Punitive psychiatry reemerges in post-Soviet states

This article was originally published by Coda’s editorial partner EurasiaNet.

Last summer, Crimean Tatar political activist Ilmi Umerov was receiving treatment for high blood pressure in a Simferopol hospital when FSB officers showed up one day and hauled him off to a psychiatric facility for an evaluation.

Umerov, a former deputy chairman of the Mejlis, the Crimean Tatar representative body, had been a vocal critic of Russia’s annexation of Crimea. In May 2016, the FSB charged him with criminal separatism after he declared, in Tatar: “We must force Russia to withdraw from Crimea.”

At the psychiatric facility, a doctor quickly let him know that he would be punished, not treated. “You just need to admit that you’re wrong, and everybody will stop bothering you,” Umerov, in an interview with Euromaidan Press, quoted the doctor as saying. “Simple as that.”

When Umerov would not make a deal, he was detained at the facility. The conditions he endured were appalling. According to his lawyers, he was kept in an overcrowded room with severely mentally ill patients, denied access to his heart and diabetes medications, and forced to go long stretches of time without food. At the psychiatric facility, a doctor quickly let him know that he would be punished, not treated. “You just need to admit that you’re wrong, and everybody will stop bothering you,”

Umerov was released three weeks later, but he remained subject to criminal prosecution. His trial commenced in June.

Human rights activists point to Umerov’s case as an indicator of a troubling resurgence of punitive psychiatry in the former Soviet space. The practice of using psychiatry to punish religious and political dissidents, including many well-known writers and artists, became notorious during the late Soviet era. The method was reportedly the brainchild of then-KGB Chairman Yuri Andropov, who saw psychiatry as a tool of systematic political repression: victims would be released only after retracting “wrong ideas” that the authorities deemed dangerous to Kremlin rule.

Discarded after the Soviet collapse, punitive psychiatry has reappeared again in Russia under President Vladimir Putin, as well as in some neighboring states.

Over the past five years across the former Soviet Union, more than 30 similar instances have been documented in which activists and journalists have been improperly detained in psychiatric institutions, sometimes for as long as 10 years, reports the Federation Global Initiative on Psychiatry (FGIP), a human rights watchdog. Experts say the real number of victims could be considerably higher.

They include teenagers as well as adults. In May 2016, 16-year-old Gleb Astafyev was confined to a psychiatric institution for 15 days after staging a solitary picket in Kurgan, Russia. He had been demonstrating in support of the dissident performance artist Pyotr Pavlensky, who himself had spent a month in a mental hospital earlier that year.

Astafyev says that his hospital stay included five days in the special ward for the most mentally ill, some of whom yelled and pounded their fists at night. “Every morning we were given pills to take, but I managed to spit them out. I don’t know what the medication was — it seemed to turn people into vegetables,” he told EurasiaNet.org in an interview.

The irony is that people often develop mental health issues precisely because of the conditions in the psychiatric hospitals, and the forced drugging, says Robert van Voren, the head of FGIP. “Every morning we were given pills to take, but I managed to spit them out. I don’t know what the medication was — it seemed to turn people into vegetables,” he told EurasiaNet.org in an interview.

A case in point is the Chelyabinsk activist Alexei Moroshkin, forced to spend 18 months in a psychiatric clinic until his release this June. He was reportedly given high doses of neuroleptics and developed depression, a condition he had not previously had.

Moroshkin was arrested in 2015 for promoting separatism on social media, where he lauded Ural nationalism and criticized central authority. A criminal court ruled that he be institutionalized as a “danger to society.”

This allegation bears particular weight in Russia and other post-Soviet societies, where mental health problems are still stigmatized. Today, as in Soviet times, psychiatric imprisonment of activists is preventative as well as punitive. In addition to sending a warning to politically active citizens, the stigma of mental illness tacitly undermines the credibility of confined individual in the public eye.

The misuse of psychiatry is making a comeback in Central Asia too. The most prominent recent case in the region is that of the Jamshid Karimov, an Uzbek independent journalist and a strident critic of the late President Islam Karimov who was also his uncle.

In 2006, Jamshid Karimov disappeared and was later found to have been forcibly hospitalized in Samarkand. Although initially ordered by a criminal court to undergo six months of treatment, Karimov was in fact not released until late 2011 – only to be readmitted for another five years shortly thereafter.

Karimov attributes his ultimate release, this past March, to his uncle’s death in 2016 after 27 years in power. Since Karimov’s death, Uzbekistan’s new leadership appears to be pursuing a cautious thaw.

“I was hospitalized for so long because I was a personal enemy,” he said in an interview with Eurasianet.org. “I was kept in a dark room with bars on the windows and forced to take psychotropic drugs. There was always a guard watching me during visits from my family.”

His chief psychiatrist repeatedly urged him to disassociate himself “from bad, evil people,” he adds. He believes this was a reference to his colleague Ulugbek Khaidarov, another journalist who was arrested and found guilty of treason in 2006.

If post-Soviet governments had designed punitive psychiatry to enforce political conformity, then the method cannot be considered entirely successful. Activists and their supporters have often reacted to the treatment by redoubling their efforts.

A year on, the teenage Russian protester Astafyev reflects on the picket that led to his hospitalization: “The point was to show how Russian authorities react to opponents who are not afraid of expressing their views. The fact that I was put into a psychiatric facility showed their misunderstanding and blind condemnation of people who are different in society.”