retention of patients on psychiatric out-patient lists "constitute a real treat to their individual rights." After his article was published abroad Dr. Kazanets was dismissed from his post at the Serbsky Institute. His article is not known to have been published officially in the Soviet Union.

By far the most prolific new evidence of political abuse of psychiatry has come from individuals within the USSR concerned with the protection of human rights. Since 1977 the reporting of A Chronicle of Current Events and individual human rights' activists has been supplemented by detailed documentation produced by the Working Commission to Investigate the Use of Psychiatry for Political Purposes, formed in January 1977. The Working Commission was set up as a branch of the unofficial Moscow Helsinki monitoring group, and had as one of its founding members Alexander Podrabinek, who was then a 23-yearold medical assistant in Moscow's public ambulance service. (The ambulance service frequently carries out forcible confinements under civil procedures.) Before joining the Commission Mr. Podrabinek had made a three-year independent study of allegations of psychiatric abuse, in the course of which he traveled to psychiatric hospitals in various republics of the Soviet Union, interviewed staff and spoke with former patients. Part of his study was confiscated by KGB officials in March 1977, but the remainder was published in samizdat form in May 1977 under the title Punitive Medicine. The book, which is 265 pages long, is based on material collected from more than 200 victims of psychiatric abuse, confined for political rather than genuine medical reasons since the 1950's. It also includes a "Black List" of 102 Soviet doctors whom the author said had participated in psychiatric abuse, and analyzes aspects of the official confinement procedures which facilitate abuse.

The other founding members of the Working Commission were Vyacheslav Bakhmin, a computer specialist; Dr. Leonard Ternovsky, a radiologist at Moscow's Sechonov Clinic; Felix Serebrov, a skilled metal-worker; and two long-standing campaigners against the abuse of human rights: Irina Kaplun (the wife of Vladimir Borisov, whose repeated confinements are mentioned above), and Dzhemma Babich from Leningrad. Within a year of its formation Irina Kaplun and Dzhemma Babich left the group. In 1980, another computer specialist from Moscow, Irina Grivnina, joined it.

The group outlined its threefold task as follows:
1."To publicize those cases where people are
wrongfully confined in mental hospitals against their
will, and to aid their speedy release.

2. To give help to people wrongfully put into mental hospitals and also to their families.

3. To assist in the general humanization of conditions for people in psychiatric hospitals."

The group explained further:

"Here it is necessary to emphasize that the Commission does not claim that all the people whose release it is seeking have no psychic abnormalities and are completely healthy. (Working Commission's own emphasis-AI). The important thing is that they are in psychiatric hospitals for ideological reasons and not on the basis of medical evidence. The Commission considers complusory confinement and forcible treatment as justified only in regard to people who have committed aggressive acts, or ill people whose psychic condition gives grounds for a doctor to presume they may commit acts dangerous to themselves or to others."

The Working Commission aims were stated in their Information Bulletin Number 9 (dated June 9, 1978). In its three years' existence the group produced 24 of these Information Bulletins, consisting of over 700 pages, in which they chronicled the cases of over 70 victims of psychiatric abuse; reporting 260 further allegations of political abuse of psychiatry and highlighted the procedures involved in the punitive use of psychiatry. The group also wrote appeals to Soviet officials on behalf of individual people who had been confined, and published letters and accounts of their confinement written by victims who had been released. Friends and relatives of victims came frequently to Moscow to inform members of the Commission about individual cases, and the Commission's members supplemented this flow of information by trips to the provinces and visits to hospitals and courtrooms, in order to obtain information on the spot.

The scope and accuracy of the research carried out by the Working Commission was strengthened by the close collaboration of the psychiatrists, Dr. Alexander Voloshanovich and Dr. Anatoly Koryagin, and also of a lawyer, Sofia Kalistratova. Sofia Kalistratova, who is now 75-years-old, was also a member of the now defunct Moscow Helsinki monitoring group. In the 1960's and early 1970's she acted as defense counsel in numerous political trials, and in 1970 defended Major General Grigorenko and the poet Natalya Gorbanevskaya at two separate trials. Both were subsequently confined to psychiatric hospitals against their will.

