Although the use of psychoactive substances (PAS) among young people has been declining in recent years, it remains at very high levels in France compared to other European countries. Studies have shown that substance use is associated with mental health. However, since the COVID-19 pandemic, numerous studies have indicated a sharp deterioration in the health of young people, with an increase in depressive disorders and inadequate psychiatric care, compounded by potential socio-economic inequalities.
Additionally, the 2020 high school reform has led to a loss of class cohesion among students and heightened academic pressure, which can negatively affect both their well-being and mental health, as well as their addictive behaviors. In this context, the aim of the study is to prevent PAS consumption using a method developed by the WHO, whose effectiveness and acceptability among young people will be evaluated. This method involved a staged intervention, starting with guided self-help (DWM for Doing What Matters in Times of Stress), followed, if necessary, by individual psychosocial intervention (PM+ for Problem Management Plus). We hope these interventions will help reduce psychological distress and prevent the onset of psychiatric disorders, and thus limit the use of PAS. The study will be conducted in voluntary classes in Parisian middle and high schools, targeting a sample of 3,000 students aged 14 to 24.
Two groups will be formed and compared: one receiving the DWM/PM+ intervention (n=1,000) and one not receiving the intervention (n=2,000). An initial questionnaire will be administered prior to any intervention to assess the students’ health status, as well as potential social and territorial inequalities.
Three additional questionnaires will be completed by all students at the end of each intervention phase (DWM and PM+). DWM is based on Acceptance and Commitment Therapy, a form of cognitive-behavioral therapy that focuses on learning new ways to manage thoughts and feelings without letting them take control. DWM is a self-administered tool designed to be used via smartphone or computer over a 5-week period. PM+ is a brief, individual psychosocial intervention based on cognitive-behavioral techniques. It will be delivered over a 5-week period to students still experiencing psychological distress after completing DWM. Its key advantage is that it can be implemented by non-mental health professionals. By combining these 2 strategies, the program aims to address both psychological issued such as stress, fear, and feelings of helplessness, and practical issues such as family and other interpersonal conflicts. A qualitative study will also be conducted with 40 volunteer students (20 from middle school and 20 from high school) who have undergone both interventions (DWM and PM+) to assess their experiences and how they appropriated them.
Thanks to the initial questionnaire, we will be able to describe the factors associated with psychological difficulties and addictive behavior in young people, including the social and family determinants of the impact of COVID-19 and the high school reform, with the aim of identifying potential socio-economic inequalities. Students who undergo the DWM/PM+ intervention are expected to have better mental health outcomes than the control group, and thus be less inclined to engage in PAS use. The study will monitor potential changes in consumption over the short term, as well as changes in how substance use is perceived. This method complements the development of psychosocial skills. It provides simple, lifelong tools that can be used at any time to manage stress, regardless of its source. If the results are promising, this intervention could be extended to all French secondary schools. This could help reduce the number of children requiring treatment and allow resources to focus on the most severe cases, thereby easing the burden on specialized care systems, which are already under strain.
ESSMA Team members involved:
Murielle MARY-KRAUSE, Thibault LANDES, Héla GHRIBI, Jean-Sébastien CADWALLADER, Angèle CONSOLI.
Project funding : Institut national du cancer et de l’IRESP (INCa-IReSP_18705).
Collaborations:
Rectorat de Paris, FCPE
Our team is located on a single site, on the 3rd floor of the Pierre et Marie Curie Faculty of Medicine, Pôle Saint-Antoine
27 rue de Chaligny
Paris 12°
Tél.: +(33) 01.44.73.84.45
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