Russia’s psychiatric homes are a ‘meat grinder’ that swallows tens of thousands. A small band of volunteers is pulling art — and artists — back out.

Tens of thousands of Russians with psychiatric diagnoses are currently confined in state institutions, the majority of them declared legally incompetent, denied basic rights, and subjected to conditions that charity workers describe as a “meat grinder.” Within a state system designed for isolation, a small number of these residents have achieved acclaim as artists. A recent feature by the independent media outlet The New Tab chronicles the lives of creators like Alexey Sakhnov and Alexander Lobanov, illustrating how dedicated volunteers and NGOs are carving out space for creative freedom within a punitive infrastructure that has largely resisted reform. Meduza examines The New Tab’s findings.

You’re currently reading Meduza, the world’s largest independent Russian news outlet. Every day, we bring you essential coverage from Russia and beyond. Explore our reporting here and follow us wherever you get your news.

The cardboard architect

Alexey Sakhnov communicates through a unique, personal sign language. At 18, he was placed in Peterhof Neuro-Psychiatric Home No. 3, entering Russia’s vast, anonymous system of state care. But instead of vanishing into that void, he became a celebrated artist whose work is exhibited far beyond the walls of his institution.

Sakhnov’s medium is cardboard. For years, he constructed intricate, multi-story houses from scrap materials. Initially, staff treated these creations as trash, but as the concept of “outsider art” gained traction in Russia, curators began to preserve his work, seeing not just craft but a sophisticated architectural vision.

His journey from what’s known as a “closed” patient to a traveling artist was grueling. Seven years ago, Sakhnov was barely allowed to leave the psychiatric home’s grounds. Today, he travels to art residencies, the result of more than a decade of painstaking advocacy by the charity Perspectives — work that required “ultrasonic delicacy.” Administrators initially viewed Sakhnov’s trips with suspicion, unable to comprehend why a ward of the state should be taken to a seaside resort simply to “make art.” His creative freedom remains a rare exception within an infrastructure designed for containment rather than expression.

A castle fit for Kafka

Olga Fominykh, founder of the Outsiderville project, describes Russia’s neuro-psychiatric homes as “Kafkaesque castles” where one department might offer progressive rehabilitation even as a neighboring wing neglects patients to the point of death.

The structural resistance to change is immense. Last year, federal lawmakers rejected a bill on “distributed guardianship” that would have allowed NGOs to share legal responsibility for institutionalized residents. Though the legislation failed, the advocacy campaign at least opened a crack in the system, helping to normalize the presence of volunteers at some psychiatric homes.

But the administrative staff’s monopoly on power at these facilities remains a major safety concern. In 2023, seven residents died of “exhaustion-related causes” at a care home in St. Petersburg. The tragedy sparked a brief public outcry, but the state’s response was defensive: the Russian Senate passed amendments that eliminated the requirement for independent patient protection services. “You basically have to be willing to toss your own ethics out the window sometimes just to get things done,” Fominykh told The New Tab, describing negotiations with facility administrators. “Honestly, most people couldn’t handle it.”

‘Hunter shoots the forest’

If Sakhnov is the contemporary face of this struggle for creative freedom, Alexander Lobanov is its founding legend. Lobanov, who died in 2003, spent half a century in a psychiatric hospital near Yaroslavl. Deaf and nonverbal, he created fantastical self-portraits featuring weaponry and the cryptic slogan: “Hunter shoots the forest.”

His work might have remained unknown had it not reached Dr. Vladimir Gavrilov, a psychiatrist who compiled one of Russia’s first major collections of outsider art. Gavrilov founded the art club Isoterra at a psychiatric hospital in Yaroslavl and curated the long-running exhibition project “INYE” (“OTHERS”), guided by the principle — drawn from the French artist Jean Dubuffet — that there is no more an “art of the mentally ill” than there is an art of people with bad knees. With Gavrilov’s support, Lobanov’s works eventually found their way into European museums. In 1999, four years before his death, Lobanov was finally issued a domestic passport — Russia’s standard identification document. He died a “citizen,” but remained a patient of the asylum until the end.

‘We’ll live to see it’

Russia’s full-scale invasion of Ukraine has added another layer of complexity to efforts to support artists inside psychiatric homes. Curiously, interest in this “outsider art” has surged, with exhibitions opening in major state museums, perhaps because officials view artists with mental disabilities as “safe,” assuming they make no political statements.

Fominykh disagrees with this assessment, noting that outsider artists are deeply attuned to the world around them. The chaperons who took Sakhnov to the Black Sea resort of Gelendzhik expected him to embrace nature and open space; instead, he preferred taxis and restaurant comforts — “we projected our own values onto him,” one volunteer later admitted. But the wartime atmosphere left its mark: rather than building one of his signature houses, Sakhnov constructed a cardboard bunker topped with a Russian tricolor flag.

Russian charities that work with “outsider artists” now find themselves caught between competing priorities: on the one hand, showcasing talent and raw expression, and on the other, protecting vulnerable people from the country’s repressive censorship laws. Outsiderville recently debated whether to publish a New Year’s card featuring an illustration of the Kremlin. The group eventually released it with a single, ambiguous caption: Dozhivem (“We’ll live to see it”).