Since August 1977 Amnesty International has learned of 110 persons who have been put in Soviet psychiatric hospitals against their will, in the absence of any evidence that they were dangerous or posed a physical threat to themselves or to others. The common feature of their forcible confinement is the direct link between their exercise of human rights and the official decision to put them in a mental hospital. In many cases they were forcibly confined only after the authorities had tried to stop their activities by other means. Often their peaceful attempts to exercise their rights were in themselves officially interpreted by psychiatrists as symptoms of mental illness. Amnesty International regards these people as prisoners of conscience.

The following is a sample of the activities which led to their forcible confinement: renouncing Soviet citizenship (Mikhail Berozashvili, 1980); sending one's passport to President Brezhnev in protest against official emigration procedures (Mikhail Utemov, 1981); holding a placard in Red Square, saying "I demand the right to emigrate" (Zita Salaseviciute, 1981); trying to cross the border out of the USSR without permission (Gerhard Buterus, 1979); arranging to meet a Swedish journalist (Yury Ternopolsky, 1981); preaching about the national tradition of the Estonian Church (the pastor Vello Salum, 1981); distributing religious leaflets (the Seventh Day Adventist Anna Lapaeva, 1980); complaining to high officials about the standard of medical treatment given to her for chronic nephritis (Sita Kirsnauskaite, 1978); joining an unofficial Helsinki monitoring group (the Lithuanian psychiatrist Dr. Algirdas Statkevicius, 1980).

In some cases individuals who were known to have expressed dissenting views were put into mental hospitals for the duration of important public occasions. One such occasion was the staging of the Olympic Games in Moscow in the summer of 1980. Shortly before foreign visitors arrived to attend the Games in July, at least 10 known dissenters were forcibly confined to ordinary psychiatric hospitals for brief periods under civil procedures. All were released shortly after the Games were over. They included Valentin Smirnov, a nonconformist artist, who was put in Leningrad ordinary psychiatric hospital No. 5 on June 1, 1980 half an hour before an unofficial exhibition of his paintings opened, and Oksana Meshko, a 77-year-old member of the unofficial Ukrainian Helsinki monitoring group, and the mother of a former prisoner of conscience Olek

sander Serhiyenko. Although she had no history of mental illness Oksana Meshko was forcibly confined to the psychiatric wing of a prison in the Ukrainian capital of Kiev on June 12, 1980 and told she would undergo "two months' examination." She was ruled to be responsible for her actions and released in September. One month later she was arrested on a charge of “anti-Soviet agitation and propaganda" and is now serving a five year sentence of internal exile.

Other prisoners of conscience already in psychiatric institutions had their confinement prolonged until after the Games were over. One such was the Ukrainian Dr. Mykola Plakhotnyuk. He was arrested in Kiev in January 1979 on a charge of "anti-Soviet agitation and propaganda" after he had written three open letters to high officials calling for the release of prominent Ukrainian prisoners of conscience who had recently been arrested. Psychiatrists diagnosed him as suffering from "schizophrenia and delusions of persecution" and for six years he was forcibly confined to special psychiatric hospitals. In 1978 he was transferred to an ordinary psychiatric hospital in the Ukrainian town of Smela, where at a regular examination in early 1979 doctors told him that "until the Olympic Games have taken place, there can be no rush [to discharge you]." Dr. Plakhotnyuk was released in December 1980.

A simple indication of how psychiatric diagnoses have been used for political persecution is that often when Soviet citizens have associated together in activities which, though not illegal, were not approved of by the authorities, several of the participants have been officially diagnosed as mentally ill and forcibly confined to psychiatric hospitals as though the group's participants were mentally ill en masse. The following are cases in point:

In autumn 1978 an unofficial trade union grouping called "SMOT" was formed in Moscow. Within three weeks one of its founding members Valeria Novodvorskaya, was taken from her place of work and put in a psychiatric hospital. Since then, four more members have been confined under the civil procedure: Vladimir Borisov, Vladimir Gershuni, Alexander Vorona and Mikhail Zotov. (Four others were arrested, tried and sentenced to imprisonment or internal exile. Another five are currently awaiting trial.)

In October 1978 a commune of socialists calling itself

the "Left Opposition Group" arranged to hold an unofficial youth congress in Leningrad. Three of the group's members were arrested, two of whom were sent for psychiatric examination. Arkady Tsurkov was ruled accountable for his actions and was later sentenced to seven years' imprisonment and internal exile for "anti-Soviet agitation and propaganda." The leader of the group, Alexander Skobov, was ordered to be forcibly confined in a special psychiatric hospital.

