Punitive psychiatry in the Soviet Union

In the Soviet Union, psychiatry was used for punitive purposes. Psychiatric hospitals were often used by the authorities as prisons in order to isolate political prisoners from the rest of society, discredit their ideas, and break them physically and mentally; as such they were considered a form of torture. The official explanation was that "no sane person would declaim against Soviet government and communism".

Psikhushka (психушка) is a Russian colloquialism for psychiatric hospital. It has been occasionally used in English since the dissident movement in the Soviet Union became known in the West.

History
Psikhushkas had been already used since the end of the 1940s (see Alexander Esenin-Volpin) and during the Khrushchev Thaw period in the 1960s. One of the first psikhushkas was the Psychiatric Prison Hospital in the city of Kazan. It was transferred to NKVD control in 1939 under the order of Lavrentiy Beria. On April 29 1969 the head of KGB, Yuri Andropov, submitted to the Central Committee of CPSU a plan for creating of a network of psikhushkas.

The official Soviet psychiatry allegedly abused the diagnosis of sluggishly progressing schizophrenia (вялотекущая шизофрения), a special form of the illness that supposedly affects only the person's social behavior, with no trace of other traits: "most frequently, ideas about a struggle for truth and justice are formed by personalities with a paranoid structure," according to the Moscow Serbsky Institute professors (a quote from Vladimir Bukovsky's archives). Some of them had high rank in the MVD, such as the infamous Danil Luntz, who was characterized by Viktor Nekipelov as "no better than the criminal doctors who performed inhuman experiments on the prisoners in Nazi concentration camps".

The sane individuals who were diagnosed as mentally ill were sent either to regular psychiatric hospitals or, those deemed particularly dangerous, to special ones, run directly by the MVD. The treatment included various forms of restraint, electric shocks, a range of drugs (such as narcotics, tranquilizers, and insulin) that cause long lasting side effects, and sometimes involved beatings. Nekipelov describes inhuman uses of medical procedures such as lumbar punctures.

At least 365 sane people were treated for "politically defined madness" in the Soviet Union, and there were surely hundreds more.

Soviet psychiatric abuse exposed
In 1971, Bukovsky managed to smuggle to the West over 150 pages documenting abuse of psychiatric institutions for political reasons in the USSR. The facts galvanized the human rights activists worldwide, including inside the USSR. In January 1972, the Soviet authorities incarcerated Bukovsky for 7 years of imprisonment plus 5 years in exile, officially for contacts with foreign journalists and possession and distribution of samizdat (Article 70-1).

Together with a fellow inmate in Vladimir prison, psychiatrist Semyon Gluzman, Bukovsky coauthored A Manual on Psychiatry for Dissidents in order to help other dissidents fight abuses of the authorities.

In 1971, a renowned Soviet physicist Academician Andrei Sakharov supported protest of two political prisoners, V. Fainberg and V. Borisov, who announced a hunger strike against "compulsory therapeutic treatment with medications injurious to mental activity" in a Leningrad psychiatric institution. For his activism in defense of human rights Sakharov was expelled from the Soviet Academy of Sciences and sent to internal exile.

Reaction by the World Psychiatric Association
When early concerns were raised in the World Psychiatric Association (WPA), the Soviet delegation threatened to withdraw from the international organization and WPA held out its involvement in the issue. As the number of documented cases of abuse continued to increase and international protests started to mount, WPA changed its stance and adopted ethical code of conduct for its members and established investigative bodies to enforce it.

The first committee against the political abuse of psychiatry was founded in 1974 in Geneva. In 1977, the WPA's World Congress in Honolulu adopted the Declaration of Hawaii, the first document to set forth a set of basic ethical standards guiding the work of psychiatrists worldwide. The congress also officially condemned Soviet political psychiatric abuses for the first time. In 1982, facing imminent expulsion from the WPA, the Soviet delegation voluntarily withdrew, and in 1983 the WPA's World Congress in Vienna adopted a resolution that placed strict conditions on its return.

Mikhail Gorbachev's glasnost campaign significantly contributed to the exposure of more evidence in the Soviet press. In 1989, two years before the collapse of the Soviet Union, the Soviet delegation to the WPA's World Congress in Athens acknowledged that systematic abuse of psychiatry for political purposes had indeed taken place in their country.

Post-Soviet times
The Moscow Serbsky Institute still conducts thousands of court-ordered evaluations per year, and is a source of many modern conspiracy theories.

When war criminal Yuri Budanov was tested there in 2002, the panel conducting the inquiry was led by Tamara Pechernikova, who earlier condemned poet Natalya Gorbanevskaya. Budanov was found not guilty by reason of "temporary insanity". After public outrage, he was found sane by another panel that included Georgi Morozov, the former Serbsky director who declared many dissidents insane in the past.

There have been reports in the 2000s about alleged imprisonment of people "inconvenient" for Russian authorities in psychiatric institutions. The BBC reported, notably, that dissident Larisa Arap was forcibly confined at a psychiatric clinic in Apatity.

People

 * Vladimir Bukovsky
 * Natalya Gorbanevskaya
 * Alexander Esenin-Volpin
 * Pyotr Grigorenko
 * Zhores Medvedev
 * Viktor Nekipelov
 * Valeriya Novodvorskaya
 * Andrei Sakharov
 * Natan Sharansky
 * Andrei Sinyavsky