It’s been eight months that independent journalist Andrei Novikov is kept for compulsory treatment in the mental hospital in the City of Rybinsk in the Yaroslavsl region (the details were published in number 74). Novaya Gazeta applied to the chair of Independent Psychiatric Association of Russia Yuri Sergeevich Savenko with a request of examining Andrei Novikov. He had a consultation in Rybinsk, but he didn’t have enough time to explain to us all the circumstances after his return from Rybinsk, as he had to go on to the First Congress of East European Psychiatrists. So we only had a short phone talk and agreed that we would discuss after his return the situation about the psychiatry which is attempted to be used for political reasons. As we have known each other for long, he gave his consent to publishing what he said on the phone, without any special permission. However, having returned to Moscow he said the following:  

Interpretation by your newspaper of my comment about compulsory treatment given to the Member of Russian Journalists Association and Member of Russian Writers Association Andrei Novikov reflects the depth of anti-psychiatric feelings in the society.

Psychiatrists didn’t diagnose Andrei Novikov with anything new. He had been diagnosed rather adequately since his juvenile age.

But Yuri Sergeevich, do you take into account that he got diagnosed in soviet times which are known with shameful practice of punitive psychiatry? And during Perestroika years Novikov was crossed off psychiatric register.

It wouldn’t be right to identify “punitive psychiatry” with “soviet psychiatry” as well as identifying “crossing off register” with “canceling the diagnosis”. “Psychiatric register” was abolished as long as 1993.

Did Andrei Novikov have such mental derangement?

No, he didn’t. That’s why he was crossed off the register in that time. He was diagnosed not for disease, but for the features of his personality, expressed in such a degree that it was equalized to the disease in accordance with humane and scientifically proved tradition. As we talk not about disease in such cases, it is inappropriate to speak about treatment either. “Personality impairment” cannot be cured, it only can be adjusted during periods of aggravation and decompensation.  

The problem is that at the point of starting a criminal case Andrei Novikov didn’t have a decompensation condition either. He started to have it as a result of the case open and 43-day long detention in the hospital with the purpose of forensic psychiatric examination. He was kept in the ward with criminals who humiliated him. All that was predictable and outpatient examination is what must have been done in his case. Actually, he wouldn’t have got to be examined but for inappropriately broad interpretation of “danger for society” within the framework of terms of “extremism” (2002) and “prevention of terrorism” (2006) in our legislation. In no democratic country can a person be sentenced for ideas, expressed in one’s own website, or, what’s more, just kept on his own PC like it was in Novikov’s case. Such wording in the legislation as “propaganda and spreading terrorist ideas” and “prevention terrorism” (Clauses 2e and 4a in section 3 of the Federal Act on Combating Terrorism), taken without limits and gradation, lead automatically to large-scale abuse of psychiatry like it was about the Act on Slander against Soviet Power in older times.       

The more actively, rudely and broadly a regime acts, the more oppositionists it begets. In case of Andrei Novikov, his original texts were read literally, one-dimensionally, primitively and barbarously by people deprived of any sensitivity to art or just ignoring any taste. Such people closed down avant-garde artist’s exhibitions in soviet times. Such people even can suit the Bible! 

Novikov’s case is a typical example of using psychiatry in political games, as any impartial court’s proceeding wouldn’t find any components of crime in the charges against him. But availability in the case of the old diagnosis helped to come to “necessary” decision in most convenient way. This is a significant example of vulnerable position by uncommon people, who have “personality impairment”, and who like shocking others. They get to psychiatrists due to broad interpretation of the notion of “danger to others”. All that puts the psychiatrists in the position of scapegoat. 

Why are psychiatrists so obedient? Why don’t’ they argue? Why don’t they say “No, it’s enough to make an out-patient examination instead of in-patient.”? Why don’t they say “No, this person doesn’t need compulsory treatment”? 

In reality, psychiatrists just represent the society. But due to the fact their profession deals with the most delicate and fragile in the medicine object – human soul – the changes going on in society are seen more distinctly with psychiatrists. The next mass imposing of “insensitiveness” onto society is the gloomiest thing in our today’s life. The social atmosphere itself is nutrient medium for that. That is what defines the order of priorities. The role of employee in one’s institution outweighs the necessity to stick to Hippocratic Oath. Also take into account the gross administration along the built vertical.  

Well, I haven’t seen so far any particular contradictions between what you say now and what we published as your comment. 

In terms of my profession, I want to stress that there was no diagnostic or therapeutic divergence of opinion between me and my colleagues from Rybinsk and Yaroslavl about Andrei Novikov’s case. Incomplete account of my comment in your newspaper, made without above mentioned explanations, only might harm him.

Why do you say “no divergence of opinion?” Do you also consider it that Andrei Novikov poses threat to others and he needs to be treated in a compulsory way?

Neither me, nor my colleagues from Yaroslavl and Rybinsk, who participated in the consultation, think so. But we are prisoners of the system with its regulations and stereotypes. The meaning of this story is that a growing wave of such cases can begin inevitably, if we don’t formulate the criteria of what is to be considered “danger” in terms of psychopathology. 

What rules should be adopted in professional community so that to avoid return to punitive psychiatry?

For a psychiatrist, the term “social threat” is restricted only to its professional, i.e. psychopathological, aspect. Everything there is defined by the clinical context that allows speaking of not only threats for others, but also about risks of aggression, suicide, victimnability. The clinical context allows speaking differentially and with different degrees of probability. Most important characteristics of danger are fixed in the law on psychiatric aid. Distinguished in the law there are three kinds and at the same time three levels of danger. These are immediate danger for others and oneself, total helplessness and probability of making significant harm to oneself unless psychiatric aid is rendered. In reality, “social threat” is interpreted in broader terms. When a criminal case is going to be terminated because of lack of evidence, for example, traditional for us accusatory attitude tries to get the most of references to mental disorders. 

During the period of 1998-2003 the State Center of Social and Forensic Psychiatry after V.P.Serbsky initiated three attempts to make amendments in the Act on Psychiatric Aid that would significantly reduce its democratic achievements made in 1992.  In particular, they tried to broad “immediate danger” just to “danger” which would make the limits of the danger just infinitely extended. But even without those amendments Clause 29 of the Act on Psychiatric Aid is interpreted like the amendments were made. Loudly made complaints, like it was in case of Larisa Arap, importunate bothering, like it was in case of Elena Popova, and shocking texts, like it was in case of Andrei Novikov, were qualified as “immediate danger” for others.

Participation in the protest actions, hunger strikes, protesting against rude and obligatory measures are also getting to be qualified as “danger to others”. I read information about a case when the person was invited to show up in the psychoneurologic dispensary because of the letter written to President’s name. It’s like soviet times when the shortest way to get to mental hospital was to send a telegram to Brezhnev. Now the term of “security” and especially “state security” has become idée fixe. We speak now about “informational security”, “psychological security” and even “spiritual security”!  

All that is the consequence of total monopolism and making the psychiatric profession purely “state” one. Even at the Soviet power we didn’t have such a situation.