Violences en milieu scolaire : 20 ans d’observations médico-légales en région Nord Pas-de-Calais

RésuméButLa mesure et l’analyse du phénomène de violence à l’école sont des problématiques actuelles de santé publique, qui peuvent être évaluées sous l’angle de la médecine légale, discipline privilégiée d’observation des violences de la société.Patients et méthodesCe travail a synthétisé et comparé trois études prospectives descriptives similaires datées de 1992, 2002 et 2012, réalisées au centre hospitalier régional universitaire (CHRU) de Lille, au cours de consultations demandées pour violences en milieu scolaire (environ 160 annuellement), en vue de l’établissement d’un certificat médical initial.RésultatsLes victimes étaient de plus en plus jeunes (moyenne d’âge évoluant de 14,8 à 13,6). La répartition par genre a montré une augmentation des victimes filles (sexe ratio évoluant de 2,9 à 2,3). Les lieux d’agression se sont transposés avec une nette augmentation des victimes sur le trajet scolaire (passant de 10 à 27 %). La récurrence des agressions s’est accentuée : les antécédents d’agressions sont passés de 18,5 à 32,2 % avec une haute proportion de violences à fort retentissement psychologique.DiscussionDes années 1990 à aujourd’hui, les politiques gouvernementales de prévention, de mesure et de répression de la violence en milieu scolaire, n’ont cessées de se développer. Pour autant, cette violence reste fortement présente.ConclusionLa médecine légale, de par son rôle d’observatoire sociétal, permet d’identifier certaines tendances dans la violence scolaire. Cette violence a de plus en plus d’implications dans la vie intime des élèves. L’accent devra être mis sur les différentes formes de violences à fort retentissement psychologique étant donné la prépondérance de celles-ci actuellement et leur implication pour l’enfant.

SummaryAimIn recent years, the National Education in France has developed tools to identify acts of violence in schools. This has allowed adjusting government policies for the care of victims. School violence can also be measured from the perspective of clinical forensic medicine, a special discipline for observing a society's violence.Patients and methodsThis study summarized and compared three similar single-center, prospective, and descriptive studies conducted in 1992, 2002, and 2012 in the Department of Forensic Medicine, University Hospital of Lille, via an evaluation form completed during consultations requested by victims in cases of school violence. The purpose was to identify the characteristics of victims, those of their perpetrators, the circumstances and reasons for school assaults, as well as their medical and administrative consequences.ResultsEach study had identified about 160 such attacks annually. The victims were younger, especially boys (the average age decreased from 14.8 to 13.6). The gender distribution showed an increase in female victims (the sex ratio decreased from 2.9/1 to 2.3/1). The location of attacks changed, with a marked increase of attacks on the way to school (from 10% to 27%). Recurrence of attacks also rose: victims with a previous history of attacks increased from 18.5% to 32.2% with a high proportion of violence resulting in a strong psychological impact, increasingly requiring psychological support (from 9 to 16%). The duration of school cases rose sharply, from 20 to 53% in 2012. The grade level of the perpetrator showed a significant increase in cases of violence at junior high school (from 40 to 67%), with a relative stability of violence in elementary and high schools. The parameters measured to characterize the aggressors remained stable: they were known to their victims in approximately 80% of cases and these attacks were for the most part related to previous disagreements.DiscussionSince the 1990s, government policies for the prevention, measurement, and punishment of violence in schools have not ceased to grow, but this violence has not attenuated. It is identified annually by the government and the data from the present study show comparable trends to national data.ConclusionThe progression of school violence over the past 20 years shows trends brought out through a forensic medicine framework. This discipline is indeed an observatory of violence and it has an important role to play in the detection of fragile psychological situations. This violence is increasing and compromises pupils’ privacy. In the future, different forms of violence with a strong psychological impact should be emphasized, including the influence on academic achievement and child development.