"No, the AP-HP is not organizing the weakening of Parisian psychiatry. It's quite the opposite."

Published on May 16, 2025 at 7:00 p.m.

Nicolas Revel, Director General of AP-HP (Assistance publique-Hopitaux de Paris), responds to the article published Wednesday by "Le Nouvel Obs" signed by a number of psychiatrists and associations.

The column published on May 14 in the "Nouvel Obs", which states that "the administration wants to install the Tarnier psychiatric service in an old, disused geriatric hospital full of asbestos" is a truncated, biased and therefore deeply dishonest presentation of the reality of the AP-HP's investment in supporting psychiatry, a discipline which is also in real difficulty.

The article published on May 14th on the temporary relocation of a psychiatric unit currently located at the Tarnier hospital makes serious accusations against the AP-HP, which allegedly shows "disdain" and "negligence" towards its psychiatric teams, which allegedly offers "nothing" to this unit other than "wandering" in a former geriatric hospital, which is "deaf" and "insensitive to medical arguments and the fate of patients" , etc. Faced with this distortion of reality, the AP-HP wishes to re-establish the facts.

Paris Cité University and the City of Paris, owners of the Tarnier site where the psychiatric unit referred to in the article is currently located, are spearheading an ambitious project for an Institute for Women's Health to be located in Tarnier. To begin the transformation of this site, the AP-HP (Paris Public Health Agency) has been asked to vacate the spaces it was occupying before the summer of 2025. Transitional or permanent location solutions have been identified for all the activities still taking place there.

Among these activities is the psychiatry unit providing exclusively outpatient services, through consultations and a day hospital. This unit is intended to permanently join the site of the New Hôtel-Dieu, as part of a strategic project decided several years ago and aimed at regrouping and strengthening the psychiatry and addiction services currently spread across several sites (Tarnier, Hôtel Dieu, Cochin) within a single department, for which Professor Granger [ a psychiatrist among the most critical of the current overhaul, editor's note] had also applied for the position of head of department in 2018, but was not selected, following the call for applications. The construction of the New Hôtel-Dieu is not a distant or uncertain prospect since the design-build contract for the operation has been signed and the start of construction is planned for the beginning of next year for delivery in early 2028.

Thus, not only does the AP-HP "offer" a perspective to the psychiatric unit of Tarnier, but the perspective it proposes is that of joining a brand new hospital, whose project is precisely to considerably improve the conditions of care for psychiatric patients. Far from being "insensitive to medical arguments and the fate of patients" , the AP-HP has built this project for a long time with the psychiatrists of the Hôtel-Dieu and Tarnier and with a view to strengthening their care capacities.

The fact is that between the liberation of Tarnier in the summer of 2025 and the opening of the hospital part of the Hôtel-Dieu, scheduled for early 2028, it is necessary to find a temporary location for this unit for approximately three years. Several transitional location solutions have been studied. The solution chosen is that of a temporary location in the vacant premises of the La Collégiale hospital, located in the ^5th arrondissement. The solution of a temporary location in a disused building on the Cochin site, which housed a daycare center, was examined but rejected for two reasons: a rehabilitation cost disproportionate to the duration of the operation (with a cost 2.5 times higher than that of the rehabilitation of the Collégiale) and a duration of work incompatible with the schedule for the liberation of Tarnier, expected in the summer of 2025.

The fact of rejecting this option as the very principle of joining the new Hôtel-Dieu having been strongly contested by Professor Granger last September, the general management of the AP-HP wished initially that a mission be entrusted to a qualified person, Mr. Edouard Couty, in order to ensure that the conditions were met to allow the Tarnier unit and the other units of the psychiatry and addiction service of Cochin to be established in the best conditions, when the time comes, in the future Hôtel-Dieu, but also to formulate recommendations likely to strengthen access to psychiatric care for patients of Cochin in the transition period but also in the long term.

This mission concluded that the conditions for the establishment of the service would be satisfactory in the future Hôtel-Dieu, with planned areas equivalent to the current areas and modernized general conditions offering the possibility of accommodating more patients. It also confirmed that the premises of the Collegiate Church were suitable to accommodate the unit previously located in Tarnier for the time necessary to complete the work on the Hôtel-Dieu. Finally, the mission highlighted the need to strengthen in the short term the liaison psychiatry provided in Cochin (not affected by the ring road) which had been insufficiently provided until then by the Tarnier unit.

Regarding the Collegiate Church premises, they will be renovated to accommodate the unit's outpatient activities for a period of three years, without the teams being subject, after the work which is underway between now and the summer, to the slightest risk of exposure to asbestos, as the AP-HP occupational health service has been led to indicate to the Tarnier teams.

Since the conclusions of this independent mission did not support Professor Granger's positions, he informed the management of AP-HP and Paris-Cité University that not only did he remain opposed to his departure from Tarnier, but that he would do everything to prevent it. He also accompanied this position with a public accusation against the director of the Paris Centre university hospital group in particularly serious and defamatory terms. Under these conditions, the director general of AP-HP, the president of the central establishment medical commission, and the dean of Paris-Cité University jointly decided to terminate his duties as head of the psychiatry unit at Cochin-Tarnier.

This decision does not in any way mean that hospital doctors would not be justified in expressing disagreements, but it does mark a limit when this disagreement turns into a call to block the implementation of an institutional decision and is coupled with insulting and defamatory remarks. Exercising the functions of head of department within a public hospital certainly confers rights but also responsibilities, and therefore carries with it a requirement of respect for people and loyalty to the positions taken by the institution to which you belong.

Responsibility for the unit has been entrusted to Professor Cédric Lemogne, currently head of the adult psychiatry department at the Hôtel-Dieu. He has also been appointed interim head of the liaison team, with the mission of strengthening the medical team in this area: three recruitments have already been made to fill vacant positions, demonstrating that far from undermining the psychiatric care of patients hospitalized at Cochin, we are creating the conditions to, on the contrary, strengthen it.

More generally, the AP-HP reaffirms that it does not wish to weaken its psychiatric services at a time when needs have never been greater. Strengthening the provision of psychiatric care is at the heart of the AP-HP's strategy through several major projects: the creation within the Armand-Trousseau Hospital of the Institute for Child and Adolescent Development (IDEAL), which aims to bring together and consolidate different forms of reception and support to become the largest child psychiatry service in Europe; the creation of the Child Brain Institute within the Robert Debré Hospital, which will significantly intensify the study and care of the child's brain in all its vulnerabilities; investment in the modernization of the Albert-Chenevier hospital or the implementation of specific attractiveness measures to facilitate the hiring of young paramedics in psychiatry and accelerate the reopening of hospital beds.