flotsam-and-jetsam

By Owen Matthews and Anna Nemtsova

Newsweek International

Sept. 3, 2007 issue - Soviet doctors once joked that the best way to get thrown into a psychiatric hospital was to send a telegram to Leonid Brezhnev that was critical of the Russian leader. Now that old gallows humor might have to be resurrected. Doctors and Kremlin critics say over the past year at least 10 journalists, political activists or critics of local authorities have been wrongfully hospitalized in mental hospitals. And though forcible psychiatric treatment for political reasons is still rare, the Independent Psychiatric Association, a Moscow watchdog, says Russia's mental hospitals are routinely used by unscrupulous relatives and criminals to remove inconvenient family members for financial gain. "We see cases of psychiatrists taking bribes and faking diagnoses all the time," says Gennady Gudkov, a member of the Duma's Security Committee.

In some cases, hospitalization is seen as a way to resolve real-estate disputes or family quarrels. In two current criminal cases, doctors in Nizhniy Novgorod and Ulyanovsk are on trial, accused of committing old people to psychiatric institutions and selling their apartments for personal profit. (One defendant has pleaded guilty; the other says patients consented to the sale of their properties.) But increasingly, it is critics of authority who find themselves sent off to state hospitals. Yuri Savenko, head of the Independent Psychiatric Association, says he hears of new political cases almost every day. The most high-profile thus far involves Larisa Arap, a 48-year-old journalist in Apatity, near Murmansk, who had given an interview to a local newspaper in June that was highly critical of the region's state psychiatric hospitals. Arap was also an activist with the local branch of United Civil Front, a Kremlin opposition movement. In early July, she went to the hospital for a routine check-up required by law to renew her driving license. But, as she recalls, someone in the hospital called the police, and by evening, she had been committed to a psychiatric hospital, stripped of her clothes, tied to a bed and sedated. "Doctors told me that I would experience all the practices I had complained about in the papers," Arap told NEWSWEEK while still in the hospital. "They also told me that I was locked up for life." The hospital's head doctor, Yevgeny Zenin, told NEWSWEEK, "We do not care what independent commissions of psychiatrists, or the United Nations, or even aliens tell us. Once we decide to keep a patient here, we will. The courts will always listen to us and no one else." Yet Arap was lucky—the United Civil Front brought the case to the international media, and complained to Russia's human-rights ombudsman. He sent a delegation to Apatity to review her case, and they found Arap to be mentally fit. She was released last week. But other cases are still ongoing. Andrey Novikov, a journalist with a newspaper in Rybinsk, in central Russia, was jailed earlier this year on charges of "extremism" after publicly criticizing Vladimir Putin's policies in Chechnya. In February, Novikov was sent for involuntary psychiatric treatment for what his doctors say in court papers would be "as long as it takes to have his mental health fully restored."

Another journalist, Pavel Kuznetsov, was declared "mentally unsound" in February after criticizing local authorities' inefficiency in the newspaper. Olga Popova, a 34-year-old engineer, landed in Moscow's Mental Hospital Number 13 after seeing Duma Deputy Svetlana Savitskaya in June to complain about alleged abuses at Moscow's Serbsky Institute of Social and Forensic Psychiatry. Savitskaya told NEWSWEEK she believed her visitor to be "insane." She called the police to remove Popova from her office and wrote a note saying that in her opinion Popova was mentally unstable, on the basis of which she was committed. Three doctors from the Independent Psychiatric Association who have campaigned or her release examined Popova and found "no reasons for involuntary hospitalization." Popova is currently appealing her hospitalization through the courts.

For old dissidents like Vladimir Bukovsky, who was forcibly committed to a psychiatric clinic in the 1960s, these stories bring back chilling memories. "Once you are admitted to a mental hospital," he says, "any attempt you make to criticize the system or treatment will be evaluated as a sign or even proof of insanity." In modern Russia, it seems, as in the Soviet Union, you'd almost have to be mad to speak out.

The night before 15-year-old Edith Campos was sent to Desert Hills psychiatric hospital in Tucson, Arizona, she made colorful computer drawings for her family. If her mother missed her, all she needed to do was look at the picture and think of her daughter and that she would soon be home. Two weeks later, Edith came home in a coffin. During the time she was hospitalized, her parents were not allowed to speak to her. On February 4, 1998, Edith apparently died of asphyxiation, her chest compressed when she was held to the ground for at least 10 minutes after reportedly raising her fist during a confrontation with staff members.

On August 18, 1997, 16-year-old Roshelle Clayborne died during restraint at a psychiatric facility in San Antonio, Texas. Roshelle was slammed face down on the floor, her arms yanked across her chest, her wrists gripped from behind by a mental health aide. “I can’t breathe,” she gasped. Her last words were ignored. A syringe delivered 50 milligrams of Thorazine into her body and with eight staffers watching, Roshelle became suddenly still. Blood trickled from the corner of her mouth as she lost control of her bodily functions. Her limp body was rolled into a blanket and dumped in an 8-by 10-foot room. There she lay in her own waste and vomit for five minutes before anyone noticed she hadn’t moved. By the time a registered nurse arrived and began CPR, it was too late. Roshelle never revived.

