Political abuse of psychiatry in Russia
|Psychiatry in Russia and the USSR|
Russian Mental Health Law
Political abuse of psychiatry is the purported misuse of psychiatric diagnosis, detention and treatment for the purposes of obstructing the fundamental human rights of certain groups and individuals in a society.:491 In other words, abuse of psychiatry including one for political purposes is deliberate action of getting citizens certified, who, because of their mental condition, need neither psychiatric restraint nor psychiatric treatment. Psychiatrists have been involved in human rights abuses in states across the world when the definitions of mental disease were expanded to include political disobedience.:6 As scholars have long argued, governmental and medical institutions code menaces to authority as mental diseases during political disturbances.:14 Nowadays, in many countries, political prisoners are sometimes confined and abused in mental institutions.:3 Psychiatric confinement of sane people is uniformly considered a particularly pernicious form of repression.
In the period from the 1960s up to 1986, abuse of psychiatry for political purposes was reported to be occasional in other Eastern European countries such as Romania, Hungary, Czechoslovakia, and Yugoslavia, and systematic in the Soviet Union.:66
- 1 Background
- 2 Mass trials
- 3 Individual cases
- 4 Extrajudicial involuntary hospitalizations
- 5 Reaction
- 6 References
Robert van Voren of the Global Initiative on Psychiatry says the emergence of individual cases of political abuse of psychiatry in Russia is directly related to the deterioration of the human rights situation and to the fact that on-the-spot authorities feel more carefree than they did before, and deal with undesirable elements at their own discretion. The aura of inviolability is returned to the Russian rulers, the rule of law becomes subject to political machinations. Everything points to the fact that Russia still has the structure to exercise political abuse of psychiatry. Both political and economic nomenklatura is quite powerful and would not stop short at using illegal means especially now, when the political nomenklatura has absorbed economic power from Russian oligarchs, and the country is, in fact, ruled by the circle of people who came directly from the KGB whose capacities to establish control are limitless. This does not bode well for the future. The same occasionally happens in many countries monitored by the Global Initiative on Psychiatry. Psychiatry is regarded as a handy tool to solve disputes, and one can easily buy a diagnosis from a psychiatrist. In most of the countries, forensic psychiatry has changed only slightly, the strong resistance to introducing the modern practices of forensic psychiatry is due to not disparities in schools or views but the fact that the reform of the system would mean the end of corruption. Criminals pay off their imprisonment of many years by having themselves declared insane. Wealthy husbands declare about the mental illnesses in their wives to get rid of them and yet keep control over their children. Children declare their parents and grandparents legally incapable to sell their apartments. Even medical institutions recognize their patients as insane to take their property. It is just a press for printing money. Today the Russian opposition cannot expect the type of help the West gave in Soviet times. Supporting Soviet dissidents was part of anti-Soviet policy but now pragmatism and precise calculation rules.
According to psychiatrist Sofia Dorinskaya, the situation always develops in the same way: either in the evening or at night, or in the early morning, when a person sleeps, the police break the door down in his apartment or room, handcuff and escort him directly or through a police office to a mental hospital, where the door is closed behind the person. When the door is closed and you sit face to face with a psychiatrist, then all written by the psychiatrist will be a proof of your madness for a judge in court. Even if you just sit on a chair, speak nothing or any anything reasonable, the psychiatrist can write that you threw yourself against walls and that you tried to scratch his eyes out and so on and so forth.
Discrediting the citizens by instituting farfetched proceedings to obtain a ground for examination is a favorite tactic of officials whose interests are hurt by the active members of public. The police deliver "the ill" to a psychiatric facility, and the doctor can be sure that his facility will not be reduced, and, in general, the more "patients", the more funding. Even if the criminal case is closed due to its complete failure, it does not regard the dispensary, the person is all the same "ill". According to Doctor of Legal Sciences Vladimir Ovchinsky, regional differences in forensic psychiatric expert reports are striking. For example, in some regions of Russia, 8 or 9 percent of all examinees are pronounced sane; in other regions up to 75 percent of all examinees are pronounced sane. In some regions less than 2 percent of examinees are declared schizophrenics; in other regions up to 80 percent of examinees are declared schizophrenics.
