Psikhushka (Russia)

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Psikhushka đŸ‡·đŸ‡ș
FSU map.png
Location: FSU
Definition: Use of psychiatric services as means of controlling and repressing political opponents
Keywords: Russia – FSU – Psychiatry – Mind – Healthcare
Clusters: Domination – Motivational ambivalence – Control – Informal governance
Author: Robert van Voren
Affiliation: Human Rights in Mental Health-FGIP, Netherlands
Website: Wikipedia entry

By Robert van Voren, Human Rights in Mental Health-FGIP, Netherlands

In the late Soviet years, and particularly under Yuri Andropov’s time as Chairman of the KGB, Psikhushka involved the frequent, systemic confinement of political and religious dissidents in psychiatric hospitals (Van Voren 2010[1]). This practice was abandoned during Mikhail Gorbachev’s regime (1985-1991). However, under Vladimir Putin various cases of the psychiatric confinement of political opponents have emerged, suggesting that Psikhushka has returned. ‘The difference is that 25 years ago the people they sent to psychiatric prison were anti-Soviet [
]. Now the people they send are those who oppose Putin’ (Vlassov 2012[2]).

After the collapse of the Soviet Union, legal and ethical policies were introduced in Russian psychiatry in order establish real independence from the state and to prevent its use for non-medical ends. However, in reality the abuse still exists. The problem lies ‘not in the law itself, but in its implementation’ (Van Voren 2013[3]).

Psychiatry is used in ‘fraudulent’ criminal trials to influence legal outcomes. This occurs because many of the conditions that facilitated this practice in the Soviet times have not been fully reformed. The most significant condition is the ‘unresolved problem of the dependence/independence of the Russian judiciary as a whole’ (Gushansky 2009[4]).

The case of Yulia Privedennaya in May 2008 highlights the issues. Privedennaya, leader of a charitable youth organisation and an anti-Putin activist, was arrested on suspicion of planning an illegal armed coup, of illegal deprivation of freedom and of torture of minors who were members of the youth organisation. Three months into her trial, she was forced to attend an outpatient examination at the Serbskii Centre, a psychiatric hospital notorious for its role in the confinement of political dissidents during Soviet times. This resulted in her month-long involuntary hospitalisation in the centre.

Reportedly, the prosecutors evidence could not prove Privedennaya’s guilt and for over two years the court failed to produce even one of the forty-three witnesses listed to testify against her. According to Mikhail Trepashkin, Privedennaya’s defence lawyer, ‘it is clear that the psychiatrists were asked to come up with some kind of psychological disorder’ in order to confine Privedennaya (‘Politzeky’ 2010[5]). It is suggested that prosecutors used the ‘psychiatric’ option to prolong Privedennaya’s trial when it had hit a ‘deadlock’ (‘Prava Cheloveka’ 2008). Following her release from the hospital, the trial continued and she was sentenced to four and a half years’ imprisonment.

The use of psychiatry in Privedennaya’s trial is inextricably linked to non-accountability in the Russian judiciary. In this instance prolonging the case appears to have given the prosecutors and judge time to find new incriminating ‘evidence’. Thus the use of psychiatry in this case provided the prosecution with greater scope both to circumvent procedural norms and to evade responsibility for proceeding with a false case. As Privedennaya states, psychiatry was used in order not to ‘shame the investigation’ (Elder 2010[6]).

According to Yuri Savenko, psychiatrist and head of the Independent Psychiatric Association in Russia (‘IPA’), psychiatry is now used as ‘part of a frequent procedure [in criminal trials] where there are no concrete justifications, it is more economical in terms of effort and time to acquire a psychiatric evaluation’ (Savenko 2010[7]). In contrast to the Soviet era, Psikhushka is no longer employed soley for the indefinite, incarceration of a person, but is now used in a more subtle way to achieve ‘flexibility’ in a trial. Problematically, this practice is also more difficult to identify than that which existed in the Soviet period.

The lack of independence and adversary in forensic psychiatry is a major factor in facilitating Psikhushka. There is said to be an ‘unwritten rule in court’ that assumes that ‘experts from the Serbskii Centre are always correct and independent experts do not have the right to evaluate and criticize them’ (Savenko 2013[8]). The opinion of experts from the Serbskii Centre’s has therefore become irrefutable evidence in a trial, as exhibited in Privedennaya’s trial when challenges to the psychiatric diagnosis and requests for independent examination were ignored by the judge, despite the many testimonies asserting her sanity. Similarly, in the Soviet times, the Serbskii Centre’s opinion was ‘almost always accepted by the court and viewed as more authoritative than other commissions’ (Bloch & Reddaway 1977:100[9]).

Unlike the Soviet era, the use of psychiatry specifically against political opponents is not frequent or systematic in contemporary Russia. It is thought to occur selectively in order to influence public opinion and behaviour, with the wider aim of strengthening support for President Putin. Privedennaya’s case is said to be ‘part of a long-standing effort by authorities to enforce political conformity’ (Leonard 2010 [10]). In another example Professor Gerhard Mangott considers the 2012 case of activist Kosenko’s hospitalisation following his arrest for his part in the Bolotnaya protests and subsequent diagnosis of ‘paranoid schizophrenia’ as a ‘signal to politically active citizens of Russia - not to participate in demonstrations against the authorities’ (quoted in Sergeev 2013).

