[Taking care of an unaccompanied minor's body at the Maison des adolescents]. / Prendre en charge le corps et son histoire, parcours d'une mineure non accompagnée à la Maison des adolescents.

The care of unaccompanied young exiles in public health care facilities for adolescents often requires teams to adapt their capacities for institutional containment. We describe the case of a 16 year old female migrant adolescent, whose follow-up occurred at the Maison des adolescents of the Cochin Hospital, with several healthcare workers involved. The healthcare team had to reflect on the meaning of her somatic symptoms and why the referring adults were so worried (such as fear of death). We describe how we articulated somatic and psychological care for this adolescent girl living in a precarious situation.

[Positions adopted by children and their parents during mediated visits]. / Positionnements adoptés par les enfants et leurs parents lors des visites médiatisées.

Mediated visitation services welcome minors placed in a context of domestic violence. The parent-child relationship is then supported in an attempt to re-establish an intra-family balance that has been weakened and marked by trauma. When the work begins, the child is gradually put back at the heart of the concerns, in his or her place, and the parent regains confidence in himself or herself as well as in his or her parenting abilities. This is a complex and often long process.

[Experienced violence and enacted violence: The place of somatic expression]. / Violences subies, violences agies : la place de l'expression somatique du repérage à l'expertise.

Being a victim of violence and neglect during childhood can expose minors to significant health repercussions on the physical, psychological, psycho-affective and neuro-developmental levels.. Self- and hetero-aggressive violences in all age groups are now considered to be possible consequences of these severe adverse experiences. The place of the body is essential in this context. The body, often considered as the only tangible and opposable marker of violence, has a singular and integral place in the psyche and overall health. It is an important vector in order for professionals to have access to the child. The examination of the body allows the expression of violence and its formulation from a very young age, especially during clinical examinations in situations of possible danger. It also "speaks" in situations of malaise, growth disorder, self or heteroaggressive acts. During the adolescence, it can also be attacked by scarification, dietary restrictions, mutilations, early and risky sexual activity, prostitution.. By taking jointly both the body and the psyche, children and adolescents find a unity, are no longer fragmented. It is this unity that will allow the continuation of more specific care and more specifically child psychiatric support. This joint concern of paediatricians, general practitioners, child psychiatrists and psychologists will also ensure, particularly during adolescence, the continuation of health monitoring. It is essential to think about these collaborations from the first meeting with children and adolescents who are victims or perpetrators of violence. Encountering child and adolescent victims of violence confronts practitioners with a reality that is difficult to see and to conceive. Although the continuum between suffered violence and perpetrated violence seems to be better known today, these different situations remain difficult to understand and to manage. We believe that the violence that is perpetrated can be a screen for the causes of the violence and for the response to the needs of minors, particularly in terms of health. For practitioners, going to meet children and adolescents who are perpetrators of violence entails to be able to take a "step aside" from the classical representations of aggression or aggressiveness, whether they are directed towards third parties or towards the minor himself. Access to the somatic examination and medical history of these children or adolescents must be fully integrated from the first meeting. Associating health in all its aspects (somatic, psychic and social) then allows for specific care to be provided, regardless of their nature and place. This initial integrated practice allows us to take care of children and adolescents and highlights the notion of otherness that is undermined in situations of violence or neglect, particularly when they occur in the family environment. This initial joint somatic and psychological care in a single unit enables re-establishment of a dialogue with the minors and their parents. The shared competencies and the links that unite these different professionals together constitutes already therapeutic care. By reintroducing a dialogue about the children and adolescents and their overall health, the response to their needs can be perceived as a common and reachable objective that inscribes the minor in the temporality and extracts him or her from the immediacy of a punctually repressed act.

[Profile of the victims of sexual violence in child psychiatry consultation]. / Enfants victimes de violences sexuelles en consultation de pédopsychiatrie.

INTRODUCTION: Child sexual abuse is a major health problem that remains under-declared and under-reported worldwide. In this paper we have taken an interest in establishing the profile of the victims in a clinical population of children consulting for sexual abuse. METHOD: We conducted a descriptive retrospective study in the child and teenager psychiatry department of the Mongi-Slim hospital (Tunis, Tunisia). We included all patients referred for treatment or medical expertise during the period from January 2013 to June 2019 and recorded sociodemographic data and clinical characteristics on pre-established charts from patient files. RESULTS: The total number of consultants was 150 patients with 61,33 % of female subjects (n=92). The average age was 9,9 years old with extremes ranging from 2 to 18 years old. The assault was unique in 62,7 % and happened in a place known by the victim in 47,33 %. Sexual abuse with non-penetrating contact was the most frequent (48 %). The average age at which the first sexual abuse happened was 9 years old. In the vast majority of cases, the abuser was a male. Concerning the identity of the abuser, he was someone of the family in 37,3 % of the cases and in half of these cases, he was the father. In the other cases where the abuser wasn't a family member, the identity was known by the child and/or his family in 48,66 %. A psychiatric diagnosis was made in 58 % of the cases with a percentage of 52,1 % among girls and 60,3 % among boys. Main diagnoses were acute stress disorder in 10,6 %, post trauma stress disorder in 19,3 %, adjustment disorder in14,6 % and a major depressive disorder in 8 %. CONCLUSION: Knowing the profile of victims of child sexual abuse and taking into consideration the social and psychiatric impact can help in adapting the means to intervene properly in order to take care of the victims and prevent such abuse.