From 1994, the nationalization of expert activity started, and people witnessed the same technologies as those practiced on political dissidents. The same gimmicks were applied to religious dissenters to a not lesser extent. In the Serbsky Center, the special group for “study of the negative influence of religious groups” under the leadership of professor Fyodor Kondratyev was created. Kondratyev’s group started supervising numerous trials initiated all over the country. It came to legal actions practically for sorcery. The Nezavisimiy Psikhiatricheskiy Zhurnal documented the history of numerous religious trials, demonstrated the total groundlessness of the charges of “gross harm on mental health”, and evolved their political and ideological background. The Independent Psychiatric Association of Russia repeatedly caught Fyodor Kondratyev, the author of pseudoscientific theory of sectomania, in his falsifications. His special department “for studying destructive cults,” which is located in the Serbsky Center, closely collaborates with Alexander Dvorkin. Known for his intolerance and radicalism, Dvorkin has nothing in common with science and ranks even followers of Nikolai Rerikh and the religious communities of Yakov Krotov and Grigori Kochetkov among “totalitarian sects.” In Yuri Savenko's words, “when a psychiatrist-academician (Dmitrieva, Sidorov) or an expert-psychologist of the Institute of Psychology of the Russian Academy of Sciences rely on the works by Dvorkin and Hassan, which do not belong to science, it is a symptom of degradation.”
The denial by the Serbsky Center of the abuse of psychiatry for political purposes in 1960–1980s and the open rehabilitation of the main director of this infamous campaign academician Georgi Morozov are a direct evidence of the restoration of the gendarme psychiatry.
There have been examples of the serious misuse of psychiatry by local authorities reminiscent of the Soviet abuses:369 A number of human rights organizations including the Independent Psychiatric Association of Russia criticized the use of psychiatry in “deprogramming” members of “totalitarian sects.”:369:182 In such cases, authorities apply spiritual and pseudo-psychological techniques to “treat” individuals who are members of new religious groups.:369:182 Six Scientologists were arbitrarily detained for psychiatric examination.:369 In January 2000 in St. Petersburg, chief psychiatrist Larisa Rubina charged leader of Sentuar (the local offshoot of the Church of Scientology) Vladimir Tretyak with inflicting psychological damage on his coreligionists.:369 On June 17, six members of Sentuar — Lyudmila Urzhumtseva, Svetlana Pastuchenkova, Svetlana Kruglova, Irina Shamarina, Igor Zakrayev, and Mikhail Dvorkin — were forcibly hospitalized and subjected to 3 weeks of criminal investigation at the behest of Boris Larionov, procurator of the Vyborgsky district of St. Petersburg.:369
In 2005, Igor Kanterov, a professor of the Moscow State University, wrote that psychiatrists and psychologists were actually being involved in a very unattractive occupation, stigmatizing “alien” religions and their followers, who were about 1 million first-class citizens of the Russian Federation, and putting them “on the basis of a list of them” in the category of “psychic terrorists.” While reviewing Sidorov’s article “Psychic terrorism is nonlethal weapon of mass destruction” published by the Rossiyskiy Psikhiatricheskiy Zhurnal in its issue 3 of 2005, Kanterov notes that, according to it, religious behavior is regarded as inherently deviant from the “norm”, that similar type of behavior is always dependent and imposed by recruiting and manipulative influence and that, thus, the possibility to be initiated into religious organizations due to free choice of religious belief guaranteed by the Constitution of the Russian Federation is outright rejected. In his 2010 article, Kanterov writes about the works by P.I. Sidorov and V.E. Pashkovskiy and points out that inspired by the desire to expose the malicious actions of “totalitarian cults,” P.I. Sidorov and V.E. Pashkovskiy at the same time never resort to Russian laws regulating activity of religious associations, and it can hardly be considered accidental, since all the original sets of the authors are in flagrant contravention of current legislation. The Federal Law of the Russian Federation “On Freedom of Conscience and on Religious Associations” contains the following types of associations of believers: religious groups, religious organizations, local and centralized religious associations, and its legislator mentions about no “sects,” “cults,” especially with the frightening adjectives “destructive” or “totalitarian.” However, in Kanterov’s words, peer-reviewed publications use the term “totalitarian sects” as a key concept that naturally generates psychiatric disorders and produces horror stories about “psychic terrorism,” “non-lethal weapon of mass destruction,” “usurpation of belongings and savings of followers,” “recruitment,” etc. P.I. Sidorov presents a list of “totalitarian cults” with the names of over twenty religious organizations, and many of them have status of registered centralized organizations that successfully passed registration and re-registration provided for by the Law “On Freedom of Conscience and Religious Associations” after the Expert Council for Religious Examination under the Ministry of Justice of the Russian Federation made for each of these organizations expert reports, in which the detailed assessment of the religious doctrine, rituals, attitude of the religious organizations to society, family, and individual were given, but no violations were found.
