History and current condition of Russian psychiatry

Abstract

Russian psychiatry has a dramatic history, and until now has been at a transitional stage of development. It is facing problems not only common in world psychiatry, but also specific to eastern Europe, in particular Russia. Starting from the beginning of the 1990s, considerable changes have occurred in psychiatry, especially after 1992 when the law on psychiatric care and guarantees of citizens' rights in its provision was adopted. It became the ideological and legislative basis for reforms. However, there are definite obstacles to structural reforms in psychiatry. They are unfavourable technical conditions in many psychiatric clinics, hypercentralization of psychiatric services, shortage of clinical psychologists and social workers in psychiatry, some difficulties in cooperation between psychiatric and general medical institutions. Economic difficulties in the transition period of Russia's social development prevent the overcoming of these problems. They are being actively discussed and some of them are being gradually solved, e.g. the organization of team work in mental health services, the increasing number of specialists on social work, and the involvement of non-government organizations in psychosocial rehabilitation.

Alcoholism and Alcohol Psychoses Trends in Russia

“…According to the document, the production of vodka and the number of shops selling it were to be cut. In 1974, the Russian Federation Supreme Soviet ratified a decree creating a system of special institutions (medical-labor dispensaries) within the Ministry of Internal Affaires for the long-term compulsory treatment of advanced alcoholics manifesting antisocial behavior [4]. Noncriminal alcoholics, who violate "labor discipline, public order, and the rules of social community", could be committed for one-to two-year in these explicitly penal institutions.…”

“…Since 1976, the narcological service grew rapidly, reaching its peak of funding and access to resources during the anti-alcohol campaign in 1985-1988 [12]. This led to the creation of the narcological in-patient and out-patient departments, as well an increase in the number of specialists in the field of narcology [4]. The overall structure of the narcological care system in post-Soviet Russia had not changed significantly since the 1970s.…”

“…It is possible that increase in alcohol psychoses incidence rates in Russia in the mid-1990s, at least partly, is a consequence of deterioration in the quality of health care system, following the collapse of Soviet Union in late 1991 [4]. A process of destruction of the state-funded narcological service that began in 1989 continued in the 1990s [2].…”

“…During the 1990s, several important changes linked to broader post-Soviet socioeconomic transformation had significant effect on the addiction treatment system. In connection with the dismantling of the Soviet administrative economy generally and the restructuring of the health care sector in particular, the narcological service experienced the budgetary cutbacks [4]. In relation to this the total number of hospital beds has decreased and the length of stay in hospital has shortened.…”

Mental Health in Former Soviet Countries:From Past Legacies to Modern Practices

“…Setting up such new models of care requires substantial financial investments. 8,31,32 There are no studies comparing cost-effectiveness of current care in CIS countries with that of introducing modern services. However, considering the low funding and poor conditions in current services, it is safe to assume the Western model of converting funds used in traditional services into funds for modern services will not work.…”