Fourteen psychiatric patients have been sterilised in the Perm region of Russia against their will and without an appropriate court ruling.

As reported in Russia Today

This was the striking discovery made by the region’s human rights committee over the course of a two-year investigation, revealing numerous grave offences.

After receiving more than 50 complaints from patients of the 15 psychiatric asylums in the Perm region, an investigation was launched to analyse living conditions in these institutions. After two years of detailed study, a series of shocking discoveries was made.

Read more

Fourteen young women, born in the 1970s and 1980s were sterilised against their will, without the signed permission of their families or any appropriate court ruling. As the report states, the most poignant justification of these actions came from an unnamed asylum staff member. They did it so that the women “would not give birth to lunatics”.

In the Russian legislation, sterilisation of legally capable women is only permissible with their accord and when they’re aged over 35, or already have two children. When the woman is not legally capable, the signed permission of two gynaecologists and a court ruling are required.

There exists, however, an appendix to the law, which states that sterilisation can be carried out based purely on medical reasons if there exists “a threat to the woman’s life or health”. Staff have tended to interpret this appendix at will, using it to cover many sterilisations.

According to the human rights commission, the staff at the institutions were not even aware that a court decision was required to conduct the procedure. They based their decision simply on the advice of the institution’s administration.

Other infringements

It was discovered that the shocking cases of unlawful sterilisation were not the only cases of severe breaches of human rights in these psychiatric institutions. The official report drafted by Tatyana Margolina outlined three main areas of severe infringements of human rights in these institutions: medical care, the right to housing and the right to fair employment.

Perhaps the most fundamental malpractice in the institutions is the lack of adequate healthcare provision. According to the report some psychiatric institutions do not even have an appropriate medical licence.

Despite being state organisations, the institutions need to renew their medical licence every few years. Of those whose license had expired, the most recent renewal was in 2001. Since then, no new medical or diagnostic supplies were provided and no new medical personnel had been taken on.

“In several institutions medical attention was not provided and people simply died,” Margolina pointed out in the report. “Their death was a result of appropriate measures not being taken in due course.”

The lack of a medical licence resulted in the absence of basic medicines and diagnostic equipment. This has resulted in several deaths due to negligence in the last two years alone. The report refers to a number of unnamed cases. The causes of death named by coronary analysis include untreated and misdiagnosed pneumonia, a stomach ulcer and meningitis.

The last case is given specific attention. The patient was admitted to an institution and passed away only days later. The orderly simply gave the patient medicines against flu-like symptoms and proceeded to ignore the case for the next two days, during which the patient’s condition steadily worsened. Renewed medical attention was only given when the patient was on his deathbed, but it was too late. Even then, an appropriate diagnosis was not made.

Staff members point out that they don’t even call ambulances for the patients since the medics simply refuse to drive out to the institutions. In most places, no individual rehabilitation programmes were developed for patients. Some do not even have a stock of the required anti-psychotic drugs.

As a result, the patients’ abilities are not developed to their fullest potential. According to the report, some of the patients would have had the chance to do basic manual work and provide for themselves if given the appropriate training. Nevertheless, such fundamentals as sports equipment, professional and educational training and development programmes simply do not exist in Perm region institutions.

The living space provided for the patient is often far less than the basic minimum required by the Russian state. Some patients live in as few as three square metres of individual space with no access to privacy – nurses often break through locked doors and into restrooms as well as shower facilities.

The report points out that the conditions in the institutions breach several clauses of the UN charter and the human rights declaration: the patients do not have access to medical care, individual space, basic dignity, employment and personal development. Nevertheless, the report only goes as far as “advising” the local administration and the relevant institution to take these facts into account.

Regional problem?

Despite the gravity of the problem and its deep-rooted nature, the local administration appears to be inert in dealing with it. RT tried to get information of what the regional government is planning to do in order to resolve this shocking breach of basic human rights.

“Tatiana Margolina is refusing to give any comments on the situation, referring to the fact that it is a regional problem and the report was released regionally,” the human rights commissioner’s press office told RT.