In 2006, Yuri Savenko stated that a first large relapse of the use of psychiatry for political purposes in post-Soviet Russia during recent decade was struggle against “totalitarian sects.” According to Yuri Savenko, the reason for the use of psychiatry against religious minorities, which began from 1995, was Y.I. Polishchuk's report containing conclusion about “gross harm on mental health” inflicted by various religious organizations. This report was distributed to all public prosecutors’ offices of the country and to the presidents of the educational institutions despite the fact that its scientific inadequacy was emphasized by not only the Independent Psychiatric Association of Russia (the IPA), but also the Russian Society of Psychiatrists since all imputed cases of illness, suicide, family breakdown, etc. proved to be much more frequent in the general population than in the persecuted religious organizations. As the result of a series of court trials, it is only the vocabulary of the accusations that changed and became less clumsy; “destructive cults” started to be used instead of “totalitarian sects”; “unlawful use of hypnosis”, then “inconspicuous use of suggestion”, and, finally, “action at a subconscious level” through lectures and printed production with even anti-drug abuse contents started to be used instead of “gross harm on mental health”.
In 1999, the IPA expressed its concern about the facts of the use of psychiatry against religious minorities in the IPA Open Letter to the General Assembly of XI Congress of the WPA. Stressing all the responsibility taken by the authors of the letter for the action involved in their statement, they noted in it that they considered it necessary to draw the WPA General Assembly’s attention to the recurrent use of psychiatry for non-medical purposes, which was recommenced in Russia from 1994–1995, was subsequently going on a large-scale without slackening and was aimed at suppressing not political dissenters but already religious dissenters. This letter was concluded with the proposal, which was addressed to the WPA, to adopt the text of statement containing words of the WPA’s concern about initiating numerous lawsuits against various religious organizations in Russia for allegedly "inflicting by them gross harm on mental health and for unhealthy changes of personality" and to express in the statement the WPA’s solidarity with the position of the Independent Psychiatric Association of Russia and the Russian Society of Psychiatrists as to inadmissibility of involving psychiatrists in issues straining their professional competence.
