Based on data from three sources—parents, teachers, and children—the Enabee results show that 13% of elementary school children have a probable mental health disorder (probable emotional disorder, probable oppositional defiant disorder, or probable attention-deficit/hyperactivity disorder). The prevalence rate is comparable to those observed in other European countries for the same age group in 2010 and 2017. These initial baseline indicators, which will be supplemented by new analyses in the coming months, enable better monitoring of children’s mental health and well-being and thus contribute to the development of public policies.

Enabee: A Solid Scientific Foundation to Guide Government Prevention Strategies

The Enabee study aims to produce indicators—which have been lacking or incomplete until now—on the mental health and well-being of children aged 3 to 11. Conducted at regular intervals, it will enable tracking changes in these indicators over time, assessing the impact of potential events (such as infectious or environmental factors) on children’s mental health and well-being, and supporting prevention and health promotion initiatives to create environments conducive to their healthy development.

The indicators focus on mental health disorders considered likely and the level of well-being. The originality of the Enabee study lies in the fact that, for the first time, it incorporates the child’s perspective into assessments of emotional disorders. The study’s methodology therefore relies on three sources of information—“Child,” “Parents,” and “Teacher”—and enables the most accurate assessment of children’s well-being and mental health, as well as the factors that may affect them. Between May 2 and July 31, 2022, more than 15,000 children and more than 15,000 teachers were surveyed in nearly 400 schools, along with 10,000 parents. This high level of participation demonstrates that the Enabee study was well received.

First snapshot of the mental health and well-being of schoolchildren in grades 1 through 5

The Enabee study measures three types of probable disorders: emotional, oppositional, or attention deficit with or without hyperactivity (ADHD). These are not clinical diagnoses but rather a cross-analysis of the reported perspectives for each child, which has made it possible to identify symptoms and, above certain thresholds, probable disorders.

Preliminary results show that 13.0% of children aged 6–11 in grades 1 through 5 have at least one probable mental health disorder. This prevalence, which encompasses a range of potential disorders of varying severity, is of the same order of magnitude as those observed in other European countries in 2010^¹ for the same age group.
Among children aged 6 to 11:

• 5.6% have a probable emotional disorder;

• 6.6% have a probable oppositional defiant disorder;

• 3.2% have a probable attention-deficit disorder with or without hyperactivity.

Probable emotional disorders [anxiety-related (separation anxiety, generalized anxiety, specific phobias) or depressive] are more common among girls, and behavioral disorders [probable oppositional defiant disorder and probable ADHD] are more common among boys. The data do not reveal any differences based on grade level or school sector (public schools outside priority education networks (REP) and private schools versus public REP or REP+ schools). Numerous additional analyses still need to be conducted to account for other factors related, for example, to the child’s living environment, their health, or that of their parents, in order to study the associations between these factors and prevalence rates or levels of well-being.

Furthermore, these initial indicators, measured in the wake of the health crisis, do not allow us to conclude whether COVID-19 had an impact during the spring of 2022 on the mental health of schoolchildren in grades 1 through 5, given the lack of pre-crisis national French data for this age group.

Analyses of children in preschool are planned for the coming months. These will be supplemented in 2024 by analyses focusing on factors associated with mental health, well-being, and healthcare utilization. An expansion of the study to France’s overseas territories is also planned.