PSYCHIATRY ABUSED FOR COMMERCIAL ENDS

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