67 NGOs asked the President not to change the law “On Psychiatric Care”

Yesterday, the State Duma Committee on Health Protection discussed the amendments to the law “On Psychiatric Care” that caused a public outcry. They, among other things, contain a proposal to abolish mandatory independent advocacy services for patients with mental disorders. The meeting was attended by social activists who handed over to the deputies an appeal to President Vladimir Putin with a request not to accept the changes – it was signed by 67 NGOs and 32 thousand people. As Nyuta Federmesser, head of the Center for Palliative Care, told Kommersant, even this did not help convince the parliamentarians. However, they claim that they consulted with public organizations.

It was proposed to change the law “On Psychiatric Care” in the spring of 2022. Psychiatrist Georgy Kostyuk explained the need for this by the “obsolescence” of the current one, adopted back in July 1992. According to him, many other regulations have been adopted since then, which have given rise to roughness and inconsistencies. And Svetlana Bessarab, a member of the State Duma Committee on Labour, Social Policy and Veterans Affairs, stated the need to make the work of neuropsychiatric boarding schools (PNI) more transparent. A new version of the document was prepared by a working group at the Public Chamber; in January 2023, the Russian government submitted amendments to the State Duma, and in March the bill was adopted in the first reading.

The project was sharply criticized by many specialized public organizations. After the first reading, 67 Russian NGOs immediately prepared an appeal to President Vladimir Putin with a request not to accept the amendments; more than 32 thousand people signed it as a petition on the Internet. The authors of the appeal also brought it to yesterday’s meeting of the committee.

The proposed changes, the letter says, “significantly worsen the legal protection of people with mental disorders, throwing Russia back in this part in the last century.” “The worst thing,” according to social activists, is the exclusion of Art. 38 of the current law. It describes the obligation of the state to create independent services to protect the rights of people with mental disorders. Instead, the legislators proposed to expand Article 46: the rights of patients can be protected by regional and federal officials, ombudsmen of various levels, lawyers, public associations and non-governmental organizations. However, they are required to coordinate the conditions for visiting the patient with the head of the medical institution. “This is a super-vague norm that does not provide for any obligations of the regions to do anything,” Nyuta Federmesser, head of the Palliative Care Center and founder of the Vera Hospice Charity Fund, told Kommersant. “And we do not believe that the regions will make efforts in this sphere.”

Social activists recalled “resonant stories of violations of the rights of people in boarding schools, which are increasingly becoming public.” So, on April 18, Nyuta Federmesser reported the death of six people in PNI No. 10 in St. Petersburg. At first, the Investigative Committee confirmed that the cause of death was the improper performance by the PNI employees of their professional duties in caring for patients. However, on July 12, Alexander Lyubimov, deputy chairman of the committee on social policy of St. Petersburg, said that the checks did not find any violations in the work of the institution. The committee concluded that all patients had multiple mental and physical disabilities and lived in the boarding school for three to five years, which is a “long time.”

The appeal also lists other claims to the new version of the law. Thus, it does not take into account the possibility of finding a person with mental disabilities at home or in assisted living projects. In addition, temporary withdrawal from the PNI will continue to depend on the director of the organization, and the draft law does not provide for grounds for refusal and the possibility of appealing it. Difficult and extract from the boarding school. Now, as Ms. Federmesser says, “getting in is much easier than getting out.” Finally, there is no direct prohibition in the law on the use of measures of physical constraint and isolation in PNI. There is no direct ban on restricting the rights to receive visitors, to use basic necessities and to use telephone communications.

Nyuta Federmesser told Kommersant that the public at the meeting failed to convey to the deputies why the parent community and socially oriented NGOs do not support the bill. “We explained: unfortunately, the existing public authorities are not able, within their powers and traditional working mechanisms, to ensure the protection of the rights of people with mental disorders, taking into account their individual characteristics. That they live in closed institutions where there are no means of communication, where it is impossible to send appeals to state authorities. That people do not even have the opportunity to formulate a problem,” said Ms. Federmesser. “We explained to the deputies that it is necessary to comply with the UN Convention on the Rights of Persons with Disabilities. Which provides that states should take measures to ensure the protection of the rights of people with mental disorders – by creating bodies that are independent both from the state and from the institutions of social services and health care themselves.

According to Rostrud, about 156 thousand citizens live in PNI, almost 16 thousand of them live in institutions for children with disabilities. In her Telegram channel, Ms. Federmesser explained that these are “not dangerous psychos, but unfortunate and lonely disabled people who grew up, but did not mature due to social deprivation, orphans, abandoned old people, men and women with dementia and Alzheimer’s disease, men, passed through Afghanistan or Chechnya and failed to integrate into peaceful life after the war.

The Ministry of Health did not respond to Kommersant’s request. Deputy Chairman of the State Duma Health Committee Sergei Leonov (LDPR) noted that the law on psychiatric care and, in particular, Article 38 had not actually worked for 30 years. “Taking into account the appeal of public organizations, certain cases that were in boarding schools, it was decided to finalize this law. The State Duma, taking into account the interests of social activists, worked on the document for several years. The bill in the form in which it has been finalized now protects the interests of patients, their relatives and public organizations more,” he said. “Misunderstanding”, according to Mr. Leonov, could arise “due to discrepancies in the mechanism of control by public organizations in institutions.” “Over the 13 years of my public work in the Smolensk region, I have visited all the boarding schools and have never heard complaints from either the people who are there, or from collectives, or from public organizations about any excesses. If they happen, it is because of the stupidity of the leaders who imagine that they can manipulate people. But for this there is an executive power in the subjects of the Russian Federation, which should control. But public organizations should also be able to control. Time will put everything in its place,” concluded Mr. Leonov.

Natalya Kostarnova