When the local administration’s press office was contacted directly, RT was told that the general office does not have the competence to comment on such issues, and the human rights commission should be contacted.

As a result, no official comment was given on how the living conditions of the psychiatric patients will be ameliorated. So, despite the severe cases of human rights breaches and even abuse from state care providers being brought to public light, it remains unclear what will be done.

Artem Basyrov, A Case Of Punitive/Political Psychiatry?

from the Daily Mail:

A Russian opposition activist has been sent to a psychiatric hospital by authorities a day before a planned demonstration.

Artem Basyrov's detention is the latest in a series of incidents suggesting a punitive Soviet-era practice is being revived under president Vladimir Putin.

Mr Basyrov, 20, was ordered to be held at a hospital in the central region of Mari El on November 23, a day before planned demonstrations, said Alexander Averin of the opposition National Bolshevik Party.

The party is part of the Other Russia coalition which organised the so-called Dissenters' Marches across the country this year.

Mr Basyrov ran for the local legislature as an Other Russia candidate.

Police who originally detained him claimed he had assaulted a girl.

A local psychiatric board agreed, deciding the activist suffered from a mental illness and he was committed to the psychiatric hospital three weeks ago.

He was only transferred from an isolation ward and allowed to have visitors on Thursday, said Mikhail Klyuzhev, a National Bolshevik member from the city of Yoshkar-Ola.

The allegations against Mr Basyrov were "idiocy" and were "part of the hysteria" before Russia's parliamentary elections which were held on December 2, Mr Klyuzhev added.

Supporters said Mr Basyrov did not appear to have been mistreated.

A psychiatric board is due to review his case at the end of the month.

His case is the latest example of journalists or opposition activists being involuntarily committed to psychiatric hospitals in Russia.

During the Soviet era, dissidents were frequently committed for protesting against Soviet policies.

Last week, Reporters Without Borders said Andrei Novikov, a reporter for a news service connected with Chechen separatist government, was released after nine months in a psychiatric hospital.

Earlier this year Larisa Arap, an Other Russia activist and journalist, spent six weeks in a psychiatric clinic.

Supporters said this was punishment for her critical reporting.

The Global Initiative on Psychiatry, a Dutch watchdog, says psychiatry continues to be used for punitive, political purposes in Russia.

Prosecutors in Mari El were not available for comment last night.

Top 10 most bizarre medical experiments

From a longer article in the Guardian, includes some psychiatric classics

Top 10 most bizarre experiments

Elephant receives massive dose of LSD to see if it induces temporary madness.
Conclusion: LSD is fatal to elephants

Aircraft passengers told they are about to die in crash make more mistakes in written test.
Conclusion: Extreme stress harms cognitive ability

Two-headed dogs created by Soviet surgeon, above, but die within a month.
Conclusion: Tissue rejection makes animals incompatible

Psychologist begins experiments on son to test if laughing is spontaneous when tickled.
Conclusion: Laughing is an innate response to tickling

A room of nail-biting boys is played a recording or spoken announcements to break the habit while they sleep.
Conclusion: Sleep learning is possible. Others prove otherwise

To test if people can sleep through anything, volunteers have their eyes taped open and bright lights shone in their eyes.
Conclusion: The men dozed off in 12 minutes

People asked to smell ammonia, put hands in a bucket of frogs and watch porn.
Conclusion: Disgust has no single expression.

Doctor rubs vomit from yellow fever patients into open wounds and drinks it.
Conclusion: Mistakenly claims it is not infectious

Animal corpses placed on seesaw to restart circulation and bring them back to life.
Conclusion: Two animals survive with blindness and brain damage

Fake female turkey dismantled limb by limb to find minimum that a male will mate with.
Conclusion: Male turkeys aroused by a head on a stick, but not a headless body

Psychiatrist Loses Criminal Appeal

As seen in this report from the Capitol News Service

A Maryland court Wednesday upheld disciplinary action against the psychiatrist who leaked details about the sexual habits and mental health of convicted spy Robert Hanssen in 2001.

