HAROLD VISOTSKY, M.D., CHAIRMAN, COMMITTEE ON INTERNATIONAL ABUSE OF PSYCHIATRY AND PSYCHIATRISTS, AMERICAN PSYCHIATRIC ASSOCIATION, AND DIRECTOR, INSTITUTE OF PSYCHIATRY, NORTHWESTERN UNIVERSITY Mr. Chairman and Members of the Subcommittee on Human The American Psychiatric Association represents 28,000 psychiatrists from the United States and abroad and has for years expressed its opposition to the abuse of psychiatry wherever it may occur. The APA has a Committee on International Abuse of Psychiatry and Psychiatrists, which I presently Chair, as well as a Committee on Abuse and Misuse of Psychiatry in the United States, which deals with any complaints brought forth relating to this country. Both of these committees review cases of alleged abuse of psychiatry in a number of different countries, but the overwhelming majority of cases which are sent to us relate to the Soviet Union. Other individuals presenting testimony today will inform you of the grim facts of this systematic form of abuse of our profession in the Soviet Union. I would, however, like to focus on the actions taken by the American Psychiatric Association and the results of these actions. The APA Committee on International Abuse of Psychiatry and Psychiatrists has written hundreds of letters to the Soviet Union on behalf of certain individuals. We have written to authorities of the Soviet government and to patients themselves. We have written to the families of patients and to psychiatrists who are treating these patients. Never have we received a response from the authorities, and only indirectly do we hear from the families of patients. In addition, the APA Board of Trustees referred over 20 cases to the World Psychiatric Association for further investigation by their Committee to Review Alleged Abuses of Psychiatry for Political Purposes. A number of these cases were sent to the All Union Society of Psychiatrists and Neuropathologists of the USSR for clarification and response. When months and months went by and the WPA had received no response from our Soviet colleagues, the APA, as well as a number of other psychiatric associations around the world,. passed a resolution stating that: "If the All Union Society of Neuropathologists and Psychiatrists of the USSR does not adequately respond to inquiries by the World Psychiatric Association on cases of alleged abuse of psychiatry by April 1, 1983, the All Union Society should be suspended from membership in the World Psychiatric Association until such time that these abuses come to an end." The Royal College of Psychiatrists in Great Britain as well as other societies passed a stronger resolution indicating that the All Union Society should be expelled from the World Psychiatric Association. These resolutions were to be voted on at the General Assembly of the World Psychiatric Association which met in July, 1983 at the time of the VII World Congress of Psychiatry. In the meantime, the All Union Society of the USSR did begin responding to cases, having submitted histories on 7 cases in all to the WPA. There was discussion between the Chairman of the All Union Society and the officials of the World Psychiatric Association about the possibility of a multi-national delegation visiting the Soviet Union to discuss these issues more fully. There were a number of details to be worked out about this trip but our Soviet colleagues indicated that they would contact the Ministry of Health regarding visas for this delegation. These discussions were abruptly cut off during a meeting in January, 1983, when the Soviet psychiatrists were called back to Moscow. A few days thereafter, the All Union Society resigned from the World Psychiatric Association claiming that the organization had become too political. (A copy of the letter of resignation of the All Union Society is attached, as well as the APA's response.) The American Psychiatric Association has been working with other organizations in the hope of bringing enough collective pressure to bear to end this practice of using psychiatry to suppress dissent in the Soviet Union. Our efforts with the U.S. State Department resulted in the All Union Society stating that "a U.S. government body is actively interfering in the work of national non-governmental organizations, and indirectly, in the work of the World Psychiatric Association." The General Assembly of the World Psychiatric Association addressed the issue of alleged abuse of psychiatry in the Soviet Union by passing (174 votes for, 18 against, 27 abstentions) a resolution put forward by the President of the Royal College of Psychiatrists of Great Britain which stated: "The World Psychiatric Association would welcome the return of the All Union Society of Neuropathologists and Psychiatrists of the USSR to membership in the Association, but would expect sincere cooperation beforehand of amelioration of the political abuse of psychiatry in the Soviet Union." In addition, the General Assembly passed a resolution making Dr. Anatoly Koryagin an Honorary Individual Member of the WPA for "demonstrating in his struggle against the perversion of psychiatry for non-medical purposes, professional conscience, courage and devotion to duty, all in exceptional measure." Dr. Koryagin has been imprisoned since February 13, 1981 for speaking out against the practice of the use of psychiatry for political purposes in the Soviet Union. We do regret that the All Union Society of Neuropathologists and Psychiatrists of the USSR has resigned from the World Psychiatric Association and that the societies of Czechoslovakia, Bulgaria and Cuba have followed them. I believe that we have lost a valuable means, through