In November 1978 Valdislav Bebko, a student, was arrested in Kuibyshev and charged with tearing down an of ficial poster celebrating the October Revolution. He was later charged with "anti-Soviet slander" as well, after police confiscated tape recordings of foreign radio broadcasts and documents of the Czechoslovak human rights' group Charter 77. In March 1979 a court ordered him sent for an in-patient psychiatric examination. Later in the same month Anatoly Sarbayev and Viktor Ryshov, two of Bebko's associates who had appeared as witnesses at the court hearing, were also confined to psychiatric hospitals in Kuibyshev.

In December 1981 two Estonian workers, Alar Kume and Jaanus Pihelgas, were arrested while attempting to cross the Soviet border into Norway without official permission. Both men were subsequently ruled mentally ill and ordered to be confined to Leningrad special psychiatric hospital.

Unofficial human rights' groups in the USSR and former victims of psychiatric abuse have repeatedly complained that prisoners of conscience are exposed to harmful conditions when they are confined in psychiatric hospitals. Some are reported to have been treated with powerful neuroleptic drugs; in particular haloperidol, aminazin, and triftazin. In some cases these drugs have been given in excessive quantities without the necessary correctives and in disregard of contraindications in the patient. In 1980 Vladimir Tsurikov, a 35-year-old worker from Krasnoyarsk, circulated an account of his treatment in psychiatric hospital. Mr. Tsurikov said that he was treated with two tablets of triftazin and aminazin three times a day, as well as five injections of sulfazin, after he was committed under

the civil procedure to Krasnoyarsk ordinary psychiatric hospital in 1980, allegedly suffering from "emigrational delusions." Vladimir Tsurikov has been applying unsuccesfully to emigrate since 1974. After officials failed to persuade him to withdraw his application he was forcibly confined to Krasnoyarsk ordinary psychiatric hospital for three months of that year and reportedly treated with insulin, aminazin and sulfazin. In February 1979 he was reconfined for two-and-a-half months after he had proposed Academician Andrei Sakharov as a candidate for the Supreme Soviet. On his release he underwent a voluntary psychiatric examination by Dr. Voloshanovich and Dr. Koryagin of the unofficial Working Commission to Investigate the Use of Psychiatry for Political Purposes. Both doctors concluded that he was not in need of compulsory confinement. Nevertheless he was reconfined in the summer of 1980 in connection with his peaceful attempts to emigrate and was released on August 4, 1980, the day after the Olympic Games ended. He has described the treatment he received during his third confinement as follows:

"The triftazin made me writhe, and my legs began to twist about in a ridiculous way. I lost the ability to walk, while simultaneously feeling very restive and also feeling sharp pains in my buttocks at any movement—a result of the sulfazin. Fainting fits began, recurring very often: I fell and hit my head on the floor and on the brick walls. The pain prevented me from sleeping or eating. The sulfazin made my temperature rise, and it then stayed around 40 degrees centigrade. Sometimes I experienced slight shivering and my; tongue hung out... This nightmare lasted a week, until I was invited to chat with some medical students. I couldn't walk, so I was carried. In the auditorium it turned out that I couldn't move my tongue. I was taken back and they began to give me anti-Parkinsonian drugs, which made me feel a bit better. I was still suffering from the sulfazin, and I had got much thinner, but at the next meeting with the students I was able to talk with them."

Some doctors are also reported to have administered drugs to prisoners of conscience in psychiatric hospitals as a form of punishment. For example, in December 1979 after a foreign radio station had publicized the case of 44-year-old Ivan Kareish who was forcibly confined in November 1979 after he had complained to high officials about his dismissal from work in a collective farm, doctors in Vitebsk Regional Psychiatric hospital reportedly subjected him to an intensive course of injections with neuroleptic drugs for a week. Other forms of punishment have included insulin-shock therapy and various forms of fixation and immobilization. Some prisoners of conscience are reported to have been subjected to beatings, often severe ones. Reports of this form of punishment most often relate to special psychiatric hospitals, where convicted criminals serve as ward orderlies. In autumn 1980, for instance, Nikolai Baranov was incapacitated and confined to his bed for two months after a beating he received from hospital staff in Alma-Ata special psychiatric hospital. Nikolai Baranov, who is now in his forties, is a worker from Leningrad. He has been forcibly confined to special psychiatric hospitals for 14 years since he was arrested in 1968 on a charge of "anti-Soviet agitation and propaganda" in connection with an appeal he wrote to the Swedish embassy, asking for help to emigrate.