A three-judge panel of the Maryland Court of Special Appeals upheld lower court rulings against Alen J. Salerian, who had been hired by defense attorneys to evaluate Hanssen, a former FBI agent arrested for giving highly classified information to Russia.

The two met over the course of a week in April 2001, during which Hanssen admitted he had a "long history of sexual betrayal and exploitation" of his wife -- a fact that Salerian later shared with Hanssen's wife.

Court documents said Salerian was warned repeatedly by Hanssen's attorney, Plato Cacheris, not to disclose any details of his conversations with the former FBI agent. Salerian, along with most others involved in the case, had also signed a letter from the U.S. Attorney General promising not to disclose information about Hanssen due to "national security interests" involved.

In May 2001, within a week after telling Hanssen's wife about the sexual betrayals, Salerian was fired by Cacheris. Salerian also received a letter from Hanssen forbidding him from discussing their meetings with anyone other than defense attorneys, including family members and "certainly with anyone outside the family."

But in the following weeks, Salerian was quoted in numerous media outlets discussing Hanssen's mental state.

In a June 2001 CBS report, Salerian claimed that he had disclosed the information with Hanssen's permission. Salerian, who believed the FBI, the church and the medical system had failed Hanssen, said it was "a situation where there was life and death involved and I had to make a call as a physician to say what I think is right."

In a disciplinary hearing against Salerian, Hanssen testified via telephone that he had agreed to let Salerian tell his wife about the sexual exploits because Salerian convinced him that the media were about to publish it.

Hanssen pleaded guilty to espionage in July 2001 and is serving life in federal prison. The 2007 film "Breach" was based on his arrest.

Hanssen's attorneys and wife filed a complaint against Salerian in September 2001 with the Maryland State Board of Physicians, charging he disclosed confidential information. That same month, Salerian's license to practice medicine in Maryland expired.

He applied for reinstatement of his license in September 2002, only to be told the board was charging him with immoral and unprofessional conduct and violating attorney-client and physician-patient privilege. He attempted to withdraw his application in July 2003, but was told he could not do so while charges were pending.

An administrative law judge initially recommended that Salerian be fined $20,000, have his license revoked and be barred from applying for reinstatement for up to three years.

In January 2005, the board decided instead that Salerian be fined $5,000 and be placed on probation for two years, which would not end until he completed an ethics course.

Salerian challenged the action, but it was upheld by the Montgomery County Circuit Court. He raised 10 issues in his appeal to the Maryland Court of Special Appeals, which rejected all 10 Wednesday.

Messages left on his voicemail Wednesday at the Washington Center for Psychiatry were not returned. A woman who answered the phone at the address listed for Salerian in the state physicians board's records said he had not lived there for six years.

Cacheris called Wednesday's ruling accurate and said he agreed with the penalties against Salerian.

Putin critic tells of her mental hospital ordeal

From this Report

Larisa Arap has just emerged from a 46-day imprisonment in two Russian psychiatric hospitals. Pills were forced down her throat and she received injection after injection. She doesn't know what medications they were, or whether they will cause permanent damage.

"I don't feel very well, but I have a fighting spirit," Mrs Arap said yesterday, adding that sometimes she was so drugged she could barely walk or speak

She was forcibly interned, not for health reasons, but over her association with the opposition group led by former chess star Garry Kasparov, the United Civil Front. Her arrest stemmed from the publication of an article entitled "Madhouse," exposing the ghoulish practices of a Russian psychiatric hospital in the Murmansk edition of his organisation's newspaper, Dissenters' March.

She was interned in the very hospital she had written about. "We're ready to take this to court, although the medics have made it clear that we'll lose," she said.

Russian activists say her ordeal confirms what they've argued for years: punitive psychiatry did not end with the Soviet Union. Now, critics suggest, if someone has a grudge - a husband, a business partner, even a psychiatrist - it isn't difficult to get them confined to a padded room.

