International Handbook on Mental Health Policy

By Donna R. Kemp | Go to book overview

governmental character, where the governmental system was the only one in the country. In some respects it created undoubted advantages, such as the rapidity with which psychiatric aid was provided practically all over the country. The general principles of the Soviet public health system (availability, medical aid, free of charge continuity, and stages in rendering aid) were implemented in psychiatry as well. It was possible to achieve quite extensive data on the prevalence of mental diseases on a wide scale over a large country during several decades. An enormous amount of scientific information from this data awaits analysis.

However, this system from the very beginning had serious shortcomings, which have become especially evident during recent years. This pertains first of all to the absence of legal protections for mentally ill; a rigid system of "psychiatric registration," which led to social discrimination against patients; and the dependence of psychiatric institutions and their personnel on government directives, which hampered any initiative and either led to stereotyped formal work or facilitated a lowering in the qualifications of psychiatric staff. The situation was aggravated by a very low level of financing for a broad network of outpatient and inpatient facilities. As a result, there are very unsatisfactory, almost-disastrous conditions in most of the outpatient psychiatric centers and psychiatric hospitals.

Fortunately, these problems have recently been discussed, not only by physicians, but by the society in general, which gives hope that these issues will be solved. A nationwide program establishing the basic prerequisites for the organization of psychiatric aid was under development. The main participants of this program were the staff of the Department of Mental Health Services Organization in the Institute of Preventive Psychiatry, National Mental Health Research center of the USSR Academy of Medical Sciences. It remains to be seen if this work will continue under the new governments.


NOTES
The authors are very grateful to Mrs. M. Shchirina, Mrs. N. Sofonova, Mrs. N. Morgounova, and Mrs. J. Langbord, who contributed to the translation and printing of this chapter.
1.
Most of the data in this chapter are provided by official statistics from government departments. Data obtained from special studies are referenced.
2.
This period also was characterized by a major rise in the number of mental disorders registered by outpatient psychiatric centers: In 1970 it was 11.4 cases per 1,000, while in 1988 it was 18.1. It is assumed that this increase was due to the creation of new psychiatric centers and a better screening of patients ( Jarikov, 1977).

REFERENCES

Djagarov M. A. ( 1937). Opyt organizatsii polustatsionara dl'a dushevnobolnykh [Experience of the organization of a half-day center for the mentally ill]. Journal of Neuropathology and Psychiatry, 6-8, 137-147.

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