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to his home town of Tashkent in Uzbekistan. in late June, 1983 it was reported that he had been confined against his will to an ordinary psychiatric hospital in Tashkent under criminal procedures. During the investigation of his case, he reportedly refused to repudiate the remarks he had broadcast. It is not yet known precisely what criminal charge was brought against Danchev. Like hundreds of other Soviet citizens who have criticized official government policies and received publicity abroad, it is highly probable that he was charged with "anti-Soviet agitation and propaganda." THE SOVIET RESPONSE TO ALLEGATIONS OF POLITICAL ABUSE: DOMESTIC E INTERNATIONAL
The Working Commission to Investigate the Use of Psychiatry for Political Purposes. Much new evidence of the political abuse of psychiatry in the USSR has come to light in recent years. Most new evidence has become available through the work of individuals within the country who have reported on individual cases and practices of political abuse of psychiatry. in particular, the Working Commission to Investigate the Use of Psychiatry for Political Purposes, an unofficial group set up in Moscow in 1977 to investigate and publicize the Soviet practice of declaring dissenters to be insane and interning them in psychiatric hospitals against their will. By February, 1981 all six of the Working Commission's active members had been arrested and are now serving terms of up to 12 years imprisonment and internal exile on charges of "circulating anti-Soviet slander" and "antiSoviet agitation and propaganda."
The founder of this group, Alexander Podrabinek, is currently seriously ill in a labor camp in Northeastern Siberia, suffering from active tuberculosis, hepatitis, a heart condition, and severe under nourishment. All of these conditions are a result of this three years of internment in labor camps.
Another member of the now-defunct Working Commission, Dr. Anatoly Koryagin, himself a psychiatrist, is currently serving a seven year term of internment in a strict regime labor camp, which will be followed by five years of internal exile. One of Dr. Koryagin's "crimes" was his publication, in the British medical journal The Lancet (April 11, 1981, pp. 821-4), of the results of his psychiatric examination of 16 dissenters who had been forcibly interned in mental hospitals, or threatened with such internment. He found most of them completely healthy, and none of them in any need of
hospitalization. Amnesty International has also adopted all of the imprisoned · members of the Working Commission as Prisoners of Conscience.
World Psychiatric Association. Despite repeated denials by the Soviet authorities, their abuse of psychiatry was condemned in 1977 by both the World Federation of Mental Health, and, at its Sixth Congress, by the World Psychiatric Association (WPA). At this Congress, the WPA noted the "extensive evidence of the Soviet Union's systematic abuse of psychiatry" and set up a Committee to Review the Abuse of Psychiatry for Political Reasons.
Since that time, the Soviet All-Union Society of Psychiatrists and Neurologists (SSPN) has been asked several times under the WPA Review Committee's carefully drafted procedures to assist in investigation of complaints regarding the USSR. The SSPN has refused to recognize the Review Committee and has been uncooperative in complying with its requests. The Soviet authorities and spokesmen for the Soviet psychiatric profession have continued to dismiss allegations made by foreign psychiatrists and human rights organizations as politically-motivated "slander." in February, 1983 the All-Union Society resigned its membership of the WPA, five months before the Seventh Congress was due to meet in Vienna.
Amnesty International is deeply concerned about, and will continue to monitor and report on the abuse of psychiatry for political purposes in the Soviet Union.
Amnesty International regards those individuals forcibly confined to psychiatric institutions for political reasons, such as Vladimir Danchev and the individual members of the Working Commission, to be Prisoners of Conscience, and continues to seek the release of these and all other Prisoners of Conscience in the USSR.
An Amnesty International Briefing
Over many years Amnesty International has learned of cases in which
In a report published in 1975 called Prisoners of Conscience in the
The following briefing paper documents developments in the Soviet
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One of the subjects discussed at the Sixth Congress of the World Psychiatric Association held in Hawaii in August 1977 was the abuse of psychiatry for political purposes. Its General Assembly subsequently adopted the following resolution:
"That the World Psychiatric Association take note of the abuse of psychiatry for political purposes and that it condemn those practices in all countries where they occur and call upon the professional or ganizations of psychiatrists in those countries to renounce and expunge those practices from their country and that the WPA implement this resolution in the first instance in reference to the extensive evidence of the systematic abuse of psychiatry for political purposes in the USSR."
The week before, the World Federation of Mental Health had approved a similar position and drawn it to the attention of the WPA. At its Sixth Congress the WPA also decided to set up a Committee to Review the Abuse of Psychiatry for Political Reasons, for monitoring individual cases.
Despite this authoritative condemnation of the use of psychiatry for political purposes, the Soviet authorities have systematically continued to practice this abuse. Since August 1977 Amnesty International has learned of 110 people who have been forcibly confined to Soviet psychiatric institutions for indefinite periods, for political and not genuine medical reasons. Nineteen of these were confined under criminal procedures to special psychiatric hospitals, which constitute the most severe form of psychiatric detention and are intended for people who "represent a special danger to society." Most, however, were confined to ordinary psychiatric hospitals under civil (administrative) procedures, sometimes on more than one occasion during this period
According to official Soviet procedures individuals may be confined to a psychiatric hospital against their will only if they are mentally ill and an "evident danger" to themselves or to others. There is no evidence to suggest that any of the 110 individuals mentioned above represented a physical danger to themselves or to others at the time of their confinement or previously. Nor did their examining psychiatrists attempt to prove that they posed such a threat. In all cases the individual was confined after he or she had peacefully tried to exercise civil and political rights in a way disapproved of by the authorities. The figures given above do not include the many known prisoners of conscience who were put in psychiatric hospitals before
August 1977 and who in many cases remained confined after that date. Nor does it include cases on which Amnesty International regards the available information as insufficient to identify the person as a prisoner of conscience.
