What was the 388? Opening the Dossier

In March of 2025, the 388 (Centre for the Psychoanalytic Treatment of Young Psychotic Adults) in Quebec City was permanently closed. This decision was implemented by the regional health authority under Quebec’s Ministry of Health and Social Services – CIUSSS de la Capitale-Nationale – despite efforts by local stakeholders to preserve the Centre, which for 43 years had offered a singular set of services to individuals living with schizophrenia and other psychoses. This essay reflects on the Centre’s final chapter by revisiting its early years and examining the longstanding challenges of coupling its practices with the public health system. In particular, it examines a series of evaluations whose frameworks proved incapable of comprehending the Centre’s clinical logic – thereby bringing to light a broader epistemic tension between psychoanalysis, public psychiatry and the administrative state. In so doing, the essay brings into view the singular clinical world of the 388 and the daily practices through which its psychoanalytic treatment of psychosis was enacted.