[Caregivers and minors who are radicalised or at risk of becoming radicalised: legal benchmarks]. / Soignants et mineurs radicalisés ou en risque de le devenir : repères juridiques.

In an era where terrorism has become modernized and globalized, the international community and the French authorities remain cautious about an invisible, yet very present army, that of the "fighters in becoming ", whose indoctrination is privileged by the Islamic State: the minors. In these times of crisis, what legal apprehension can be brought to caregivers confronted with radicalised minor patients or undergoing radicalisation? Several limitations can be pointed out on this subject in the international response. Despite this, it is possible to give some guidance to caregivers confronted with situations of radicalized minors, or undergoing radicalisation, facing the dangers they represent for themselves and for society.

[Integrating beliefs and religion into psychiatrie care]. / Intégrer les croyances et la religion dans le soin psychiatrique.

The mission of the mobile ethnopsychiatry team (EMIE) is to provide consultations to patientsfrom an emigrantbackground whopresent problems of acultural nature. Ayoung Congolese is in the grip of rituals and black magic.Heistorn between his father'sinfluence,his mother'sopinions and his place in the familycircle.His story is aperfect illustration of the specific role of the EMIE in the health and immigrant caresystem.

[Socio-demographic and clinical characteristics of adolescents hospitalized in French units for inmates: Results of a cross-sectional study]. / Caractéristiques socio-démographiques et cliniques des adolescents détenus hospitalisés en unité hospitalière spécialement aménagée : résultats d'une étude transversale nationale.

BACKGROUND: In France, on the first of January 2018, 772 underage persons were in jail or about 1.1 % of the incarcerated population. The prevalence of psychiatric disorders among those inmates is high. As a result psychiatric care (and particularly full-time hospitalization) is essential for this population. The unités hospitalières spécialement aménagées (UHSA) are full-time inpatient hospitalization units for inmates in France. Adults but also underage inmates can be admitted to UHSA for voluntary or involuntary hospitalization. However, no study about the characteristics of young patients admitted to UHSA is currently available. The aim of this study is to describe the population of children and adolescent patients hospitalized in these facilities and to evaluate the care provided. METHOD: We conducted a retrospective study, including all the patients under 18 years of age, who have been hospitalized in UHSA since its creation in 2010 until 31 December 2016. Anonymized data concerning socio-demographic profile, clinical symptoms and care provided have been collected from the medical records of each patient. RESULTS: Overall 80 underage patients were included, for 120 hospitalisations in UHSA. Those patients are mainly male (80%) with a mean age of 16.7 years. They are mostly hospitalized with their consent (59%) for stays of about 50 days and frequently after self-harm behaviours. The main diagnoses are anxiety disorders (26%) and psychotic disorders (25%). At the end, 86% of the patients are prescribed a psychotropic drug treatment and 40% of those medical drugs are prescribed outside the guidelines. Finally, several specific problems were identified. Especially, contact with families and educators or access to education programs are very challenging. CONCLUSION: This study highlights the current difficulties encountered in the management of inmate underage patients in full-time psychiatric hospitalization. In this paper, we propose areas for improvement through (1) specific arrangements to receive young patients (specific service's management in order to reinforce the observation of those young people, to facilitate contact with their families, to improve the access to education programs, etc.); (2) specific arrangements in the treatment offered to young patients in UHSA (specific training course for nurses, specific therapeutic programs, etc.); (3) the development of networks working with psychiatric services inside and outside the prison, educators, families and prison services, in order to promote the continuity of cares.

[Assessment and health needs of unaccompanied minors]. / État des lieux et besoins de santé des mineurs non accompagnés.

Unaccompanied minors are particularly vulnerable due to their pathway marked with multiple bereavements and constant uprooting. They find themselves confronted with the ordeal of mistrust due to administrative contradictions between the need to protect and immigration control. They are particularly at risk of developing psychiatric pathologies. Care must be multidisciplinary and in continuity with the educational support, taking into account the young person's original culture.

[Care of unaccompanied minors in a psychiatric emergency unit]. / Prise en charge des mineurs non accompagnés en service d'urgences psychiatriques.

Emergency psychiatric units are receiving more and more foreign unaccompanied minors: for many of these young people it is their first contact with psychiatric services. This context of crisis crystallises the administrative and legal paradoxes at work in the support of these youngsters. Coordination between emergency care, statutory bodies and community-based care enables stability to be established while the care project is being set up.

[Representations and experience of caregivers on the pathway of pregnant unaccompanied minors]. / Représentations et vécu des soignants sur le parcours des mineures non accompagnées enceintes.

Pregnancy and motherhood are additional ordeals for young unaccompanied girls, a particularly vulnerable section of the population. They are marked by the revival of the traumatic valence, the need to reconstruct themselves through the pregnancy and the importance of establishing a relationship of trust with the professionals supporting them. A qualitative study was carried out through the prism of the perspective of these professionals.

