Psychiatrist: Protester Given Forced Psychiatric Treatment Is Not Dangerous

October 9, 2013
REUTERS/Esam Omran Al-Fetori

A Russian court has sentenced a protester to mandatory psychiatric treatment in a case that has been widely criticized by human rights watchdogs. Mikhail Kosenko, who has been voluntarily seeking mental-health treatment for much of his life and is a productive member of society, was accused of assaulting a police officer during the Bolotnaya riots last May. While Kosenko attended the protests before they were disrupted, the officer whom the court says Kosenko assaulted could not identify him, and a leading psychiatrist now says that the mental-health experts who testified against Kosenko provided false evidence.

The testimony of the police officers has been widely criticized, as has the fact that the Russian prosecutors are only saying that two protesters were injured in the riot, despite the fact that the real number is over 60.

It’s worth noting that this interview appeared in Izvestia, an outlet with close ties to the Kremlin that is often criticized for its lack of impartiality. – Ed.

In an interview with Izvestia, Yuri Savenko, a leading psychiatrist, criticized the sentence passed on one of the Bolotnaya rally participants, that was based on the conclusion by Serbsky Psychiatry Center.


Today, Lyudmila Moskalenko, a judge in Zamoskvoretskii Court of Moscow, sentenced 38 year-old Muscovite Mikhail Kosenko, a mentally disabled person, who participated in the rally on Bolotnaya Square, to compulsory treatment in a psychiatric hospital of a general type. The court ruled that he will remain in custody until he is placed for treatment.

Kosenko was charged under Part 2 of Art. 212 of the Criminal Code (“Participation in public unrest,” punishable by a prison term from 3 to 8 years) and Part 2 of Art. 318 of the (“Use of Violence Against a Representative of the Authority, endangering life or health of the person,” punishable by up to 10 years in prison). According to investigators, Kosenko “struck at least one blow with his hand and one with his foot,” at Alexander Kazmin, a 21-year-old riot police officer. Kosenko pleaded not guilty. In court, Kazmin testified that he did not see who hit him.

In an interview with Izvestia, Yuri Savenko, the head of the Independent Psychiatric Association of Russia (IPAR), who has represented Russia at the World Psychiatric Association for the last 25 years, explained why he did not agree with the conclusions of the experts from the Serbsky State Scientific Center for Social and Forensic Psychiatry (SSCSFP) who examined and evaluated Kosenko:

– Last September psychiatrists from IPAR were outraged by the evaluation by colleagues from SSCSFP and demanded a re-examination of Kosenko. You testified to that effect in court as an independent psychiatrist. Why, in your opinion, was a re-examination denied?

– This sentence has been programmed a long time ago, nobody had any doubts that it was pre-determined. In the expert opinion of the SSCSFP psychiatrists, the experts had diagnosed Kosenko with a much more severe condition based on less than an hour-long evaluation. Their diagnosis was “paranoid schizophrenia” instead of “sluggish neurosis-like schizophrenia,” for which Kosenko had regularly been observed and treated for 12 years. Moreover, contrary to the results of dynamic follow-up monitoring, they reclassified the condition that was clearly sluggish, which is crucial, to “continuous flow with episodic exacerbations.

– For many years Kosenko attended the psycho-neurological clinic and was under supervision, he also took medication. The condition was the result of a injury suffered during the military service…

– Kosenko was treated with the weakest anti-psychotic and active antidepressant. But experts arbitrarily declared a “progressive aggravation,” “diluted emotional reactions,” and “unfocused and paralogous thinking.” They diagnosed him with a primitive apathoabulic syndrome, which means that Kossenko is supposedly a weak-willed and easily influenced person. Meanwhile he is a very active and eloquent person. It was obvious to anyone who was present at the trial. The SSCSFP experts, and then the court acted shamelessly. Psychiatrists changed the diagnosis that existed for 12 years and was based on dynamic monitoring. That alone allows professionals to draw the right conclusion about the condition of the patient. But the SSCSFP psychiatrists completely made it up. And then the expert who testified in court, simply lied to the judge, calling his condition schizophrenia.

– And what was the deception?

– In the Soviet Union a broad interpretation of schizophrenia made it possible to use psychiatry for political purposes. The expert, who answered the judges’ questions, displayed an extreme superficiality in classifying severe psychotic disorders. The assertion that Kosenko was not only paranoid, but had a paraphrenic delirium condition, and his ideas are megalomaniac – all this is just a total apotheosis of the resurrection of the Soviet style psychiatry! An expert from the Serbsky Center said that “sluggish schizophrenia is schizophrenia all the same, which sooner or later becomes paranoid schizophrenia being one of its stages.”

– And what is the reality?

– The international standards regarding schizophrenia have long since changed. And the “Soviet style schizophrenia” for the last 15 years has been divided into three different categories and conditions. In our country, ICD-10 is adopted as a standard, according to which the diagnosis of schizophrenia does not cover schizotypal personality disorder (formerly sluggish neurosis-like and psychopathic schizophrenia) or chronic delusional disorder (formerly paranoid schizophrenia) that call for an entirely different treatment and social rehabilitation measures than in case of schizophrenia.

– But did the Serbsky SSCSFP experts have to do it?

– You know, in Soviet times, when political opponents were diagnosed with schizophrenia left and right, this was due to the fact that “it is necessary, otherwise the system will fall apart.” From the outset an expert was placed in an idiotic position: he is not entitled to challenge the accuracy of the alleged charges or set out facts. Although by law an expert has the right to examine any witnesses testimony and the case file on equal terms. I believe, the experts, just like in old times, just went along with the investigation, that, having learned that Kosenko had a psychiatric diagnosis, assigned the case under a separate procedure. But any expert has enough ways out of this situation. It is simply outrageous that they decided to do it that way.

– In the assessment by the Serbsky Center psychiatrists, that the judge relied upon when imposing a sentence, it is stated that Kosenko never displayed any aggression while under observation. But the conclusion was just the opposite: he presents danger to himself and to the society. How is this possible?

– I do not know how! The man who never showed any aggression during his entire life, who voluntarily, promptly and regularly received outpatient treatment, all of a sudden “requires compulsory treatment in hospital of a general type” as “presenting a danger to himself and the people around him.” Meanwhile Kosenko was not identified by the riot police officer who testified in court as a victim. That means that a mere participation in an authorized protest rally is classified as an active danger. In fact, the psychiatrists, and then the judge, likened Kosenko to incompetent. And this is despite the fact that for all the 38 years before his arrest, he had a responsible life! I will do my best, if not in court, then at least within the professional community, to make sure these experts explain why they did what they did.

– And yet, does Kosenko require compulsory treatment?

– Of course not!

Russia’s chief psychiatrist, the acting Director of the Serbsky SSCSFP Zurab Kekelidze refused to comment on the expert evaluation by his colleagues or the sentence, because “it’s not acceptable to give a public assessment of the employees actions.”