In a report published in May 1980 called Prisoners of Conscience in the USSR: Their Treatment and Conditions (2nd edition) Amnesty International analyzed Soviet official procedures for confining people to psychiatric hospitals against their will and concluded that they give inadequate protection against wrongful confinement. In particular they make it easy for dissenters to be confined arbitrarily and difficult for them to defend themselves through legal means. There has been no significant change in the procedures for compulsory confinement since then.
Much new evidence of the political abuse of psychiatry in the USSR has come to light since the WPA last met in 1977. A number of victims of the practice have emigrated, been met by foreign psychiatrists and given detailed accounts of their treatment. Other victims have been released from psychiatric hospitals and their accounts of their treatment have circulated in samizdat form. Several psy. chiatrists have emigrated from the USSR and have added information from their professional experience to what is known of the abuses. In 1978 a British psychiatrist, Dr. Gary Low-Beer, visited the USSR and personally examined at their own request nine people who feared that the authorities might intern, or reintern them in psychiatric hospitals against their will. In his conclusions, published in a report to the Royal College of Psychiatrists in the United Kingdom in May 1978, he said that he could find no medical justification for their forcible confinement.
Most new evidence, however, has come to light through the work of individuals within the country who have reported on individual cases and practices of political abuse of psychiatry. To the reporting of A Chronicle of Current Events has been added the prolific documentation of unofficial groups set up to monitor implementation of the 1975 Helsinki Final Act and in particular, the Working Commission to Investigate the Use of Psychiatry for Political Purposes, an unofficial group set up in Moscow in 1977. In its three year existence the group produced 24 Information Bulletins which documented more than 70 cases of the political abuse of psychiatry, and investigated 260 more. The scope and accuracy of the Commission's work was reinforced by the close help of two Moscow psychiatrists and a lawyer.
Since the Sixth Congress of the WPA met in August 1977 there has been little indication that the Soviet authorities have seriously investigated alleged abuses of psychiatry with a view to stamping out corrupt practices.
Individuals and members of unofficial groups within the country who have monitored cases of psychiatric abuse and attempted to publicize their findings have been imprisoned or otherwise persecuted. At the time of writing this paper, for example, 32 members of Helsinki monitoring groups are imprisoned or in internal exile in connection with their efforts to document human rights' abuses. Another one, the Lithuanian psychiatrist, Dr. Algirdas Statkevicius, is confined against his will to a special psy.
chiatric hospital. The unofficial Working Commission to Investigate the Use of Psychiatry for Political Purposes has also been a target for official suppression. By February 1981 all six of its active members including the psychiatrist Dr. Anatoly Koryagin, had been arrested. The six are now serving terms of up to 12 years' imprisonment and internal exile on charges of "circulating anti-Soviet slander" and "anti-Soviet agitation and propaganda" and Amnesty International has adopted them as prisoners of conscience.
Official Procedures for Confining Soviet Citizens to Psychiatric Hospitals
Against their Will
Two formal procedures are most commonly used to commit individuals to mental hospitals against their will: the civil and the criminal. There is also a third procedure whereby individuals convicted of a criminal offense may be transferred from their place of imprisonment to a psy. chiatric hospital.
Most of the 110 individuals forcibly confined since August 1977, whom Amnesty International has identified as prisoners of conscience, were confined under the civil procedure to ordinary psychiatric hospitals, sometimes on more than one occasion during this period. Nineteen were committed under the criminal procedure to special psychiatric hospitals, which constitute the more severe form of psychiatric detention and are intended for people who "represent a special danger to society."
The civil commitment procedure is applicable to people who have not committed criminal offenses. It is laid down in a directive called "On Emergency Confinement of Mentally II Persons who Represent a Social Danger," issued on August 26, 1971 by the USSR Ministry of Health. The text of this directive is not published in any easily available Soviet publication.
The directive states that mentally ill people may be confined to a psychiatric hospital without their permission or that of their family if they are in "evident danger" to themselves or to others. The police are authorized to assist with an emergency confinement if there is a "possibility": that the individual will resist, or if his or her family opposes confinement.
The directive lists a number of symptoms which are to serve as criteria for forcible confinement. This list has been
criticized by foreign psychiatrists and opponents of psychiatric abuse within the USSR because of the obscurity and lack of medical precision of the symptoms listed. The terms are so elastic as to cover almost any nonconformist behavior. The directive does not give even a rough explanation of what is meant by 'social danger." Moreover, it advises those applying the procedure that any of the listed conditions of mental illness "may be accompanied by externally correct behavior and dissimulation." This gives added scope for the wrongful confinement of peaceful citizens.
According to this procedure the doctor who first orders the confinement must send a report to the psychaitric hospital, and within one day of being confined the individual must be examined by a commission of three psychiatrists who decide whether the confinement should be prolonged. On being discharged the released person must be put on a "special list" and receive "systematic preventive treatment" from the local psychiatric dispensary.
Violations of these regulations are common. Frequently the relatives of the confined person have not been informed within 24 hours of what has happened. Often the individuals have been confined after being picked up in the strert or at their place of work, without first being examined by a psychiatrist. In many cases dissenters have not been examined by a psychiatric commission within one day of being detained; in a number of cases they have not had any psychiatric examination at all.
Neither the courts nor any other judicial agency is involved in the civil commitment procedure. The regulations do not indicate any right of the confined person to have ac