To bring "mental patient" back to the society: the way of social changes or reforms in psychiatry?

Abstract

This article concerns the questions of social citizenship and discusses the possibilities of overcoming the social exclusion of people who have received psychiatric diagnoses. In post-Soviet Russia, the social condition of the mentally ill remains dire and here the author considers the prospects for the de-institutionalization of the psychiatric profession in Russia. Within the framework of a social policy toward disability, the national programme for the transformation of the psychiatric care is analysed. The results presented here are obtained from fieldwork done by the author in private psychiatric clinics. These clinics, which are based on alternative principles to the traditional views of many organizations, differ in many ways from standard psychiatric hospitals and go further in transforming psychiatric care than what is prescribed in the National Programme of psychiatric reform. Aside from a description of the main differences between the two main systems of treatment centres, the author also carried out an analysis of biographical interviews with patients of the clinics. These were carried out before and during hospitalization in traditional sanatoriums and involved interpreting their subjective fears and evaluations of their own still continuing experience of their experiences in mental illness. This includes their impressions about their own social position and their future prospects. The research was also aided with the utilisation of visual analysis of pictures drawn by informants, which revealed a whole range of insights into their emotional conditions and social life in the clinic. In the light of the results received, the options for reforming Psychiatric Care in Russia are reviewed and the necessity for the transformation of the interlaced social, cultural and political aspects become clear. The success of the private clinics as places where patients can relax and socialise paves the way for further improvements in psychiatric hospitals throughout Russia and in the process of reducing the stigmatization of patients returning to society.