Mental health research in minors in France: Legal and ethical issues

The mental health of children and adolescents is a major public health issue in France. However, there is a lack of epidemiological data on this subject. Epidemiological studies on mental health in minors are subject to numerous legal and ethical constraints. The main objective of this study was to provide an overview of epidemiological studies on the mental health of minors aged 10 to 18, conducted in France among the general population. Its secondary objective was to analyze the legal and ethical constraints governing this type of research. A literature review was conducted using the PubMed, Web of Science, and PsycInfo databases. Articles published between 2017 and 2023 were included if they reported results from epidemiological studies conducted in France among minors aged 10 to 18 in the general population, with a main objective related to mental health. Only studies in which minors were directly questioned about their mental health were included. Of the 1115 articles identified by the search strategy, 25 (corresponding to 20 separate studies) were included. In 90% of the studies, minors were interviewed anonymously. The questionnaires were administered in schools in 70% of cases. The most frequently addressed topic was psychoactive substance use (80% of studies), followed by suicidal ideation, addressed in 45% of studies. Informing legal guardians and obtaining their consent can present a barrier to minors' participation in mental health studies. The anonymization of questionnaires raises ethical questions. Epidemiological studies on the mental health of minors are constrained by strict legal and ethical requirements. Adjusting these requirements, with support from experts, could facilitate the conduct of such studies while ensuring respect for the safety and rights of minors.