[At the heart of the transcultural psychotherapy of a traumatised unaccompanied minor with psychosis]. / Au cœur de la psychothérapie transculturelle d'un mineur non accompagné psychotique et traumatisé.

Transcultural consultations receive unaccompanied minors experiencing psychological distress as a result of their personal history in their country of origin, their harrowing journey until their arrival in France and their vulnerable situation. Presentation of the mental health pathway and identity issues of one of these young unaccompanied foreigners, and asylum seeker.

[The mental health care of unaccompanied minors in children's homes]. / Penser le soin psychique des mineurs non accompagnés en foyer de l'enfance.

Many unaccompanied minors in the care of children's welfare services are housed in a children's home after their assessment. Adapting to this living environment means going from a high level of autonomy to being subject to certain rules, as well as giving oneself permission to settle and accept the support of the educational setting. Care is an important aspect of a children's home: the body is an indicator of the health of these youngsters.

« Les soins sont de plus en plus absents du parcours des mineurs non accompagnés ¼.

"Care is increasingly absent from the pathway of unaccompanied minors". Legal experts of the French ombudsperson work with professionals supporting unaccompanied minors on different levels. They can also have a watchdog role with legislative authorities and judicial bodies. They note in particular increasing difficulty for these youngsters in accessing appropriate care. Interview with Nathalie Lequeux, legal expert and coordinator at the French children's rights centre.

Parcours migratoire d'un mineur non accompagné et sa destinée en France.

MIGRATION JOURNEY OF AN UNACCOMPANIED MINOR AND HIS DESTINY IN FRANCE.: Among migrants, unaccompanied minors are rendered particularly vulnerable by their journey, the trauma endured and their solitude. Once they have been confirmed as minors, they remain under the care of child protection services. The adolescent children's home in Bobigny, Casita, provides psychological trauma consultations for these young people. This article focuses on the journey of a 16-year-old who arrived in France less than two years ago.

[Management of minors returning from regions controlled by Islamic State]. / Prise en charge de mineurs revenant de zones contrôlées par l'État islamique.

Certain children's welfare accommodation facilities have, since the end of 2015, taken in minors returning from regions controlled by Islamic State. These complex situations challenge professionals and involve political, media-related and religious issues. They require understanding of the process of radicalisation in order to be able to support the children and their families. In this context, training and team work are essential.

Quand l'adolescent devient adulte, aspects juridiques.

WHEN AN ADOLESCENT BECOMES AN ADULT, LEGAL ASPECTS: When it comes to medical care, the move from minor to adult status is problematic, between the age of puberty and the age of majority, which only allows decisions to be taken independently. Medical law has evolved over the last few years, propelled by the promotion of child rights. It gives more space for adolescents to decide about their own health.

[Drawing, a tool to use with unaccompanied foreign minors]. / Le dessin, support de soins aux mineurs isolés étrangers.

Supporting unaccompanied foreign minors requires a different clinical approach. These youngsters must be given individualised support to help them make the transition from exile and loss, to an existence as an individual, yet still a son or daughter. The drawing, as a transcultural and atemporal imprint, constitutes a tool enabling these young people to bring to the surface their unconscious thought processes, to exist and to come into being with dignity.

[Minors and treatment orders]. / Les mineurs et l'injonction de soins.

In France, minors over the age of 13 can be given a common law sentence but their status as a minor is taken into account, reducing the maximum sentence by half. They can however be subjected to a treatment order, a measure applicable in the context of social and legal supervision, which aims to prevent repeat offending.

[Haematopoietic stem cell donation from minor donor: Respecting laws, assessing fitness, delivering information and good care (SFGM-TC)]. / Don de cellules souches hématopoïétiques à partir d'un donneur mineur : cadre réglementaire, information, évaluation de l'aptitude au don et parcours (SFGM-TC).

Haematopoietic stem cell collection from paediatric donors is a common and life-saving practice, as evidenced by the fact that there is a growing annual number of cases of transplants from minor donors among SFGM-TC centers over the last decade. Still, medical use of human tissue from a healthy and underage donor requires proper regulations and medical management. The guidelines below aim at underlining the importance of pondering the legal, medical and ethical aspects of using stem cells from healthy paediatric donors and stress out the importance of obtaining informed consent at the time of assessing HLA compatibility. Combined medical and psychological assessments are required before the donation, as well as one month later and one year later to ensure of the child's physical and mental wellbeing. Bone marrow harvest under general anaesthetics remains the preferred method of collection for children. Peripheral blood stem cell collection should only be considered for children who will not require a central venous access for collection. We aim at offering guidelines centered on the healthy child donating stem cells and his/her wellbeing, and these should be regularly reviewed as medical practices evolve.

[Prison health care for juveniles who are incarcerated in France]. / État de santé et soins des personnes mineures incarcérées en France.

In France, on the 1st march 2022, 656 underage persons are in prison. They have more psychiatric and substance use disorders compared to the juveniles in the general population. In prison, health care is organized according to three levels. A global and partnership approach is promoted. The main objectives are prevention, risk reduction and continuity of care.