the World Psychiatric Association, of helping concerned psychiatrists within those nations seek reforms in the use of their profession. It is my hope and the hope of the American Psychiatric Association that a way will be found to continue discussions with our colleagues in those countries. However, we cannot continue to collaborate with the Soviet Society until there is acknowledgement that abuses have occurred, that they are being corrected, and that our fellow psychiatrists who have dared to speak out against these abuses are no longer themselves being persecuted. The American Psychiatric Association will continue to speak out against these practices as long as they occur and will continue to take whatever actions possible on behalf... of the victims of psychiatric abuse as well as those who have been persecuted for their actions in this regard in the Soviet Union and elsewhere. The American Psychiatric Association appreciates the opportunity to testify before this distinguished committee and I will be happy to answer any questions. Harald Visitsdy, M.D. Haroid Visotsky, M.D. Chairperson, APA Committee on Psychiatry and Psychiatrists June 23, 1983 Prof. G. V. Morozov Chairman of the Board All Union Society of Psychiatrists and Neuropathologists c/o General and Forensic Psychiatry Institute of the USSR (Serbskil Institute) 'Kropotinskii per 23 Moscow 119034/USSR Dear Professor Morozov: The American Psychiatric Association is aware of the resignation of the All Union Society of Psychiatrists and Neuropathologists of the USSR from. the World Psychiatric' Association. The All Union Society is also aware of the continuing concern of allegations of the abuse of psychiatry in your country. We do, however, regret that the situation has deteriorated to the extent that your Society felt the need to resign from the World Psychiatric Association, rather than to use the opportunity for dialogue and exploration for understanding. In your letter of resignation,, you mentioned the August 1, 1982 letter from the American Psychiatric Association to the member societies of the World Psychiatric Association. There are several issues which I will address at: this time: First of all, the APA notified all member societies of the WPA of the resolutions • regarding your Society. Secondly, the APA notified the member societies of a Forum to be held in Vienna at the World Congress to discuss these issues. It was our hope that your Society would be represented at this Forum where you could have had an opportunity to openly address the complaints made against certain alleged practices and against some of your colleagues. In addition, there was information given about a possible resolution going before the United Nations Human Rights Commission on the issue of the misuse of mental institutions to control dissent. You should note, however, that your country was not mentioned in any statement regarding this particular issue in any comment by the APA or in any of the background information on the UN Commission on Human Rights. The American Psychiatric Association was pleased to learn of your responses which were sent to the World Psychiatric Association to cases which were referred by the WPA leadership. We had hoped that this was the beginning of a dialogue on these issues leading to a better understanding. You will recall that the APA resolution stated that: "If the All Union Society of Psychiatrists and Neurolopathologists of the USSR does not adequately respond to all inquiries from the WPA regarding the issues of psychiatric abuse by April 1, 1983...." was a conditioned one which you were apparently prepared to meet at that time. You mentioned.possible abuses in other countries and the APA wishes to respond with the information that we have submitted Information and made inquiries into allegations in other countries, in addition to those in the USSR. The difference is that the cases presented to the APA from other countries were less in number and, in addition, we have received responses from these other countries. The APA is careful to investigate any allegations of abuse in the United States and would be cooperative in replying to requests of this sort. The American Psychiatric Association is on record as being opposed to the use of psychiatry for political purposes wherever it may occur. We believe that issues of ethics should be of vital concern to any scientific organization. We further agree that the profession of psychiatry and any organization representing this profession should take an active stance on ethical issues in order to "promote the advance of psychiatric science,. improve the system of organizing aid for the population," as mentioned in your letter of resignation. We hope that Soviet psychiatry would not be opposed to this stance. Your letter accused the World Psychiatric Association of becoming involved in outright political activity and that the APA has contributed to the politicizing of the WPA. If psychiatry were not being used for political purposes, this would not have occurred. It is our opinion that the resignation of the All Union Society in the face of criticism by colleagues regarding the use of psychiatry for political purposes, seems to be a political move in itself. Psychiatric science would have been more advanced by the All Union Society taking -part in discussion, with a possible change of practices or elaboration of new practices. It is on this basis that we negate your statement that it is the APA that is politicizing the WPA. In closing, I will say that we do hope that it will be possible someday for all countries to be members of the World Psychiatric Association. |