In 2003, a “wrongful confinement” lawsuit, in which Yuri Savenko took part, was filed in the European Court of Human Rights.:294 When writing about this case, Savenko charged the Serbsky Institute with “having pernicious effect on Russian medicine” and warned that the psychiatric leadership “is now completely under the shadow of the state.”:294
Savenko’s organization cooperated with a number of other NGOs to compose a highly critical report about rising rates of mental disease and the deteriorating system of mental health care.:294 In the report, authors blamed “chronic underfunding of psychiatric care, corruption, and poverty” and pointed an accusing finger at the psychiatric leadership.:294
In modern Russia, the role of psychiatry in the criminal field is the same as in other countries: to evaluate whether defendants in criminal cases are legally sane to stand trial. For example, when an accused war criminal Yuri Budanov was tested at the Moscow Serbsky Institute in 2002, the panel conducting the inquiry was led by Tamara Pechernikova, who had declared poet Natalya Gorbanevskaya insane several decades earlier. Budanov was found not guilty by reason of temporary insanity, but later he was found legally sane to stand the trial by another panel that included Georgi Morozov, the former Serbsky director who had declared many dissidents insane several decades earlier
Legal proceedings took place against the organization “F.A.K.E.L.-P.O.R.T.O.S.”, a youth commune of the similar type as Anton Makarenko’s one. The organization was engaged in self-improvement of its members and re-education of street children and created successful farms under Kharkov and Moscow. In 2000, the commune was smashed up by Luberetskiy RUBOP, with gross violations of law, the members of the organization was wrongly accused of creating “an illegal paramilitary group.” In particular, Yuriy Davydov was sentenced to imprisonment and compulsory treatment with a diagnosis of “schizophrenia, delusional ideas of perestroika and reformation of society” made by the Serbsky Center. Evgeni Privalov was declared insane with the diagnosis of “schizophrenia”. The defence insisted that Davydov and Privalov had to be acquitted “as mentally healthy people”. Yulia Privedyonnaya was eventually recognized as mentally healthy by forensic psychiatric expert examination. The case of Privedyonnaya lasted for a long time. In human rights activists’ opinion, her inpatient forensic psychiatric expert examination was a means to intimidate and psych out her.
In December 2003, in St. Petersburg, Ivan Ivannikov, who lectured at the State University of Economics and Finance for 38 years, was committed to the city psychiatric hospital after a long dispute with a contractor over repairs to his apartment. The recommendation for commitment was signed by an influential state psychiatrist, who had not met Ivannikov before it was decided that his multiple legal complaints against the contractor were an "obsession" with "revenge." He was discharged after 60 days.
In 2004, Igor Molyakov was imprisoned on libel charges for six months. While imprisoned, he was ordered committed for hospitalization to a psychiatric hospital after government lawyers persuaded a judge that Molyakov expressed in his writings about corruption among local authorities a view so "somber" that it might be regarded as a "mental disorder."
In the fall of 2005, Albert Imendayev was committed to a psychiatric hospital when he collected the signatures to run for the legislature in Cheboksary. Nine days later he was discharged and was out of the race, because by that time the election filing deadline had passed. Imendayev's act of insanity was filing a number of legal complaints against local officials, judges, prosecutors, and police, alleging violation of court procedures, corruption, and cronyism—charges that are typical of modern Russia. The prosecutor, who was a frequent target of Imendayev's criticisms, qualified his behavior as "paranoia."
In March 2006, a former nuclear scientist and vocal public defender Marina Trutko was subjected to daily injections for six weeks at Psychiatric Hospital No. 14 in Dubna, Russia, to treat her for a “paranoid personality disorder.”
Dmitri Shchyokotov, who defended the rights of ordinary inhabitants of Muromtsevsky District in their conflicts with headmen and local authorities, was accused of slander on the head of local judicial authority and committed in a psychiatric hospital. After he spent two days in its violent unit without having food, water, and medicines, he was recognized as sane by the commission of doctors of the Omsk psychiatric hospital and discharged. However, he lost his eyesight because he could not use his eye drops for these two days in the psychiatric hospital.
In 2007, an activist of the coalition "The Other Russia" Artyom Basyrov was involuntarily placed in a psychiatric hospital on the eve of planned "demonstration of dissent", one of the organizers of which was A. Basyrov. A. Basyrov suffered from slight mental disorder, but there was no real reason for his hospitalization: Artyom was in need of outpatient therapy, not involuntary inpatient treatment. In the reasoned opinion of the medical commission sent to the court, his mental disorders were grossly exaggerated.
There were also no reasons for the involuntary inpatient treatment of Andrei Novikov, journalist imprisoned on charges of extremism and sent to involuntary psychiatric treatment, after he publicly criticized Vladimir Putin’s policy in Chechnya. Impartial legal proceedings would not have found formal components of a crime in the charges brought against Novikov, but his old psychiatric diagnosis along with the expansive interpretation of the concept of "danger" as the reason for his involuntary hospitalization allowed to solve his case in the way most convenient for authorities.
