Mental Health Hospitals in 19th Century Russia: Philanthropic Psychiatry and Politics of Gender

Abstract

Even today the purpose of psychiatric institutions remains ambiguous, do they exist to help the sick individual or merely to reinforce and police existing social divisions? This can also be traced in the writings of early psychiatrists, who also had to grapple with such questions. This article focuses on the gender dimension in psychiatric discourse at the end of 19th and beginning of 20th century. It takes on Pavel Ivanovich Yakobiy’s work "Osnovu administrativnoi psychiatry" as the core of analysis. This text was marked by a completely new and distinctive positioning the problem of understanding women as a criterion of political and economical development of the society. This meant understanding gender inequality less in terms of biology by arguing women have a different psychiatric constitution and more seeing it as a social phenomenon. It also made important points as to what the criterion should be for the development of philanthropy and how to progress the humanization not only of psychiatric institutions but of Russian society in more general terms. The article provides an overview of the psychiatric profession of Russia in this period and its place in society. Two main periods of development are discerned in Yakobiy’s work; firstly when psychiatric facilities were seen as ‘policing’ the mentally ill, the second is marked by the emergence of the ‘philanthropic’ position, as the professionalization of psychiatric work progresses. Through detailed analysis of Yakibyi’s ideas, we can see that even the more progressive psychiatric institutions of 19th and 20th century Russia proved themselves to be unable to avoid functioning in a punitive fashion, leaving the psychiatric institution with a markedly penitentiary feeling. This remains keenly relevant to modern discourses on the nature of psychiatric institutions, bodies that are often torn between the principles of medical ethics and the economic priorities of survival and profit.