Following numerous questions from those around me about “what I thought of Sonia Lupien’s opinion letter” implicitly referring to the work we recently carried out, I thought, as project manager, that it was worth the trouble of rectifying certain facts.
Since you seem to have the time to write such a letter, Ms. Lupien, I would have hoped that you had also taken the time to read our work before criticizing it publicly. Here are the many reasons that lead me to believe that your criticism of our work is unfounded:
According to your letter, the recent work to which you refer would have reported that it is “50% of young people who suffer from anxiety”. Unfortunately, this is a misinterpretation of our data. Our observations rather lead us to affirm that among our 17,708 respondents aged 12-25 in four regions of Quebec, 37% of young people in high school and 52% of those in higher education report moderate to severe symptoms of anxiety or depression. If you had attended our webinar on February 8, as 600 other people did, you would have understood the nuance.
Your letter states that our results seem extraordinary (referring to the 50%), when typically 20-25% of young people struggle with anxiety issues. Interesting, because in our January 2023 survey, 25% of young people surveyed in high school reported only moderate to severe symptoms of anxiety. Not so extraordinary…
In your opinion piece, you rightly mention that a distinction must be made between transient anxiety symptoms and those that are more sustained over time. It should be noted that, in our surveys, the symptoms of anxiety and depression are measured using two internationally recognized scales (GAD-7 and PHQ-9) which examine the frequency of different symptoms (seven for anxiety and nine for depression) in the last two weeks.
Thus, to “be part of our statistics”, young people must report at least five symptoms of anxiety or five symptoms of depression, and this, more than one day out of two during the last two weeks. Similar criteria are used clinically to make a diagnosis of depressive disorder. However, the data collected by survey never make it possible to distinguish the so-called “pathological” symptoms from the “non-pathological” symptoms. Only a clinician can tell that difference. This clarification was clearly made in the webinar and in our subsequent communications.
You also mention that “to worry about a high percentage of young people who say they experience manifestations of anxiety when these symptoms have only been measured once is a hasty conclusion”. Allow me to add an important nuance here once again. Our surveys were conducted among young people from various regions in January 2020, January 2021, January 2022 and January 2023. Even if the young people were not followed individually, we can still speak of repeated measurements over time (at ecological scale). It therefore appears erroneous to say that the manifestations of anxiety (and depression) were measured only once.
Our measurements repeated over time have also highlighted several worrying trends when comparing data from January 2023 (one year after the pandemic) to January 2020 (just before the pandemic). In particular, we note a lower proportion of young people reporting good mental health, as well as a lower proportion of young people reporting an ease in talking about their problems with their family or friends in 2023. Do not want to believe these data , but I feel the duty on my side to share them so that we better understand how our young people are doing.
Concerning the possible biases related to our work, obviously they exist, as in any survey or any study for that matter. Again, if you had bothered to listen to the webinar or contact me directly, you would have understood that we have never attempted to hide these biases. That said, it is important to emphasize that our surveys in secondary schools are usually carried out during school hours, with all the students in the participating classes (on a voluntary and anonymous basis of course). Most of the time, therefore, it is not a question of a simple hyperlink to be filled in on a weeknight by the students most motivated by the subject, as you seem to insinuate.
You sharply criticize the fact that works such as ours wrongly focus on the problems and not on the solutions. This is, in my opinion, the most disturbing comment, because we, like you, find it important to highlight the protective factors and possible solutions to promote the well-being of young people. Two of the five pages summarizing our work are moreover intended for these more positive aspects (a full report will follow shortly). We’ve even highlighted your website as a relevant resource.
We should also highlight the entire co-construction approach behind this survey, in close collaboration with partners from the educational and health sectors in four regions. This collaboration, which spans several weeks, helps us choose the themes, validate the questionnaire, interpret the results, establish possible solutions and distribute leaflets for each participating school (in production). We are proud of this great mobilization work carried out with so many people on the ground.
Thus, Ms. Lupien, I must admit that I am dismayed by your rather incisive criticism of our work, without even having tried beforehand to obtain an explanation from the team responsible for said work.
For the love of young people, let’s stop bickering between experts, researchers or clinicians. It is our concerted efforts that will lead our decision-makers and society as a whole to prioritize, once and for all, the health and well-being of our future generations.
Out of love for young people, I suggest that we start a real dialogue and that we join forces in this important societal issue.