In July 2007, the activist Larisa Arap was forcibly confined at a psychiatric clinic in Apatity soon after publishing her article about mistreatment of patients in the same hospital where she was committed.
On 23 December 2010, Alexey Manannikov, one of organizers of oppositional rallies in Novosibirsk, was sent for psychiatric examination to a mental hospital because of his insulting the judge of the Central Regional Court of Novosibirsk Mariya Shishkina by writing in his blog.
In 2012, Nadezhda Nizovkina and Vera Lavreshina were detained during their protest action at the Red Square. After Nizovkina refused to write an application that she is sorry for what she had been doing at the Red Square, she was convicted to “involuntary hospitalization in psychiatric hospital for six months.” On the doctors’ request, her mother assumed responsibility for her by signing documents and was permitted to take her from the hospital.
In August 2012, non-medical use of psychiatry surfaced in the case of "Pussy Riot". The defendants passed through forensic psychiatric examination in the Kashchenko psychiatric hospital outside Moscow, a facility that in Soviet era was heavily involved in political abuse of psychiatry. The psychiatric and psychological report presented by the prosecution alleged that the three women suffered from "personality disorders" and thereby must be isolated from society. However, the defense could not question the experts as they did not come to the court. The report used the language very similar to the qualifications used in Soviet era when diagnosing dissenters. On 25 August 2012, this examination entailed an open letter by Russian psychologist Aleksandr Asmolov who wrote, "In the eyes of the civilized world, our science, psychology in the first place, is turned into an ideological weapon of punishment and repression. First of all, it is a matter of the non-professional use of psychological and psycholinguistic examination in court practice. The ghost of the insulin Gulag, of punitive science reappears in the country."
On 8 October 2013, a verdict was announced in the case of Mikhail Kosenko. He took part in the protest march at Moscow's Bolotnaya Square on 6 May 2012. Along with other witnesses, Alexander Podrabinek, a former Soviet dissident and currently Radio France Internationale commentator, testified that Kosenko had stood next to him and had not scuffled with police. After just one brief conversation with Kosenko, specialists from the Serbsky Center made a highly questionable diagnosis and the conclusion that Kosenko "presented a danger to himself and others" and "required compulsory treatment." This conclusion ignored his prior diagnosis and the fact that he was not once cited for aggressive or suicidal behavior within 16 months of his pretrial detention in Butyrka prison. A special announcement on the case was issued by the Independent Psychiatric Association of Russia: "On the basis of a conversation that lasted less than one hour, the specialists made the far more serious diagnosis of paranoid schizophrenia instead of the diagnosis of sluggish neurosis-like schizophrenia that Kosenko was treated for over the course of 12 years." The court sent Kosenko for open-ended treatment to a psychiatric hospital. On 19 December 2013, the Commission on Professional Ethics Issues at the Board of the Russian Society of Psychiatrists delivered to the president of the Independent Psychiatric Association of Russia Yuri Savenko, who raised ethical issues concerning Kosenko in publications, a resolution as follows:
Savenko Yu. S. in his public appearances has grossly violated the norms of professional ethics. In numerous declarations, appeals, appearances by Savenko Yu. S. in the media, there are noted impermissible, insulting, offensive statements, which derogate from honour, dignity and goodwill of both individual experts and the expert institution F[ederal] S[tate] B[udgetary] I[nstitution] "the Serbsky S[tate] S[cientific] C[enter for] S[ocial and] F[orensic] P[sychiatry]" and at the same time undermine the authority of the psychiatric community as a whole.
Savenko responded that the strikingly unethical nature of the resolution by the Ethical Commission (of 12 December 2013) showed in the ascription to the IPA open letter to the WPA, hosted on the website, of phrases that were never used there. He adds we see a rather awkward performance of a social role using the old scenario of accusatory campaigns of Soviet times to have the possibility to refer to "the opinion of the professional public" for use abroad.