In recent years, Mrs Arap had been looking after the child of her daughter, Taisiya, in her home town of Murmansk, north of the Arctic Circle. Problems first arose in 2003, when she uncovered corruption in her local housing association, as she reported in "Madhouse." She was then attacked in her building, mystery callers threatened to murder her, and finally she was warned by the FSB, the KGB's successor, to keep quiet. She didn't.

Taken to a mental ward, Mrs Arap noted that many of its occupants seemed perfectly sane. "I was surprised that among them were lots of normal people," she wrote in "Madhouse". "But how they [staff] communicated with them: They shouted, they beat them up, they put them on drips, after which people became like zombies, they raped them, carried them off in the night and returned them in the morning, tormented."

One woman was threatened with the removal of organs, Mrs Arap said. Children were told that if they didn't give massages to medics they'd receive electro-shock therapy.

Mrs Arap was freed, but on 5 July, she was restrained at a clinic after stopping for documentation needed to obtain a drivers' license. Her doctor asked if she had written "Madhouse," and when she confirmed, police escorted her to a Murmansk mental hospital.

Taisiya said that when she was first arrested, Mrs Arap was beaten, and went on a 5-day hunger strike in protest, consuming nothing but water and smoking cigarettes.

It was only on 18 July that a court sanctioned her hospitalisation; until then, she had been detained illegally. Mrs Arap was moved to a hospital near Apatity, 180 miles from Murmansk, "without her agreement or the agreement of her relatives," Taisiya said.

It was "a closed hospital from which people rarely return. ... No positive feelings arise in this hospital. It's a psychological hospital for the difficult, the dangerous, the abandoned."

Mrs Arap was eventually released when a commission, initiated by Russia's human rights ombudsman, Vladimir Lukin, said there was no reason for her to be hospitalised.

She is due in court today to protest her treatment, and the United Civil Front plans to prosecute everyone involved, although a representative admitted the group has little chance of winning.

"We were never told anything concrete about why she was locked up," Taisiya said. "The most frightening thing of all is that the law gives a lot of power to psychiatrists and doctors to do what they want."

Labelled mad for daring to criticise the Kremlin

From the Daily Telegraph

Naked and with her hands and feet bound to the corners of a metal bed covered by a rubber incontinence sheet, Larisa Arap eyed with quiet defiance the doctors who wanted to declare her mad.

It was a futile gesture. The men in white coats standing over her were bitter adversaries.

Enraged by the allegations that she had levelled against them, they also knew that, as an open Kremlin critic, the state would do little to help her.

A needle sank into her arm. Over the coming weeks, as the treatment took its effect, Mrs Arap would become everything the doctors declared her to be: her head lolled to one side, her tongue hung out of her mouth and her face went slack.

"When she was brought out she was covered in bruises," said Taisia, her daughter. "She couldn't stand, could hardly speak and was drifting in and out of consciousness."

The practice of "punitive psychiatry", perfected by Nikita Khrushchev in the aftermath of Stalin's Great Terror as a more palatable way of dealing with political dissidents, was once thought to have been buried with the Soviet Union.

But Mrs Arap's ordeal has raised fears among Russia's browbeaten human rights community that the Kremlin is preparing to incarcerate a new generation of dissidents in asylums.

Mrs Arap was by no means a high-profile critic of President Vladimir Putin. But in Murmansk, a drab city inside the Arctic Circle where she was seized by police, she had begun to be noticed.

At a rally in the city in June, she delivered as a member of the United Civil Front - the opposition party of Garry Kasparov, ex-chess champion - a powerful denunciation of Mr Putin's crackdown on dissenters.

Such unorthodox views are enough to get anyone labelled an eccentric in Russia these days. But the state psychiatrists holding her insist she has a history of mental instability, pointing out that she sought counselling for stress and insomnia in 2004.

Because she is forbidden from seeing anyone apart from her immediate family - who were also threatened with enforced treatment after they demanded visiting rights - it is impossible to judge Mrs Arap's state of mind.

