"Depression doesn't stop on Friday night": In Paris, one of the only psychiatric centers soon to be dismantled

At the end of June, Juliette ¹ , an artist, suffered a suicidal crisis. For the past year, she has been receiving treatment at the private psycho-traumatic center in Paris after a serious trauma.

That day, her caregivers referred her to the suicide emergency room, which immediately directed her to the Ginette-Amado crisis center (CAC, a psychiatric care facility) in the 7th arrondissement of Paris. "It was a relief, " she says. "The reception was quick, compassionate, and completely free."

Since then, Juliette has been cared for in a peaceful setting, without extensive hospitalization or isolation. "I come here almost every day, and sometimes have lunch with the team. One night, I even slept there: going home was impossible in my condition," says the artist.

But this support is now in jeopardy. In early July, management announced the center's move to its former premises on Rue Garancière, in the 6th arrondissement, accompanied by a drastic restructuring: the end of night and weekend care, the elimination of all accommodation beds, and a reorganization of staff. "We are being asked to continue our mission with incompatible resources," warns a CGT union representative.

The Ginette-Amado CAC covers the 5th, 6th, and 7th arrondissements of the capital. Its unique feature: offering intensive, brief care without traditional hospitalization for people in acute psychological distress. This model, by anticipating crises, avoids many lengthy hospitalizations. A multidisciplinary team provides a 24-hour physical and telephone presence, in a location "outside the hospital walls," to destigmatize access to care.

Close consultations, therapeutic meals, temporary accommodation, direct link with hospital services... The CAC acts in prevention as well as in emergencies, without restraint or isolation, except in exceptional cases – less than 5% in 2019. "It's rare, but our team cohesion allows this respectful and effective approach," emphasizes the staff representative.

The decision was made without consultation with either caregivers or patients, causing great concern. The loss of reception beds, in particular, threatens the capacity to accommodate patients in crisis for a few days, a pillar of this system.

"Depression doesn't end on Friday night," says Alexandre, a patient since October. "Knowing that the office and the hotline, staffed by competent personnel, are open at all hours helps a lot of patients and prevents overcrowding in the emergency room. Unfortunately, office hours don't correspond to this mission."

The elimination of the night shift, composed of four nurses and three nursing assistants, and several hospital staff positions further weakens the provision of care. "This is an experienced team, capable of preventing major hospitalizations. Without it, we overload already overwhelmed hospitals and increase the risk of cases being taken," warns the CGT representative.

Added to this is a financial loss for paramedical staff, who are now deprived of night and weekend bonuses. "For some, it's a hundred euros less per month. The only solution will be overtime in other departments," laments a nursing assistant with seventeen years of experience, "which won't be compatible with the family lives of many of us."

For the staff, this restructuring is not a simple reorganization, but a political choice dictated by a logic of budget reduction. "The CAC is not a mandatory unit, so it is easier to weaken. But, in the long term, it is an investment. It stabilizes, anticipates, and avoids costly hospitalizations," explains the CGT representative.

The center also offers equitable access to care, especially for those most in need. "At the institute, I was prescribed an unsuitable anxiolytic , and it cost me a fortune ," says Juliette. "They never heard from me again. Here, I'm listened to and monitored, at no cost to me."

The new premises were granted to the hospital by the Senate for a symbolic €1, but their limited operation could disrupt an already strained sector. Each psychiatric sector is expected to cover approximately 100,000 residents.

Today, they cover double that, and the definitive abandonment of an alternative hospitalization possibility risks creating an embolism in emergency rooms, already undermined by the policies of recent years.