Bruno Falissard: statistics serving child psychiatry
Bruno Falissard is Professor of Public Health at Université Paris-Saclay, as well as a child psychiatrist and Director of the Centre for Epidemiology and Population Health (CESP - Univ. Paris-Saclay, French National Institute of Health and Medical Research INSERM, Univ. Versailles Saint-Quentin-en-Yvelines UVSQ). With a background in maths and psychiatry, a member of the French Academy of Medicine, he is currently focusing his research efforts on the epistemology and research methodology in medicine.
Embarking on a career in medicine after graduating from the École polytechnique may come as a surprising choice, but that is exactly what Bruno Falissard did after graduating from the prestigious school. "It was when I met aspiring doctors during my military service in my first year that the idea of moving towards medicine began to resonate with me. So when I graduated, I didn't hesitate to set out on this new academic path." Yes, but... It takes a long time to study medicine, and so to finance his studies, Bruno Falissard began a funded thesis in statistics dedicated to intermediate analysis in a therapeutic trial, alongside his medical courses. "This subject allowed me to bridge both my passions and apply my mathematical expertise to my future medical work." Over the course of his internships, he made the crucial decision to specialise in psychiatry, a field in which he began to gain experience of the doctor-patient relationship. He then took the opportunity during his internship to undertake a postdoctoral placement in psychometrics, this time applying statistics to psychiatry.
The choice of child psychiatry and a passion for teaching
After this dual pathway, Bruno Falissard chose to sub-specialise as a child psychiatrist, "it's a genuinely complex discipline that both impressed and attracted me, as I was deeply passionate about working with children," he explains. He then became Head of the Child Psychiatry Clinic at the Robert Debré Hospital and began teaching this discipline at Bichat Hospital. "I was 38 at the time and still on a temporary contract! Alongside my clinical work, I therefore applied for and was accepted as a lecturer in biostatistics at the Faculty of Medicine of Paris-Sud (now Paris-Saclay)," explains Bruno Falissard.
Promoted to Associate Professor in 1997, he became Professor of Public Health at the same faculty in 2002. Today, as Professor of Public Health at Université Paris-Saclay and Director of the Centre for Epidemiology and Population Health (CESP - Univ. Paris-Saclay, Inserm, UVSQ), he is quick to affirm that teaching is his primary passion. "In teaching, I find what initially attracted me to child psychiatry, namely the relationship with young people, verbal communication and encounters. That's what truly motivates me every day, whether as a practitioner or as a teacher," he confides. His love for debate and sharing is evident in his YouTube channel featuring lectures on biomedical research.
From biostatistics to methodological innovations
Coming from a background in mathematics research, as he specialised further, Bruno Falissard gradually turned his attention to more applied issues related to his field of expertise. In terms of research, he embarked on what he describes as a "fairly conventional" career path. "Initially, we were a university research team of fifteen people working on issues of methodological innovation in mental health," he says. This was an opportunity for him to delve into topics such as mental health in prisons, or to develop outcome measures for schizophrenia. "The team has grown to almost 600 people since merging with the Centre for Epidemiology and Population Health (CESP - Univ. Paris-Saclay, Inserm, UVSQ), where I have become the director," he adds.
A decisive commitment
The most important turning point in his career came in 2015, when he was entrusted with the presidency of the International Association for Child and Adolescent Psychiatry and Allied Professions. "This responsibility has allowed me to travel the world, witness the shortcomings of child psychiatry healthcare systems across the globe, and opened my eyes to the urgency of working differently. Having previously dedicated most of my time to statistics and clinical research, I realised that I needed to take a step back from my research practice and work harder to change behaviours in my field, which suffers from what I would call a denial of complexity."
Bruno Falissard illustrates this denial of complexity with the example of neuroscience, which, while undeniably contributing to extraordinary progress, cannot explain everything in the context of child psychiatry. This is because child psychiatry draws on contributions from a wide range of disciplines, including philosophy, sociology, psychology and epistemology. Moreover, there are sometimes conflicting representations of what it means to be a human subject. "If we want to improve care for children, we have to be willing to embrace this complexity. However, to achieve this, we need a multi-disciplinary approach that combines perspectives and a discussion on how to integrate these various contributions," adds Bruno Falissard.
Another approach to research
After many years dedicated to research management in public health and epidemiology, it is hardly surprising that Bruno Falissard is now prioritising epistemology and research methodology in medicine. "It seems to me that there is an urgent need for extensive consideration of the ethical issues involved in research." By 'ethics', Bruno Falissard specifies that he means giving ourselves the resources to conduct the best possible medical research. "We cannot push our researchers into ever greater productivity, more publications, more research and more funding. We need to ask ourselves how all these efforts can be optimised, to avoid endlessly repeating the same research on the same subjects. To do this, I believe we need to be willing to stop and think. In fact, that's the advice I give my teams: act less and think more," concludes Bruno Falissard.