People "complaining to various authorities" are often sent to a psychiatric hospital without indications for the involuntary hospitalization when the only purpose for it is to stop their "paranoic-litigious activity". When talking about punitive psychiatry, Lyubov Vinogradova of the IPA says, it is now used mostly not in political cases but in those related to family disputes or disputes over apartments.
Extrajudicial involuntary hospitalizations
There are cases when the motive for the unfounded psychiatric hospitalization was the intention of the administration of an orphanage to punish its inmates for their runaways and disobedience. During many involuntary hospitalizations in recent years, the staff of psychiatric hospitals did not follow the mandatory judicial procedure provided by the Law. In 2009, several orphans from the city of Kimovsk in Tula Oblast ran away from their orphanage to a local priest. They told that they were sent to a psychiatric hospital through the explanation of their teachers "for disobedience and the edification of others." The expert report from the Serbsky Center for Forensic Psychiatry showed that they were "mentally healthy."
In 2010, 20 out of 72 orphans from an orphanage in Komsomolsk-on-Amur were placed in a psychiatric hospital and exposed to neuroleptic medication. The city prosecutor found that all the children were placed in the hospital to be treated for "emotional disorders" without having been examined by a commission of psychiatrists or provided for by a court judgment. The children told they had been warned that they would send to a madhouse because of their bad behavior.
In the rurban of Sofino in Moscow Oblast from 2008 to 2011, psychiatric hospitalizations and treatments have been imposed on 23 of 46 inmates who reside in a local orphanage. In March 2011, the Saint Petersburg Commissioner for Child Rights Svetlana Agapitova reported on the hospitalization of four orphans from the orphanage No. 19 as a punishment for their disobedience. The medical records of the children did not contain notes of these hospitalizations.
It is significant that none of the cases has reached a trial and entailed real convictions. All taken measures were limited to the prosecutor's investigation. According to some estimates, a psychiatric diagnosis is given to half of all children who live in state institutions. Infant orphans who came of age and received a diagnosis in a psychiatric hospital are sent to psychoneurological internats without asking their consent. There a new problem arises: quite legally capable people cannot get out of there, work, start their family and live a normal life.
The charge that psychiatry is again being abused is not universally accepted within the profession in Russia. Vladimir Rotstein, who is the president of Public Initiative on Psychiatry, an advocacy group, stated that the problem of psychiatric persecution or forced treatment existed more than 20 years ago, but it was solved and since then he has not heard of any case of forced psychiatric treatment or examination. However, the Independent Psychiatric Association of Russia states that the number of activists being wrongfully committed to psychiatric institutions totals dozens of cases in recent years. According to its president Yuri Savenko, law enforcement practice, of course, is very far from the letter of the law, forensic psychiatric expert examination has deteriorated because of the lack of competition, and courts implicitly fulfill wishes of the vertical of executive authority affected by corruption. The Russian legislation did not implement Principle 18 of the Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care, approved by the UN General Assembly in 1991, with respect to patient’s right to an independent psychiatric report. According to the analysis by psychotherapist Elena Romek, provisions of the Russian Mental Health Law are in conflict with civil rights guaranteed by the Constitution of the Russian Federation, universally recognized norms of international law, professional and ethical norms of medicine, and presumption of innocence. According to representatives of the Moscow Helsinki Group (MHG), the Law does not comply with the European practice of mental health care. The case of Rakevich v. Russia considered in the European Court of Human Rights gave grounds for the following assertion by the head of MHG legal programs Natalia Kravchuk:
… Russian legislation in this area is featureless and vague. It is for this reason that it is so hard for people to assert their rights, and they have to reach the European Court of Human Rights.
In 2006, the Association of American Physicians and Surgeons issued a warning that in the Russian Federation 'psychiatry is used as a tool against dissent.' As mentioned in 2010, reports on particular cases of psychiatric abuse continue to come from Russia where the worsening political climate appears to make an atmosphere in which local authorities feel able to again use psychiatry as a means of frightening. It is the Independent Psychiatric Association of Russia that appears to make very active efforts to communicate their views on the previous and present abuses of psychiatry in Russia to psychiatry in the West.:541
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