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English Language Page In spring and summer of 2003, the Moscow Helsinki Group, the Independent Psychiatric Association of Russia (IPA), and the human rights monitoring network of regional NGOs under coordination of the MHG conducted a well-rounded monitoring effort on the situation in Russian psychiatric institutions. We were confident that a human rights monitoring was the optimal method to bring the subject of the status of patients of psychiatric institutions on the agenda of a wide public debate. It is important to note that a complex independent examination of psychiatric institutions had never been undertaken prior to our initiative. In addition, provisions of Federal Law “On Psychiatric Care and Guarantees of the Rights of Citizens in Therapy” adopted in 1992 that account for the establishment of an Internal Service for the Protection of Rights of Patients of Psychiatric Institutions still remain to be implemented. At the same time, mentally challenged individuals are an especially vulnerable group of people who, due to their mental health problems, are sometimes unable to adequately assess not only the necessity of therapy but also the need in legal protection. Restrictions imposed upon patients of psychiatric clinics are an induced measure which is necessary for an effective therapy. But it is in this particular situation that the restrictive measure applied in each case must have reasonable justification, and any arbitrary limitation, let alone cruel and degrading treatment are not to be tolerated. This is especially important with respect to those individuals who have been hospitalized involuntarily, i.e., those who undergo therapy against their will. The survey would have been impossible without expert and organizational support from the Independent Psychiatric Association. IPA has a great deal of experience in constructive interaction with head physicians of Russian psychiatric institutions which proved to be invaluable for the purposes of the monitoring. Experts from this human rights organization have analyzed the data obtained by regional human rights activists and prepared the text of the report. The final version of the report presented in this compilation is a product of joint efforts of the Independent Psychiatric Association and the Moscow Helsinki Group. The monitoring effort would not have been successful without the support from the RF Ministry of Health and Head of its Special Care department, A. Karpov, and that of the Chief Psychiatrist of Russia, B. Kazakovtsev. With their assistance, we managed to implement our initial plan: to conduct comprehensives survey and site visits in all Russian regions using a standard mechanism that entailed a number of special arrangements. The cooperation between the Independent Psychiatric Association, the Moscow Helsinki Group, and the network of regional human rights organizations coupled with active participation of the RF Ministry of Health and its regional departments accounted for the success of our monitoring initiative. The strong ties built between the Moscow Helsinki Group and the Independent Psychiatric Association within this project laid groundwork for the subsequent permanent monitoring of individuals afflicted with mental conditions. Regional organizations have established working contacts with human rights organizations specializing in psychiatry-related issues (regional chapters of the Independent Psychiatric Association), as well as local officials and heads of psychiatric institutions. Groundwork has been laid to enable the regional human rights organizations-partners of the Moscow Helsinki Group to pursue independent activities targeted at the protection of rights of citizens in psychiatric therapy. The monitoring effort has also proven to be valuable in that it stimulated independent civic activities of regional NGOs and brought the subject of psychiatric care into the focus of public scrutiny. For many it has become obvious that urgent measures are required to change the state policy in the area of psychiatry and its funding, as well as to speedily institute a Service for the Protection of Rights of Patients of Psychiatric Institutions. It has also become evident that NGOs must pursue more insightful monitoring projects in order to more clearly identify discrete and most acute problems and methods of their solution. Data obtained in the course of this monitoring effort reflect a wide spectrum of issues within the field of psychiatric care that require solution and are an inexhaustible source of information for further analysis. This publication incorporates only the amount of data that was necessary to answer initial questions on the status of psychiatric care in Russia. The given volume includes the actual report on the observance of the rights of patients and staff of psychiatric institutions based on our monitoring findings, an analysis of relevant Russian and international legislation, as well as a section containing thematic articles dedicated to problematic aspects and spheres within contemporary Russian psychiatry. Owing to the Independent Psychiatric Association, a number of experts in the field of psychiatry partook in the development of the report which gave us an opportunity to at least partially cover some topics that had initially lain outside the framework of the research. We would like the reader to pay special attention to materials about patients who had been hospitalized on the basis of court decisions, as well as those who reside in neuro-psychiatric boarding facilities. |
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