Speaking to RTL Radio on Tuesday morning, psychiatrist Dr Paul Hédo, president of the Luxembourg Association of Psychiatrists, Child Psychiatrists, and Psychotherapists (SLPPP), commented on the recent knife attack carried out by a 14-year-old girl in Limpertsberg.
He used the case to highlight broader concerns about youth protection and mental health care in Luxembourg, referring mainly to the fact that the 14-year-old girl was placed at the Luxembourg Penitentiary Centre in Schrassig, as the socio-educational security unit for minors in Dreiborn was full.
Dr Hédo said the fact that such a young person ended up in an adult prison already shows that something has gone wrong in the system. If a 14-year-old ends up in an adult prison, youth protection mechanisms have clearly failed, he said.
While Hédo noted that it is difficult to determine whether violent behaviour among young people is generally increasing, he stressed that the incident appears to be a serious but isolated case.
More broadly, Dr Hédo said there has been a significant rise in psychological distress among young people, and that support services are increasingly struggling to keep up.
He added that developmental disorders among children have become more frequent, along with what specialists describe as oppositional behaviour at school or at home. Among adolescents, the SLPPP has observed a growing number of cases involving anxiety, depression, and self-destructive behaviour, including eating disorders.
However, Dr Hédo stressed that the biggest challenge remains the limits of the care system, which often struggles to provide adequate support.
According to Dr Hédo, the SLPPP has long called for improved nationwide, multidisciplinary outpatient care, but progress has been extremely slow.
He noted that many of the same recommendations had already been made in a 2010 audit, making it frustrating that little has been implemented since. The recent opening of a day clinic for child and adolescent psychiatry in Wiltz is a positive step, he acknowledged, but comprehensive nationwide coverage remains far from reality.
Significant gaps persist in both inpatient and outpatient psychiatric care for children, adolescents, and adults, Dr Hédo said. He added that hospitals also still lack dedicated crisis units. Although these needs are recognised in the government’s coalition agreement, he stated that relatively few measures have actually been implemented.
Dr Hédo also criticised what he described as a lack of political will to implement reforms.
While there is indeed a shortage of specialised staff, he argued that this cannot explain why certain reforms have not been carried out. In his view, responsibility lies with decision-makers who have failed to put existing plans into practice.
He also pointed to poor coordination between different parts of government, saying that one branch of the administration often does not seem to know what the other is doing.
According to Dr Hédo, the SLPPP last met with Minister of Health and Social Security Martine Deprez almost two years ago to discuss the association’s concerns and proposals. However, the organisation is still waiting for a follow-up meeting, he said.
Dr Hédo also warned against automatically linking violence with psychiatric illness.
He noted that many people with psychological disorders are more often victims of violence rather than perpetrators. At the same time, the SLPPP has also noticed an increasing number of cases in which people who have made threats or behaved violently are taken by police to hospital emergency departments for psychiatric assessment.
Dr Hédo argued that such cases should often be handled by the police or the justice system rather than by psychiatric services.
When minors are involved, however, the situation becomes more complex. In the case of the 14-year-old girl who carried out the knife attack, Dr Hédo said it is likely that psychological and developmental problems played a role. Nevertheless, this does not necessarily mean that psychiatric treatment is the primary solution, as the issue also falls within the scope of youth protection measures, he said.