Under Russian law, a patient can only be sectioned if they are a danger to society or to themselves. Colleagues say Mrs Arap is neither.

However, she was angry. Earlier this summer, she wrote a newspaper article that infuriated the medical establishment in Murmansk.

Detailing a pattern of systematic abuse at the clinic where she is being held, she alleged that children were subjected to electric shocks against their will.

She also wrote of several cases of sane individuals being held against their will at the behest of powerful opponents: a businesswoman sectioned by rivals intent on seizing her financial interests, a witness to a murder and a mother whose daughter was raped at a school where the well-connected headmaster wanted to avoid scandal.

"There are two reasons for what has happened to Larisa," said Yelena Vasilieva, Mr Kasparov's party chief in Murmansk.

"The doctors are concerned with the defence of their honour. Secondly they want to discredit the United Civil Front. They are using her as a political weapon in the struggle against the opposition."

Mrs Arap's allegations come as no surprise to those who have followed psychiatry in Russia in recent years.

In 2001, the law was quietly changed to remove the rights of sectioned patients to seek an independent assessment.

The Daily Telegraph has learnt of dozens of incidents that suggest that Russia's psychiatric system is rapidly becoming as unsavoury as it was in Soviet times.

Andrei Fedorovich was held in a clinic for 43 days last autumn after his neighbours, who had powerful connections in the Moscow police force, reported him as mad in an attempt to seize his apartment.

Alexei Shuralyov tells a similar story - although this time his antagonists came from the FSB, the feared domestic spy agency that employed his wife.

Such stories are common. But increasingly the same fate is befalling those who oppose the authorities in Russia's regions.

After fighting a lone battle to expose judicial, police and local government corruption in the city of Cheboksary, Albert Imendayev was hauled into an asylum the day before he was to register as a candidate in local elections in 2005.

In the same city the previous year, Igor Molyakov was sectioned after psychiatrists ruled (and a judge agreed) that his repeated letters detailing local corruption reflected an outlook so sombre it constituted a "mental disorder".

"Once again psychiatrists see stubbornness in an individual as a sign of psychosis," said Lyubov Vinogradova, the executive director of the Independent Psychiatrists' Association. "If a person goes to court against a state institution or writes letters of complaint he is treated as a social danger and is in danger of incarceration."

In a country where anyone with a history of mental deficiency is ostracised, the victims of abusive psychiatry must live with the stigma for the rest of their lives.

But until Mrs Arap's case, it was generally believed that "punitive psychiatry" was not meted out on the orders of the Kremlin itself.

With a presidential election due next March, when Mr Putin hopes to shoehorn a handpicked successor into the Kremlin, fears are now mounting that her ordeal has been a "test case" - the first of many to come.

"Everything is ready for a wide scale political abuse of psychiatry," said Mrs Vinogradova.

Criminals can use Psychiatry as a weapon

From the periodical Russia Today - a look at how psychiatry can get out of control.

Mentally ill or mentally healthy - it's up to a psychiatrist to determine, and a patient's life often depends on this decision. Almost half of all mental health patients in Russia are being mis-diagnosed, according to a human rights organisation.

Inna and her fourteen-year-old daughter Nastia say they were victims of a false diagnosis.

Inna couldn't sleep for several days because of stress she had experienced after a car accident. She says she took some medicine to help her fall asleep, and during the night her daughter drank the water with the medicine - by accident. The mother and daughter both got poisoned, and called an ambulance. Both woke up in psychiatric hospitals – Inna charged with attempted murder.

On the basis of a psychiatric examination, a court has now decided Inna needs to be put into a psychiatric clinic. The two are currently in hiding.

Valery has a different story. He is a 53-year-old engineer, and he has spent the last years of his life fighting for his apartment. He says criminals wanted it, so they decided to get rid of him by locking him up in a psychiatric ward. They found a psychiatrist who would help out by saying Valery was ill and needed to be put into a hospital. Additional testing later proved that Valery was quite healthy.