Soviet prisoners of conscience are also known to have been pressured by psychiatrists to renounce their beliefs as a condition for their release. In early 1979, for instance, doctors promised to transfer Voldemaras Karoliunas from Chernyakhovsk special psychiatric hospital to a less severe form of confinement in an ordinary psychiatric hospital. This transfer, however, did not take place. Doctors told his relatives that they were not satisfied with his behavior, since Karoliunas, a Lithuanian Catholic, "is always praying and says he will live as God wants him to."

In 1980 Amnesty International received information that patients in Section 4 of the special psychiatric hospital in Chernyakhovsk had staged a revolt against medical staff. They were reportedly protesting against their treatment with heavy doses of neuroleptic drugs. The patients are said to have seized members of the staff as hostages and barricaded themselves in a block. They released the hostages after a psychiatrist, Colonel Rybkin, had promised to investigate their complaints. Hospital orderlies are then reported to have burst into the block and beaten the

patients as a result of which one patient lost an eye. Amnesty International knows of a number of prisoners of conscience who are confined in Chernyakhovsk special psychiatric hospital. None is reported to have been involved in the revolt.

Since 1977, as before then, the Soviet authorities have imprisoned many people for the nonviolent exercise of their human rights. Between October 1979 and October 1981 alone more than 500 Soviet citizens are known by Amnesty International to have been arrested in connection with the peaceful exercise of their human rights. A significant number of these prisoners of conscience were individuals who had independently monitored violations of human rights in their country and attempted to publicize their findings. At the time of writing this paper, for example, 32 members of unofficial Helsinki monitoring groups are currently serving terms of imprisonment or internal exile on account of these activities. Another one, the pyschiatrist Dr. Algirdas Statkevicius who is a member of the Lithuanian Helsinki monitoring group, has been forcibly confined to Chernyakhovsk special psychiatric hospital since February 1980. In September 1982 the Moscow Helsinki monitoring group announced that it was closing down, explaining this by the arrests of so many of its members.

Among the targets of arrests have been individuals and groups who have specifically highlighted the continuing use of psychiatry for political purposes, which was condemned by the World Psychiatric Association in 1977. The unofficial Working Commission in Moscow, for example, became a target of official persecution within one month of its formation. In February 1977 one of its founding members, 52-year-old Felix Serebrov, was demoted from his job as a skilled lathe operator at the "Rassvet" factory. In April of that year he was informed that a criminal charge had been brought against him in connection with an alleged forgery in his workbook. He was tried in October and sentenced to one year's imprisonment under Article 196 of the RSFSR Criminal Code. The evidence available on his case indicates clearly that the charge against him was fabricated and that Felix Serebrov was imprisoned in connection with his involvement with the Working Commission. Amnesty International therefore adopted him as a prisoner of conscience.

The official harassment and arrest of the other members of the Working Commission swiftly followed Felix Sere

brov's first imprisonment. In March 1977 KGB officials searched the Moscow flat of Alexander Podrabinek, another of the group's founding members, and confiscated the manuscript of his book Punitive Medicine. Nevertheless an incomplete version of the manuscript was sent abroad in the summer of that year, which included a postscript by Mr. Podrabinek, calling on the Sixth Congress of the WPA to establish an international committee to investigate individual cases of political abuse of psychiatry. In May 1978 Alexander Podrabinek was arrested in connection with circulating this manuscript, and was charged with "circulating anti-Soviet slander." In August of that year a Moscow court sentenced him to five years' internal exile.

He began his sentence in the Irkutsk region of eastern Siberia before being transferred in 1979 to Krasnoyarsk Autonomous Republic. While in internal exile he continued his work for the Commission, contributing appeals on behalf of individual prisoners of conscience confined in psychiatric hospitals against their will, and in November 1979 writing to the Minister of Internal Affairs for the USSR to ask that patients in special psychiatric hospitals be paid for their work at rates in keeping with the provisions of the Constitution of the USSR. In June 1980 Alexander Podrabinek was re-arrested in internal exile, once again on a charge of "circulating anti-Soviet slander." In January 1981 a court sentenced him to a further three years' imprisonment in a corrective labor colony. Mr. Podrabinek is now confined in a corrective labor colony in the Yakutsk ASSR, and is reported to be suffering from active tuberculosis, rheumatism and a heart complaint. In June 1982 he was hospitalized, but against doctors' advice, he was once again returned to the camp in October. Alexander Podrabinek is now 29-years-old.

