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C O N F I D E N T I A L SECTION 01 OF 03 MOSCOW 011652 SIPDIS SIPDIS DEPT FOR EUR/RUS E.O. 12958: DECL: 10/17/2016 TAGS: PGOV, PHUM, KDEM, PINR, RS SUBJECT: PSYCHIATRY ABUSED FOR COMMERCIAL ENDS REF: A. 10/05/2006 ARMSTRONG - PATTERSON E-MAIL B. 09/30/2006 "PSYCHIATRY IS AGAIN A TOOL AGAINST DISSENT" (WASHINGTON POST) Classified By: Ambassador William J. Burns. Reasons: 1.4 (b,d). ------- Summary ------- 1. (C) Anecdotal evidence suggests that psychiatry is increasingly being used as a tool, especially in more "sophisticated" urban areas like Moscow, in the resolution of family squabbles or business disputes. The interpretation of a 2001 law on legal expertise activities allegedly has been used by government psychiatric institutes to ensure their monopoly in the provision of expert testimony in court cases. Those outside the government allege that psychiatric experts from organizations like Moscow's Serbskiy Institute for Social and Forensic Psychiatry and Alekseyeva Hospital have, increasingly, used that monopoly to advance the financial interests of well-paying clients. Much more rarely, psychiatry has been used to punish those out of step with the powers-that-be. End summary. ------------------------- Who is an Expert Witness? ------------------------- 2. (U) Poloff met October 16 with the Director of the Russian Research Center on Human Rights (RRCHR) Lyubov Vinogradova following a September 30 Washington Post article (ref b) alleging that abuse of psychiatry for political ends is increasing. The RRCHR was created in 1989 and has about 600 dues-paying members in 52 Russian Federation regions. It was recently re-registered as an NGO by the Federal Registration Service. The RRCHR is a member in good standing of the International Psychiatric Association. In years past, the RRCHR received grants from the Soros Foundation, the European Union, the Swiss government, and Eurasia. It is currently the recipient of money from the Embassy's "Small Grants" program. 3. (C) Vinogradova described the use of psychiatry against those dissatisfied with the authorities as not widespread. "There are a handful of cases," she said. More common, and more worrisome in Vinogradova's view, is the use of psychiatry in business or family disputes to seize property or money. Catalyzing the ability to use psychiatry as a tool in property disputes, according to Vinogradova, was the GOR's, and the courts', interpretation of the 2001 law on "Legal Expertise Activities in the Russian Federation." Article 41 of the law, which concerns legal expertise provided by non-government legal experts, seems to say that expertise can be provided by "persons having special knowledge in the fields of science, technology, art or crafts, who are not government legal experts." Paradoxically, according to Vinogradova, that article has been interpreted to exclude all but government experts from testifying in court. 4. (C) Until 2001, private sector psychiatrists were able to testify in court on behalf of clients. Immediately after the passage of the law, the courts began to hold that only governmental experts could testify. The RRCHR and other organizations appealed their exclusion as expert witnesses to Moscow's Taganskiy Court in 2001, but their appeal was rejected. Informal approaches have been made by Vinogradova and others to the Duma, but with no success. According to Vinogradova, the 2001 law was drafted by the Moscow Serbskiy Institute for Social and Forensic Psychiatry (Serbskiy). Serbskiy crafted the law to establish the profession of "legal expert-psychiatrist," and determined that only those who had worked as psychiatrists for at least three years in a state institution could become "legal expert-psychiatrists." ---------------------- Monopoly Fosters Abuse ---------------------- 5. (C) The monopoly by government consultants on the expert witness profession acquired as a result has fostered abuse, Vinogradova said. She cited as an example the case of a 91-year old Moscow man whose caretaker used his weakened condition to win possession of his apartment. The man's relatives are contesting the decision, but government expert witnesses have insisted that the man was mentally competent at the time of his decision. Vinogradova believes it likely that the expert witnesses have been bribed. The prevalence of bribe-taking, Vinogradova said, can be deduced by the number of cases that come across her desk whose