Vasiliy Vlassov: Psychiatry and political dissent in Russia

On 17 August 2012 the whole of Russian society was taken aback by the harsh court verdict given to three women—the members of the music group “Pussy Riot.” They entered Moscow’s Orthodox cathedral and tried to sing their “Pank Pray,” asking Mary to expel Putin.  At the time Putin was on his way to a third presidential term. Shortly after, on 6 March 2012, they were arrested and they have already spent half a year in prison. During the trial they were kept in a cabin with armoured glass and in handcuffs. You can see the full video of the sentence reading on many web sites, including here (in Russian), and a live text commentary on the Guardian.

The civil judge has sentenced them to two years hard labour. The significant part of the verdict is that they were found guilty of hooliganism motivated by religious hatred and the act of singing in the cathedral was classified as blasphemy.

Russian psychiatrists have had their say too. The verdict included a psychiatric assessment of these “criminals.” They were found to have a “mixed personality disorder” expressing itself in each of the three in different combinations of “active life positioning, as an aspiration to self-realization, a tendency to make categorical statements, diligence, low emotional sensitivity, a tendency to behave in a confrontational manner, high self-esteem, impulsive behaviour, and a tendency to suicidal blackmail.”

The wording was typical of that used during the Soviet era 25 years ago to send dissidents to psychiatric prisons for life. It is not an unexpected event. Since the end of the Soviet era the same psychiatrists have been misusing psychiatry for their political goals. They help to send journalists, non-professional bloggers, and political activists to asylums. The difference is that 25 years ago the people they sent to psychiatric prison were anti-Soviet, including religion activists. Now the people they send to prison are those who oppose Putin. Because Putin has formed a close alliance with the powerful Russian Orthodox church, and psychiatrists act on the side of the church. Russian psychiatry promotes the enforced testing of school children and university students to check for drug use and it enforces other scientifically unreasonable interventions in people’s social life by criminalizing a wide spectrum of behaviours.

After Perestroika, the World Psychiatric Association quickly changed its mind in relation to psychiatrists from the then USSR. They had been expelled earlier because of the misuse of psychiatry for political purposes. It was a pragmatic rush. Obviously Russian psychiatry continues to be mostly unchanged. It would be of great importance if colleagues in the World Psychiatric Association would try again to help Russian psychiatry. It is 26 years since the publication of the article “The debasing of medicine in the Soviet Union” by Caroline White in BMJ, but the need for  help from the international medical community to transform the outdated medical profession in Russia and other transitional countries is still enormous. It is not only the important, but secondary need for technical progress, but also the need for help with progress in the heart of the profession—its humanitarian content. Read this 26 year old comment and you will find that the old “pragmatic” arguments, like “do not support dissidents, because it irritates the Politburo” are in use today again.

Vasiliy Vlassov is a Professor of medicine at the Higher School of Economics, Moscow. His research interests are in epidemiology, evaluation of diagnostic tests, public health, and especially health care delivery with scarce resources. He is the co-founder and current president of the Russian Society for Evidence Based Medicine.