In 1980 two more founding members of the Working Commission were arrested. They were Vyacheslav Bakhmin, a 34-year-old computer programmer and editor of the Information Bulletins, and Dr. Leonard Ternovsky, a 49-year-old radiologist. Both men were charged with "circulating anti-Soviet slander" and were subsequently given the maximum sentence of three years' imprisonment in a corrective labor colony by a court in Moscow. Vyacheslav Bakhmin is serving his sentence in the Tomsk region of the Russian Republic and Dr. Leonard Ternovsky is imprisoned at Omsk.

Following the arrest of Vyacheslav Bakhmin in February 1980, his place on the Working Commission was taken by another computer programmer, 35-year-old Irina Grivnina, who had assisted the group informally since 1978. Six months after she joined the group Irina Grivnina was herself arrested, also on a charge of "circulating anti-Soviet slander." During her six months' participation, she helped prepare Information Bulletins Nos. 21, 22 and 23, which reported on a total of 34 cases of psychiatric abuse and investigated seven more. Miss Grivnina's arrest in September 1980 followed a search of her apartment during which materials relating to the Working Commission were confiscated.

Irina Grivnina was held in investigative detention in Moscow's Butyrka prison for ten months, although the maximum period of detention without trial permitted in the RSFSR Code of Criminal Procedure is nine months. At her trial in July 1981 she was sentenced to five years' internal exile, a sentence she is serving in the Central Asian Republic of Kazakhstan. A report of her trial by the official Soviet news agency TASS accused her of preparing "deliberately mendacious fabrications" which she "processed in a slanderous spirit for use by anti-Soviet publishers and the imperialist propaganda media in ideological sabotage against the Soviet Union."

Three days after Irina Grivnina's arrest, Dr. Anatoly Koryagin, a consultant psychiatrist to the Working Commission, gave a press conference in Moscow, in which he defended her work and pointed to continuing psychiatric abuse. At the conference he announced the conclusions of his personal examinations of 15 former victims of psychiatric abuse, all of whom he considered had been confined for political and not genuine medical reasons. In December 1980 one of the individuals he had examined, the 44-year-old Donbass miner Alexei Nikitin, was rearrested in the Ukrainian city of Donetsk, after he had met with foreign journalists to discuss working conditions in Soviet mines, and the attitudes of Soviet workers to events in Poland. He was ruled not-responsible for his actions and is now confined to Alma-Ata special psychiatric hospital for an indefinite period. At a second press conference in Moscow, held in January 1981, Dr. Anatoly Koryagin spoke out against Nikitin's wrongful confinement. The following month Dr. Koryagin was himself arrested on a charge of "anti-Soviet agitation and propaganda." In June 1981 he was tried and given the maximum sentence of 12 years' imprisonment and internal exile. He was sent to serve the first part of his sentence in a corrective labor colony in the Perm region. While he was there he sent out of the camp an open letter appealing for "people of good will" to help victims of the political abuse of psychiatry. In July 1982 he was officially stripped of his doctoral research degree and transferred from the corrective labor colony to a prison in Chistopol, in the Tatar Autonomous Republic. Prison is the harshest form of corrective labor institution authorized by the Corrective Labor Code of the RSFSR.

After his release in August 1978 Felix Serebrov had resumed his work for the Commission, and on February 15, 1979 he issued a successful protest against the restrictions on correspondence imposed on persons held in the Serbsky Institute of Forensic Psychiatry in Moscow. By late September 1980 he was the only formal member of the Working Commission still at liberty. He collected and issued in samizdat the group's last document-Information Bulletin No. 24-which documented 16 cases of psychiatric abuse and reported on a further 14 allegations of abuse. On January 8, 1981 Felix Serebrov was himself arrested on a charge of "anti-Soviet agitation and propaganda." He was subsequently sentenced to a total of nine years' imprisonment and internal exile. He is currently serving the first part of his sentence in a labor colony in the Perm region near the Ural mountains.