19-20 May the XII Congress of the “Independent Psychiatric Association of Russia” (IPA) was held in Moscow. Psychiatrists from 27 regions of the Russian Federation, assembled in Moscow to discuss stressing issues in psychiatry, to review the Association work for the last 3 years, to determine priorities for the near future and finally try to find the answer for sacramental question: “What shall we do?” (11-JUNE-07)
Written by HRH Moscow/ Inna Komar. Source: http://www.hro.org
New reform discussed
In 2007 the government accepted a program having a special purpose of psychiatric service developing in 2007-2011 and laid out 80 billion rubles. However the discussion on the Congress made it clear that nobody could exactly formulate, what was the essence of this reform, what they were really going to do to make patients´ service better and to approach a psychiatric service to people etc. It became clear that psychiatrists learn more about the reform from Mass-Media than from professional discussions. As a result, Mass-Media constantly intimidate people by future beds reduction almost for 50%, mental hospitals shutting, discharging dangerous mentally-ill criminals. Psychiatrists only know about out-patient treatment methods widening and switch to brigade methods of patients service. Meanwhile a program of ambulatory psychiatric care improvement doesn’t exist, just as there are no trained specialists in psychology, social workers, lawyers and nurses with higher education. And how is it possible to extend ambulatory care if people don’t trust psychiatrists and they don’t undergo medical treatment in out-patient centers on their own will?
The Congress members are also particularly concerned about the outrageous fall of forensic psychiatric examinations level, independent psychiatric examination abolishment and complete legal psychiatry monopolization by Serbskiy State Center.
The alarming questions for Russian psychiatry
The answer to the question “Is it possible to restore a punitive psychiatry in Russia?” turned out to be distressing: “There`s no official order from the upper-strata about it yet! But if psychiatry is going to be used in commercial efforts it can also be easily used in polical ones. Some powerful methods are already used to frighten and discredit those people who is discordant.”
There’s another IPA alarming conclusion: real mental health policy is lacking in the country. If psychiatry’s destiny and mental health is being later determined by authorities, not both by professional association and patients and their relatives themselves, we will not be able to avoid the catastrophe.
Resolutions
The Congress made some important decisions concerning making changes to the legislation about psychiatric aid, law enforcement practice, children’s psychiatrist specialization reinstatement. Besides it was decided to restore the 38th Article realization applying to psychiatric aid and Protection of Patients Service establishing, which had been out of use for about 14 years. It was decided to obtain leading into legislation an independent psychiatric examination and annexing IPA representatives and other specialists in this field to Social Council for Mental Health amounting to the Ministry of Health. The main purpose is to transform this structure into the platform for psychiatric service reform discussing and to work out some corresponding recommendations.
What shall we do?
There’s a need to have an independent competent professional association as a partner and expert, but not only an ordinary mental health policy executor. The two Russian psychiatric associations (Independent Psychiatric Association of the Russian Federation and Russian Society of Psychiatrists) cooperation is an essential condition to succeeding.
But the most significant thing is not to lose heart! We must reveal our civil position. Besides, every psychiatric service worker must be active at his own workplace, within the limit of their competence. As again reelected IPA President Yuriy Savenko (right) said: “A personal factor is increasing during crisis-epoch. And even a little mouse can turn the switch on the track and aim the train in theopposite direction”.