When Jennifer Martin’s 70-year-old mother experienced headaches and nausea and stopped eating and talking, a psychiatrist claimed she was in shock from recent deaths in her family and gave her ECT. Less than 24 hours later she was dead. An autopsy revealed that the problem was not depression, but a brain stem complication. “Shock treatment killed her,” Ms. Martin said.

A grieving husband says a psychiatrist recommended electroshock because it would release a chemical in the brain that would make his wife, Dorothy, feel better. Aware of her earlier heart attacks, he administered 38 electroshocks. The last one killed her.

With billions in government appropriations allocated for mental health treatment, just how safe and effective are psychiatric institutions? The following cases illustrate the dangers of a system that lacks scientific understanding of causes of mental health problems, with subsequent lack of workable remedies and the terrible consequences of this.

On April 12, 1991, 14-year-old Jeramy Harrel was with his grandmother when a patrol car pulled up beside them, and two hulking uniformed men who appeared to be police officers announced that they were taking Jeramy to Colonial Hills Psychiatric Hospital. They said that psychiatrist Dr. Mark Bowlan and a child welfare agent—who had never spoken with Jeramy or his parents—had filled in an application for the boy’s detention, claiming he was a “substance abuser” and that his grandparents had physically abused him. The psychiatrist also stated that Jeramy was “truant from school, failing grades, violent [and] aggressive,” and was “likely to cause serious harm to self.” It took the efforts of Texas State Senator Frank Tejeda to finally obtain Jeramy’s release from the hospital after he had discovered the boy’s admission was based on the unsubstantiated and untrue comments made by Jeramy’s 12-year-old brother, Jason. The family’s health insurance was billed $11,000 for this fraudulent “admission” and “treatment.”

In 2001, a psychiatric nurse found a 53-year-old man unresponsive 12 hours after he had been medicated for “hostile, cursing behavior.” The man died within hours. An autopsy revealed that he suffered from multiple sclerosis (MS). Hospital staff thought “MS” on his admission form meant “mental status.”

Carl McCloskey says his son, John, 19, was sodomized with a broom-like handle so savagely in a psychiatric hospital that his bowel was torn and his liver was punctured. The teenager became violently ill, lapsed into a coma, and died 14 months later.

Seventeen-year-old Kelly Stafford agreed to enter a psychiatric facility expecting a brief respite from troubled family relationships. But once the door was closed, she was kept for 309 days, many of them behind blackened windows in cruel darkness. Her arms and legs were strapped for months at a time. Others in the facility were forced to sit motionless and silent for 12-hour stretches. “I had to eat Thanksgiving and Christmas dinner in restraints,” Ms. Stafford said. “There’s not a day that goes by that you don’t think about it.”

In 2003, Dr. Masami Houki, head of Houki psychiatric clinic in Japan, was charged with manslaughter after he plugged the mouth of a 31-year-old female patient with tissue, put adhesive tape over her mouth, injected her with a tranquilizer, tied her hands and feet, and forced her to lay on the back seat of a car while being transferred to the clinic. She was dead on arrival.

In Athens, Greece, the Ntaou Pendeli psychiatric institution kept children in a ward with mentally handicapped adults. Some of the children were naked; all were housed in cold, barren rooms and often left to lie in their own feces and urine. A teenager had been locked up for 10 years after he misbehaved when his father left his mother for another woman. He witnessed horrors such as the rape of other children by psychiatric nurses.

In his book A Dose of Sanity, the late neurologist and psychiatrist Sydney Walker III wrote of the dangers of the Diagnostic and Statistical Manual of Mental Disorders, citing cases such as these:

John, a successful and happy family man, began experiencing fatigue and sadness. Two psychiatrists saddled him with a variety of DSM labels and treated him with 26 different drugs without ever conducting a single neurological examination. When a qualified medical doctor finally conducted a thorough diagnostic evaluation, he discovered that John had a brain tumor. Once removed, his “emotional” problems and tiredness rapidly vanished.

Lilian, a 46-year-old normally athletic woman, felt sad and weary. A psychiatrist prescribed an antidepressant. “After all, Lilian had enough symptoms to be lumped into the DSM category of ‘depression’—and that was all he needed to know.” However, in the final analysis, “the simplicity was that her husband’s chronic snoring had been waking her up every five to ten minutes during the night—she was suffering from a severe case of sleep deprivation.”

Another example is Austin, who was hailed as “the poster child for Attention Deficit Hyperactivity Disorder.” He had been kicked out of 11 preschools in three years for doing everything from shouting obscenities and hitting other children to poking a teacher in the eye with a pencil. He was prescribed stimulants. But after a blockage was removed from his colon, he suddenly stopped terrorizing his teachers and classmates. Austin, who is now nine, was able to sit quietly and was a joy to be around. He gave up the medication. His mother said she never would have thought to connect Austin’s behavior with the chronic constipation he had suffered since infancy. “The bad behaviors disappear as soon as the impaction is removed,” said Dr. Paul Hyman, chief of pediatric gastroenterology at the University of Kansas Medical Center in Kansas City.

Dr. Walker concluded, “It’s important to remember...that a number of DSM-oriented psychiatrists have, to a large degree, abandoned the science of differential diagnosis, and thus consider most psychiatric illnesses ‘incurable.’ This leaves them with only two weapons: psychotherapy and drugs. It’s not surprising that they’re among the first to leap on each new drug bandwagon; like long-ago doctors who recommended bleeding for every ailment, they have little else to offer....”