He is now trying to prove he was a crime victim. He wants those responsible punished. And his life's goal has become warning innocent citizens about these kinds of crimes.

The Civil Commission on Human Rights operating in Russia says, according to research, almost half of the patients who are told they have a psychiatric illness actually have a regular physical sickness, and don't need psychiatric help.

Mikhail Vinogradov - a prominent Russian criminologist and psychiatrist - says the reason for abuse in psychiatry is that doctors are human too: "Among them, there are very good doctors and there are bad doctors. But there are definitely less bad ones. And naturally, there are criminals among them, like in every social sphere - among priests, policemen, bureaucrats. They are all human," he says.

The expert says what happened to Inna was an attempt of suicide and murder.

"To simply fall asleep, you would take one or two of the pills that she took. The only reason you would take more, is to kill yourself. The doctors did the right thing by taking both Inna and her daughter to a clinic. The mother in this case was trying to kill herself and to take her daughter with her. This is an absolutely obvious case in psychiatric study. The only question is - was she acting under affect or is she psychologically ill?" doctor Vinogradov asks.

And he says getting someone's property by putting them in a psychiatric clinic nowadays happens very often.

"Valery's case is very typical. These stories take place often, when people want to get someone else's living space, there are sometimes fraudulent psychiatrists assisting in the crime," he says.

According to the psychiatrist's statistics, about 67% of Russia's population is either undergoing or needs some form of psychiatric treatment. Among these, 19% are chronically ill. Doctor Vinogradov says the statistics are similar in Europe.[...]

Russian Psychiatrists claim whipping therapy cures depression and suicide crises

Of course this is from Pravda, which has become well known as the Russian equivalent of the National Enquirer, with an occasional taste for weird articles similar to those seen in the Weekly World News. With all that , we'll have to label this one as satire, although we could only wish they were serious. As seen here

The effect is astounding: a patient starts seeing only bright colors in the surrounding world

Russian scientists from the city of Novosibirsk, Siberia, made a sensational report at the international conference devoted to new methods of treatment and rehabilitation in narcology. The report was called “Methods of painful impact to treat addictive behavior.”

Siberian scientists believe that addiction to alcohol and narcotics, as well as depression, suicidal thoughts and psychosomatic diseases occur when an individual loses his or her interest in life. The absence of the will to live is caused with decreasing production of endorphins - the substance, which is known as the hormone of happiness. If a depressed individual receives a physical punishment, whipping that is, it will stir up endorphin receptors, activate the “production of happiness” and eventually remove depressive feelings.

Russian scientists recommend the following course of the whipping therapy: 30 sessions of 60 whips on the buttocks in every procedure. A group of drug addicts volunteered to test the new method of treatment: the results can be described as good and excellent.

Doctor of Biological Sciences, Sergei Speransky, is a very well known figure in Novosibirsk. The doctor became one of the authors of the shocking whipping therapy. The professor used the self-flagellation method to cure his own depression; he also recovered from two heart attacks with the help of physical tortures too.

”The whipping therapy becomes much more efficient when a patients receives the punishment from a person of the opposite sex. The effect is astounding: the patient starts seeing only bright colors in the surrounding world, the heartache disappears, although it will take a certain time for the buttocks to heal, of course,” Sergei Speransky told the Izvestia newspaper.

The whipping therapy has not become a new discovery in the history of medicine. Tibetan monks widely used it for medical purposes too. Soviet specialists used a special method of torturing therapy at mental hospitals. They made injections of brimstone and peach oil mixture to inspire mentally unbalanced patience with a will to live. A patient would suffer from horrible pain in the body after such an injection, but he or she would change their attitude to life for the better afterwards.

”People might probably think of me as a masochist,” Dr. Speransky said. “But I can assure you that I am not a classic masochist at all,” he added.

The revolutionary method may take the Russian healthcare to a whole new level. The method is cheap and highly efficient, as its authors assure. Why not using something more efficient, a rack, for example?

In Russia, Psychiatry Is Again a Tool Against Dissent

As spotted in the Washington Post

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."