By Peter Finn
Washington Post Foreign Service
Saturday, September 30, 2006
DUBNA, Russia -- On March 23, police and emergency medical personnel stormed Marina Trutko's home, breaking down her apartment door and quickly subduing her with an injection of haloperidol, a powerful tranquilizer. One policeman put her 78-year-old mother, Valentina, in a storage closet while Trutko, 42, was carried out to a waiting ambulance. It took her to the nearby Psychiatric Hospital No. 14.
The former nuclear scientist, a vocal activist and public defender for several years in this city 70 miles north of Moscow, spent the next six weeks undergoing a daily regimen of injections and drugs to treat what was diagnosed as a "paranoid personality disorder."
"She is also very rude," psychiatrists noted in her case file.
In person, Trutko presents a different profile, reserved and formal as she recounts her legal and psychiatric ordeal and invokes the minutiae of Russian law without having to refer to texts. An independent evaluation found that although she did not have an "ordinary personality," she was "very gifted and creative" and displayed no psychiatric symptoms.
Trutko is new evidence that Soviet-style forced psychiatry has reemerged in Russia as a weapon to intimidate or discredit citizens who tangle with the authorities, according to human rights activists and some mental health professionals. Despite major reforms in the early 1990s, some officials are again employing this form of repression.
"Abuse has begun to creep back in, and we're seeing more cases," said Lyubov Vinogradova, executive director of the Independent Psychiatric Association of Russia, an advocacy group. "It's not on a mass scale like in Soviet times, but it's worrying."
In those years, tens of thousands of dissidents were wrongfully subjected to forced hospitalization, sometimes for years, based on trumped-up diagnoses of "schizophrenia." Dissidents were said to exhibit inflexibility of convictions and nervous exhaustion brought on by anti-government activities. "Reformist delusions," the Soviets called it. If you were against communism, in other words, you were insane.
Some of the new cases have been abetted by institutions or doctors involved in it in the Soviet period. Trutko, who is originally from Uzbekistan, was diagnosed at the Serbsky Institute for Social and Forensic Psychiatry in Moscow, one of the most infamous of the Soviet institutions that imprisoned dissidents. It remains a secretive institution that has never faced up to its repressive past, according to human rights groups.
As recently as 2001, the institute's director, Tatyana Dmitriyeva, denied that the Soviet Union engaged in any more psychiatric abuse than Western countries, according to the report "Human Rights and Psychiatry in the Russian Federation" by the Moscow Helsinki Group.
One of signatures on Trutko's official evaluation, which declared she had paranoid personality disorder, is that of Yakob Landau, a longtime Serbsky psychiatrist who headed the institute's notorious Unit No. 4 during Soviet days.
Officials at the institute, a walled and forbidding complex in central Moscow, said no one was available to comment for this article. Investigators in Trutko's case declined to comment.
The charge that psychiatry is again being abused is not universally accepted within the profession. "The problem of forced treatment or psychiatric persecution existed more than 20 years ago, but it was solved. And since then I haven't heard of any case of forced psychiatric examination or treatment," said Vladimir Rotstein, president of Public Initiative on Psychiatry, an advocacy group.
The Independent Psychiatric Association, however, says that the number of activists being wrongfully hospitalized in mental facilities totals dozens of cases in recent years and is increasing. Doctors and the courts are complicit with investigators who insist on a forced psychiatric evaluation or treatment, it says. Activists have also documented an increase of family or business disputes in which wrongful hospitalization provides an opening to seize a person's property, Vinogradova said.
Most of the targeted activists are not affiliated with major human rights groups. Rather, like Trutko, they are stubborn gadflies who are involved in long-running feuds with local authorities. Their sometimes intemperate complaints against authorities are used to open criminal investigations for slander. This allows authorities to seek hospitalization. Unlike Soviet dissidents, these activists are put away for relatively short periods of a week to several months.
Roman Lukin, a businessman in the Volga River city of Cheboksary, was hospitalized last year for "unexplainable behavior" after he held up a sign on a public square calling three judges "creeps." Seeking redress for a bad debt that ruined him, Lukin felt he had not received justice from the courts. He spent two weeks in the local psychiatric hospital, which recommended that he undergo further examination at a specialized clinic in Moscow for possible "paranoid personality disorder." Independent Psychiatric Association specialists evaluated Lukin and found no sign of mental illness.
Nikolai Skachkov, who protested police brutality and official corruption in the Omsk region of Siberia, was ordered to undergo a psychiatric evaluation last year because investigators said they suspected he was suffering from "an acute sense of justice." He spent six months in a closed psychiatric facility where he was diagnosed as paranoid. The association, which conducted a separate evaluation earlier this year, found that he was healthy.
"Psychiatry in this country has always been a tool of the authorities, a tool for managing people and pressuring people. And it still is," said Boris Panteleyev, head of the St. Petersburg Committee for Human Rights.
In an interview in her apartment, Trutko recounted her own long run-in. "Now I have this stamp on my forehead that I am a psychiatric patient," she said. "I will always have this medical record now. That means I cannot go to court because judges say I'm a psycho and call for an ambulance."
Trutko is well known in the courts in this town, having argued dozens of court cases against the local authorities and police. She is studying to be a lawyer, and for several years has acted as a public defender, as advocates without law degrees are called here.
Her troubles with mental health authorities began four years ago in a courtroom in Dmitrov, about 35 miles from Dubna.
Trutko asserted that the judge displayed bias against her client in a property dispute, and she moved to have the judge withdrawn. She also complained that the judge was not wearing her robe as required and that the Russian flag was improperly displayed. The judge, who later left the bench and could not be reached for comment, alleged that Trutko said, "Look at that fat pig sitting up there," according to legal papers.
Prosecutors opened a criminal case against Trutko on charges of contempt of court. In July 2003, the court ordered Trutko to undergo an involuntary psychiatric evaluation. Psychiatrists at the hospital said she was uncooperative, illogical and displayed emotional reactions that were "not adequate" -- a common phrase here for mental illness.
The Independent Psychiatric Association questioned these conclusions. Its own evaluation of her, conducted by four psychiatrists, found that "she is not an ordinary personality, but a very gifted and creative person. . . . No psychiatric symptoms were observed. She shows high intellectual ability and good memory. She does not need any treatment."
Trutko continued to battle the criminal complaint in court. Before a hearing at the higher Moscow regional court, she filed a motion seeking the removal of a panel of judges from her case, again asserting bias. In this case there was no claim of verbal abuse, but prosecutors said her motion amounted to slander and contempt.
In April 2004, after leaving a hearing on her case in Moscow, Trutko was detained by investigators and taken to the Serbsky Institute. It was a Friday evening when she was admitted and there was no expert commission available to evaluate her, Trutko said. Human rights groups protested her detention and threatened legal action. Trutko said she was released the following Tuesday morning without having undergone any formal examination by psychiatrists.
But the institute issued a six-page evaluation that said she suffered from a "paranoid personality disorder." The condition manifested itself in her "subjectivity," her "tendencies to verbal aggression," her "suspicious" personality and her "inability to understand the peculiarities of interpersonal relations and communication," medical records show.
The report recommended that she undergo forced hospitalization and treatment.
In September 2004, a Moscow court approved that approach. But the authorities, for reasons that remain unclear, did not act on the order until they stormed Trutko's apartment earlier this year.
Despite her subsequent release, Trutko said, the court order remains in effect and she could be institutionalized again at any time. "My career is ruined," she said. "I just stay at home."