Les jeunes ont faim!

ParMarie France

Insécurité alimentaire et itinérance des jeunes

Le projet Un Oeuf pour la vie, qui était justement sur le point de s’achever pour une première année, s’est vu interrompu et les conséquences de cette pandémie furent sérieuses autant pour l’organisme que pour les enfants. Nous sommes inquiets pour leur état nutritionnel et la remontée ne sera pas facile. Néanmoins, il y a à faire ici pour prévenir l’insécurité alimentaire, notamment auprès des jeunes en difficulté, que NSF prend sous son aile grâce au nouveau projet HOPE.

Pourquoi un projet de prévention de l’itinérance?

Selon le Plan décennal de l’alliance canadienne pour mettre fin à l’itinérance, un plan un rêve ‘’ (1) les plans communautaires réussis sont les produits d’une procédure communautaire inclusive qui implique les principaux acteurs dans le système local d’aide à l’itinérance, y compris des gens qui ont vécu cette l’expérience. En ce qui a trait à l’alimentation, il n’y a qu’une seule personne pouvant nous aider à comprendre son problème d’insécurité alimentaire, et c’est la personne elle-même. Pour avoir un impact sur l’état nutritionnel , une intervention doit répondre aux besoins nutritionnels spécifiques de l’individu. Hors, il y a toute une foule de ressources venant en aide aux personnes itinérantes, et elles permettent d’accomplir le résultat suivant, qui est de remplir le ventre. Pour la majorité des itinérants, le besoin énergétique de base est comblé, et nous avons la chance de bénéficier d’un grand réseau de banques alimentaires. C’est déjà beaucoup. Mais la santé va au-delà de l’apport en calories. C’est ce à quoi le projet HOPE veut s’adresser. De plus, il y a un isolement de certains groupes de personnes, dont les jeunes, pour lesquels les services de soutien alimentaire répondent moins bien.

Pour vaincre l’itinérance, on doit agir en aval et en amont : non seulement il faut limiter les dégâts et faire ‘sortir’ l’itinérant de la rue mais il faut aussi en fermer la porte d’entrée, et ce le plus précocement possible. La détection et la prise en charge précoce des individus les plus à risque peut faire toute la différence. C’est à ce niveau que le programme HOPE peuvent agir, tant en prévention qu’en contexte curatif. L’incapacité de s’alimenter est souvent un des premiers déclencheurs de comportements malsains chez les jeunes en difficulté,comme l’abus d’alcool ou de drogues, mais aussi un facteur de criminalisation. Ultimement, on finit par voler pour remplir son ventre. Ou devenir la proie de mauvaises fréquentations.

Les carences nutritionnelles reliées à l’itinérance

De plus, les carences nutritionnelles sont beaucoup plus déterminantes qu’on le croit dans l’installation de problèmes de santé mentale qui sont un des facteurs menant au rejet de l’individu par sa famille ou sa communauté ou son milieu de travail. Selon un rapport des diététistes du Canada (2), des initiatives de dépistage nutritionnel devraient être mises en oeuvre dans les programmes communautaires et les services visant les personnes souffrant de troubles de santé mentale (incluant les itinérants). À cet égard, une analyse combinant une approche épidémiologique et interventionnelle contribuerait à définir des mesures alimentaires qui peuvent prévenir la déroute vers l’itinérance chez ce groupe de personnes à risque que constituent les individus aux prises avec des problèmes de santé mentale.

Une étude récente dans le journal The Lancet Psychiatry (3) a fait ressortir un lien important entre une carence de certains nutriments spécifiques et la présence de maladies, notamment la dépression. Ils constatent que les omégas 3, les vitamines B (notamment les folates et la B12), la choline, le fer, le zinc, le magnésium, la vitamine D et plusieurs acides aminés comme la cystéine sont essentiels à la santé mentale. Il n’est pas surprenant de constater que ces nutriments sont ceux qui sont plus difficiles à combler dans la population itinérante. En particulier, les carences en B12 sont les plus ravageuses car elles créent des dépressions sévères typiques qui mimiquent la démence et favorisent des tendances suicidaires importantes et des comportements agressifs.

Ce n’est qu’un exemple de ce qui peut être prévenu grâce à l’intervention du projet HOPE car outre les impacts sur la santé mentale due à la B12 qui est totalement et rapidement réversible, il y a tellement de conséquences à la malnutrition qu’il est impossible de toutes les nommer. Pour certains nutriments-clés, les séquelles ne sont pas que temporaires, mais permanentes, comme par exemple l’effet d’un statut nutritionnel médiocre sur la fertilité future ou l’issue de la grossesse (prématurité ou risques de certaines maladies comme l’autisme, diabète gestationnel etc). Les jeunes femmes itinérantes qui tombent enceinte sont d’ailleurs peu susceptibles d’être réchappées au bon moment par des programmes tels qu’OLO, car pour avoir connaissance de ces services, il faut avant tout être en contact avec un médecin ce que l’itinérance rend moins probable.

Avant tout, le projet HOPE sert à redonner l’espoir aux jeunes et à les remettre en branle vers la recherche d’autonomie. C’est par le biais d’activités collectives de cuisine, de couture et autres projets créatifs que les jeunes pourront apprendre des compétences tout en s’engageant socialement. L’approche d’autodétermination est préconisée, donc des activités PAR les jeunes et POUR les jeunes sont mises en place.

Article rédigé par Marie-France Lalancette, fondatrice de Nutrition sans Frontières. Marie-France Lalancette possède 25 années d’expérience en nutrition dont plus de la moitié en nutrition pédiatrique et périnatale.

Références :

(1)http://fr.caeh.ca/wp-content/uploads/2012/04/A-Plan-Not-a-Dream_Fr1.pdf

(2)Davison KM, Ng E, Chandrasekera U, Seely C, Cairns J, Mailhot-Hall L, Sengmueller E, Jaques M, Palmer J et Grant-Moore J pour Les diététistes du Canada. Promouvoir la santé mentale par la saine alimentation et les soins en nutrition : sommaire. Toronto : Les diététistes du Canada, 2012. Disponible au :www.dietitians.ca/mentalhealth.

(3)Sarris J, Logan AC, Akbaraly TN, Amminger GP, Balanzá-Martínez V, et al. The International Society for Nutritional Psychiatry Research. Nutritional medicine as mainstream in psychiatry. Lancet Psychiatry 2015; 2: 271–74. http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(14)00051-0/abstract http://dx.doi.org/10.1016/S2215-0366(14)00051-0

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