court MOSCOW 00011652 002 OF 003 verdicts "do not proceed logically from the evidence." The exclusion of testimony by non-governmental expert psychiatric witnesses leaves plaintiffs desiring a second opinion with nowhere to turn. 6. (C) In addition to the advent of the 2001 law, the removal of the Ministry of Health's Chief Psychiatrist Boris Kozelovtsev, and his replacement by Serbskiy Director Tatyana Dmitreyeva has further eroded standards in Russian psychiatry. Dmitreyeva, who holds the title "Chief Expert-Psychiatrist," was Minister of Health from 1996 - 1998. Vinogradova described Dmitreyeva as "deft" in her management of Russia's expert witness industry. Under pressure from advocates for psychiatry, Dmitreyeva has recently created a "public council" on psychiatry, as required by law. Instead of allowing independent psychiatrists to serve on the council, Dmitreyeva has invited the relatives of psychiatric patients. Vinogradova said that the relatives are easily manipulated and become in fact GOR "rubber stamps." ------------------------------ Human Rights Ombudsman Resists Government Psychiatry Industry ------------------------------ 7. (C) An ally in the efforts of non-governmental psychiatrists to counter the GOR's monopoly on psychiatric legal expertise has been the office of human rights Ombudsman Vladimir Lukin. Among Lukin's undertakings: -- he is backing efforts of the RRCHR to have independent psychiatrists included on the public council; -- he is working to create a "Service for the Defense of Patients," as required by law. According to Vinogradova, President Putin has given his assent to the creation of such a body; -- he has sent letters backing the appeals of several court cases whose verdicts did not seem to be supported by the evidence. 8. (C) Vinogradova thought it impossible, however, that Lukin would mount a more high-profile assault against corruption in psychiatry. "He is too careful a bureaucrat for that," she said. --------------------------- Abuse is Where the Money Is --------------------------- 9. (C) Vinogradova believed that much of the corruption was centered in Moscow, where "there is more money to be made" and people are more sophisticated. In addition to the Serbskiy, Moscow's Hospital Number 1, or "Alekseyeva" Hospital, is a key player in the diagnosis-for-sale industry. Psychiatry in the provinces is handicapped by the lack of trained personnel, which leads to flawed diagnoses and treatment regimes. Vinogradova singled out Arkhangelsk, Naberezhnye Chelny, Yekaterinburg, and Voronezh psychiatric hospitals as well administered. St. Petersburg, she said, is more uneven, with some of the hospitals very well run; other less so. Among the more corrupt, she said, was the Krasnodar psychiatric facility. ------------------------ Limits to Exposing Abuse ------------------------ 10. (C) Vinogradova reported that she has been unsuccessful in getting media attention to the problem of corruption in psychiatry. The RRCHR's access to the newspapers Novaya Gazeta, Izvestiya, Russkiy Kurer, and Moskovskiy Komsomolets has ended, and the only radio station to offer a forum for discussion recently has been Radio Svoboda. ---------------------------- Human Rights Crusader Agrees It's Societal, Not Political ---------------------------- 11. (C) Moscow Helsinki Group's Lyudmila Alekseyeva agreed that there is significant, and significantly underreported, abuse of psychiatry, and agreed with Vinogradova that today's misuse of psychiatry is rooted in societal conflicts --families fighting over real estate and inheritance, or business partners falling out. It is also the case, she offered, that the victims are often difficult, hysterical, or simply unbalanced. Few organizations have the mix of medical MOSCOW 00011652 003 OF 003 and legal expertise necessary to track the problem, Alekseyeva said. Her organization has seen a growing number of walk-ins who allege they have been the victim of such abuse. ------- Comment ------- 12. (C) Alekseyeva was at pains in her conversation with Embassy to stress that today's misuse of psychiatry is rooted in societal and business conflicts. Vinogradova agreed, saying that the number of cases that might be called political could be counted on the fingers of one hand. Still, she cautioned, the current interpretation of the "Legal Expertise Activities" law has created a framework for the use of psychiatry to suppress political dissent, should the GOR choose to do so. BURNS