Has Russian punitive psychiatry returned? The authors of a new report on compulsory treatment in psychiatric hospitals say today’s practices are less systematic than in the Soviet era but still brutal.
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Since 2022, the Russian human rights and legal aid group OVD-Info has counted at least 84 defendants in politically motivated cases ordered into compulsory psychiatric treatment. Researchers at the human rights project APUS spent two years documenting how people are committed to compulsory treatment — interviewing prisoners held in psychiatric wards, their lawyers, psychiatrists, and former prison-service staff. Their findings appear in a report titled “You’re Not Getting Out of Here.” Meduza asked two of the study’s authors: has the Soviet system of punitive psychiatry returned to Russia? Both women spoke under pseudonyms; here they are called Olga and Arina.
“As a system, punitive psychiatry ceased to exist along with the Soviet Union,” Olga says. What survives is narrower and less coordinated — particular cases rather than the old “conveyor belt” that once processed dissidents wholesale. The people APUS interviewed described doctors working from defendants’ existing medical histories rather than inventing diagnoses like “sluggish schizophrenia,” a label routinely applied to Soviet dissidents. And the Russian state, Olga notes, has no need to declare every critic insane when it has prison terms, fines, and “foreign agent” designations at the ready.
For example, the human rights activist Oleg Orlov was not sent for treatment even after a prosecutor requested it. Since Russia’s full-scale invasion of Ukraine, the only prominent public figure ordered into psychiatric treatment was the formerly pro-Kremlin blogger Ilya Remeslo, who wasn’t taken by force or held long. Punitive psychiatry should have clear markers, Arina says — nonexistent diagnoses, forced hospitalization, the deliberate targeting of prominent critics — and Russia, she says, isn’t displaying any of them.
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The “You’re Not Getting Out of Here” report documents enormous cruelty and abuse in Russia’s psychiatric wards — where mental illness itself is treated as a mark of shame — and attributes the problems to institutional bad habits more than “orders from above.” In cases involving a defendant’s mental health, it is state investigators, not doctors, who often set things in motion. “The harshness of a convict’s treatment is often set by security officials, not doctors,” Olga says. “The investigator comes in and explains how he’d like the person held.” When prisoners challenge these requests or the expert assessments of their sanity, they risk those very appeals becoming evidence of their own mental unfitness. “If the state’s aim were to frighten people, the old punitive psychiatry — with its made-up diagnoses — really would have come back,” Arina says.
Olga describes compulsory treatment as one of the instruments the state uses against dissent. The rights workers she knows, she says, have stopped reading these cases as scattered incidents and started treating them as a steady pattern. Arina is more cautious about what the numbers mean. “I think it’s simply tied to the growth in political cases,” she says. “If there are more political charges, and more prosecutions under them, the number of people sent for psychiatric evaluation or compulsory treatment can grow too.” Both note how little can be confirmed: independent researchers can’t get into the wards, and inmates’ medical files are sealed.
So has the Soviet system come back? Neither Olga nor Arina says yes: the invented diagnoses are gone, and a critic is easier to silence with a prison term than a hospital bed. And yet compulsory treatment carries no end date — it’s done only when a medical commission decides a patient has improved. In the institutions APUS documented, restraints and forced sedation are routine, and fellow inmates serve as orderlies who beat the people in their care. “A person with a mental illness is treated badly as it is,” Olga says, “and if he’s a convict on top of that, it’s as though he isn’t a person at all.”
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