobilize for the benefit of mental health from a very young age. Strengthening CPS can indeed help create a protective and inclusive educational climate, while preventing dynamics of domination and violence between peers. Thus, in 2022, the Agency published a first state of knowledge on CPS and a theoretical framework, supplemented by an operational framework and resources published in 2025 for volume 1 and in 2026 for volume 2. As part of the interministerial strategy on the development of CPS for children, Public Health France develops and co-constructs these tools in order to support stakeholders in the territories. This is how she provided CPS expertise for the construction of the National Education empathy kit, generalized at the start of the 2024 school year in nursery and elementary schools.
Effective or promising prevention programs on the subject of mental health are listed in ReperPrev, the national register of interventions in prevention and health promotion set up by Public Health France, such as the Good Behavior Game (GBG) and the family and parenting support program (PSFP).
Furthermore, multiple information tools supported by Public Health France, such as CléPsy and Psycom, make it possible to raise awareness and guide educational professionals and families on subjects relating to mental health. In addition, the My psy support system allows access to a psychologist for children from the age of 3.
Supported by Public Health France and intended for young people aged 12 to 25, the Youth Health Line offers a helpline (0 800 235 236) accessible 7 days a week from 9 a.m. to 11 p.m. (anonymous and free service and call). Young people can also consult the website providing information, a forum, a chat, directions to support structures (reception and listening places, adolescent centers, associative structures, professionals and care structures). These services are provided by professionals (psychologists, educators, family counselors, doctors).
Finally, 3114, the national suicide prevention number, is accessible 24/7. This line is aimed at people in distress, but also at those around them, at professionals and at people bereaved by suicide. The calls, free and confidential, are handled by healthcare professionals, psychologists or nurses, trained in suicide prevention. This system also includes a website which provides resources to better understand the suicidal crisis and advice for overcoming it.
• Results of the Enabee 2022 study in mainland France
• The results of the EnCLASS 2024 survey.
