title: [Early detection of mental health disorders at school: The Fil Harmonie pilot program].
abstract: OBJECTIVE
  Most psychiatric disorders arise during adolescence, a period of life during which school takes an important place. School in France has an official mission of health education and prevention, and early detection of mental disorders is part of these goals. The aim of this study is to describe an innovative service operating in Paris that helps educational staff to deal with students having psychological or psychiatric symptoms. The Fil Harmonie program was launched in 2011. It consists of a telephone line available to all educational staff working for high schools in Paris.
  
  
  METHODS
  When in need of assistance, a member of the educational staff can call the dedicated hotline and expose the situation of their student to a trained psychologist. Over the course of the study, data concerning these phone calls were collected such as: socio-demographic characteristics of the student, the reason behind the call, the caller's professional role within the school, and care pathway information. All data collected during the phone calls were anonymized and computerized. We performed an observational descriptive study based on this data by using mixed methods: we integrated quantitative analysis and qualitative research in order to provide a better understanding of the Fil Harmonie program.
  
  
  RESULTS
  Between 18 September 2013 and 12 May 2014, the Fil Harmonie program handled 68 calls from educational staff. Students concerned by the calls were aged between 11 and 22 and the average age was 17.3 years. Over half (52.5%) of the pupils concerned had never seen a mental health professional before the call. In more than 70% of cases, the caller was a school nurse while other professionals such as teachers or headmasters represented only a minority of the callers. Approximately two thirds (67.2%) of students were described by the caller as socially isolated and 48.2% were described as sad or anhedonic. One out of four (26.7%) had repeated a school year at least once, and 55.9% of young people for whom a member of staff contacted Fil Harmonie had been missing class. In 56.7% of cases, there had been no contact with the student's family about the psychological situation. The qualitative analysis particularly highlighted the complexity of the collaboration between the family and the educational staff.
  
  
  CONCLUSIONS
  Schooling is an important opportunity to seize in mental health regarding early detection and access to care. By fostering collaboration between educational professionals and mental health services, Fil Harmonie meets a public health objective of prevention and should contribute to the reduction of care delays thus leading to better treatment outcome. Our study shows that such programs are feasible and answer a real need in our current health care system.
authors.affiliation: Service hospitalo-universitaire, faculté de médecine Paris Descartes, hôpital Sainte-Anne, université Paris Descartes, 1, rue Cabanis, 75014 Paris, France; Inserm U894, laboratoire physiopathologie des maladies psychiatriques, centre psychiatrie et neuroscience, université Paris Descartes, 2ter, rue d'Alésia, 75014 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Oppetit
authors.affiliation: Relais étudiant lycéen, fondation santé des étudiants de France, 60, rue des Grands-Moulins, 75013 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Brébant
authors.affiliation: Relais étudiant lycéen, fondation santé des étudiants de France, 60, rue des Grands-Moulins, 75013 Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Monchablon
authors.affiliation: Service hospitalo-universitaire, faculté de médecine Paris Descartes, hôpital Sainte-Anne, université Paris Descartes, 1, rue Cabanis, 75014 Paris, France; Inserm U894, laboratoire physiopathologie des maladies psychiatriques, centre psychiatrie et neuroscience, université Paris Descartes, 2ter, rue d'Alésia, 75014 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Bourgin
authors.affiliation: Service hospitalo-universitaire, faculté de médecine Paris Descartes, hôpital Sainte-Anne, université Paris Descartes, 1, rue Cabanis, 75014 Paris, France; Inserm U894, laboratoire physiopathologie des maladies psychiatriques, centre psychiatrie et neuroscience, université Paris Descartes, 2ter, rue d'Alésia, 75014 Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Gaillard
authors.affiliation: Service hospitalo-universitaire, faculté de médecine Paris Descartes, hôpital Sainte-Anne, université Paris Descartes, 1, rue Cabanis, 75014 Paris, France; Inserm U894, laboratoire physiopathologie des maladies psychiatriques, centre psychiatrie et neuroscience, université Paris Descartes, 2ter, rue d'Alésia, 75014 Paris, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Olié
authors.affiliation: Service hospitalo-universitaire, faculté de médecine Paris Descartes, hôpital Sainte-Anne, université Paris Descartes, 1, rue Cabanis, 75014 Paris, France; Inserm U894, laboratoire physiopathologie des maladies psychiatriques, centre psychiatrie et neuroscience, université Paris Descartes, 2ter, rue d'Alésia, 75014 Paris, France.
authors.forename: M-O
authors.initials: MO
authors.lastname: Krebs
authors.affiliation: Inserm U894, laboratoire physiopathologie des maladies psychiatriques, centre psychiatrie et neuroscience, université Paris Descartes, 2ter, rue d'Alésia, 75014 Paris, France; Département de psychologie, UFR SPSE, laboratoire CLIPSYD, université Paris Nanterre, 200, avenue de la République, 92000 Nanterre, France. Electronic address: yannick.morvan@inserm.fr.
authors.forename: Y
authors.initials: Y
authors.lastname: Morvan
mesh_terms: D000293:Adolescent; D002648:Child; D042241:Early Diagnosis; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D010297:Paris; D010865:Pilot Projects; D024382:Professional Role; D012573:School Nursing; D012574:Schools; D012959:Socioeconomic Factors; D013334:Students; D013689:Telephone; D055815:Young Adult
keywords: Access to care; Accès aux soins; Détection précoce des troubles psychiatriques; Early detection; Educational health; Mixed methods; Méthodes mixtes; Prevention; Prévention; Santé scolaire