This can be understood as a strategy of ‘selective repression’ described by Vladimir Gel’man in ‘The Politics of Fear’ (2015 and in this volume[11]). Its main function is not so much to punish opponents as to prevent the spread of opposition in society. Psychiatry achieves this in two ways. Firstly, it displays the risks of vocal and public opposition to the rest of the population, thereby creating a fear of protesting. Secondly, it discredits the opposition, which serves to reinforce the view of Putin as the only source of political legitimacy. In this way, the opposition is controlled either through fear or by genuine support for Putin.

Other instances in Russia where the use of psychiatry has been used to repress political opponents include the 2007 cases of Larissa Arap and Artyom Basyrov, both activists from ‘Other Russia’, (Garry Kasparov’s anti-Putin coalition) who were diagnosed with schizophrenia and forcefully hospitalised for six weeks and one month respectively, resulting from their protest actions. It is believed that Arap’s hospitalisation was directly connected to her anti-Putin views and her critical articles about the hospital in Murmansk in which she was confined. Basyrov’s hospitalisation in Bashkortostan is similarly thought to have been related to his political activism as it occurred on the eve of a ‘demonstration of dissent’, which he helped to organise. Arap and Basryov were separately examined by the IPA, which concluded that there was no basis for their hospitalisation.

In 2012, psychiatry was also used against the feminist rock group ‘Pussy Riot’ following their anti-Putin protest in Moscow’s Christ the Saviour Church. Psychiatrists at Kashchenko hospital diagnosed them with a ‘personality disorder’ and recommended their isolation from society (Van Voren 2013[12]).

In contrast to the late Soviet years, the main political function of Psikhushka in today’s Russia lies not in the systematic confinement of political opponents, but in the psychological effects that selective hospitalisation and the diagnosis of opponents has on the general population. In contemporary Russia Psikhushka is differently connoted. The practice may now be used in a more subtle way to support the ‘right’ verdict in fraudulent criminal trials. This, of course, has serious implications for upholding accountability in the Russian judiciary. The psychiatric confinement of political opponents is not systematic and the term of an opponent’s hospitalisation is not indefinite as it was in the Soviet era. Rather, it is used selectively against the most politically active citizens in order to influence public opinion. However, its purpose of controlling the opposition remains.


  1. Amnesty international. 2014. ‘Russia: detention of protester Mikhail Kosenko in psychiatric institution is 'Soviet-era tactic', 25 March,
  1. Prava Cheloveka v Rossii, 2010. ‘Oglashen Prigovor Yulia Privedennoi’,
    1. ↑ Van Voren, R. 2010 ‘Abuse of psychiatry for political purposes in the USSR: a case study and personal account of the efforts to bring them to an end’ in Helmchen, H. and Sartorius, N. (eds.) in Ethics in Psychiatry- European contributions , Berlin: Springer
    2. ↑ Vlassov, V. 2012. ‘Psychiatry and political dissent in Russia’, The British Medical Journal , 31 August
    3. ↑ Van Voren, R. 2013. Psychiatry as a tool of coercion in post-Soviet countries, Policy Department, Directorate-General for External Policies, European Parliament.
    4. ↑ Gushansky, E. 2009. ‘Psikhiatr kak sudebnyi ekspert mezhdu molotom i nakoval’nei’, Polit, 19 November,
    5. ↑ Politzeky: Soyuz Solidarnosti politzaklyuchennymi. 2010. ‘Yulia Privedennaya’,
    6. ↑ Elder, M. 2010. ‘Courts Dish Out Soviet Style Justice’, Global Post, 27 July,
    7. ↑ Savenko, Y. July 2010. 'Politicheskoe delo apolitichnoi organizatsii i psikhiiatriia: nestandartnoe reshenie tsentra im. Serbskogo', Nezavisimyi Psikhiatricheskii Zhurnal,
    8. ↑ Savenko, Y. 2013. ‘O nevypol-nenii zakona o psikhiatricheski pomoshchi I o trevozhnykh tendentsiiakh v otchestvennoi sudebnoi psikhiiatrii’, Nezavisimyi Psikhiatricheskii Zhurnal, December,
    9. ↑ Bloch, S. & Reddaway, P. 1977. Russia’s Political Hospitals. London: Gollancz.
    10. ↑ Leonard, P. 2010. ’Russian poet faces mental ward’, Associated Press,
    11. ↑ Gel’man, V. 2015. ‘The Politics of Fear: How the regime confronts its enemies’, Russian Politics and Law, 53, 5-6: 6-26
    12. ↑ Van Voren, R. 2013. Psychiatry as a tool of coercion in post-Soviet countries, Policy Department, Directorate-General for External Policies, European Parliament.