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The political abuse of psychiatry has returned. This time it has been revived in full in the concrete case of Mikhail Kosenko, a defendant in the Bolotnaya trial:

– in the text of the forensic psychiatric assessment of the experts;
– in the responses to the court’s questions by the expert from the Serbsky Centre; 
– in the conduct of the judge and the prosecutor. 

On the basis of the charges, which had yet to be proved in court, the experts equated the actions of which the defendant was accused and what he had actually done (that’s how it is in our law). And they have become so accustomed to this approach, that the absurdity of it does not embarrass them.

The experts concluded, on the basis of a conversation of less than an hour, that the diagnosis should be significantly worsened, replacing ‘mild neurosis-like schizophrenia’, of which Mikhail Kosenko had regularly shown symptoms and for which he had been treated over 12 years with ‘paranoid schizophrenia’. Moreover, despite the data of the out-patient observations showing the course of the illness was undoubtedly – and this is most important - mild, they write of ‘episodic flareups’. He was treated with the weakest tranquillizers and antidepressants. The experts talk in just as irresponsible a manner about ‘progressive development’, ‘weak and undeveloped emotional reactions,’ ‘lack of direction and logic in thought processes. This has already been refuted by the highly emotional responses by Mikhail Kosenko from the cage in which he was detained in the courtroom which showed a very clear understanding of the essence of the charges against him. He was very indignant that the content of his personal writings were read out in public, and were published on the Internet. He even demanded that all members of the public be removed from the courtroom. According to the experts, this person who never in his life had exhibited aggression, who voluntarily, conscientiously and regularly took his treatment as an outpatient, ‘needs compulsory treatment in a psychiatric hospital’, since ‘he presents a danger to himself and to those around him.’ At the same time, Kosenko had not been identified by the riot police officer who was the alleged victim. It turns out that they even consider taking part in a permitted protest rally constitutes a ‘danger to the public’. The experts went so low as to say that the Kosenko’s psychological state ‘deprived him, in the period when the actions for which he is being charged took place, of the possibility of recognizing the real nature and public danger of his actions, and to act upon this.’ ‘In his current psychological state, Kosenko cannot understand the nature and significance of the criminal process and his procedural situation, he is not capable of independently taking actions with regard to his procedural rights and duties, he cannot take part in the judicial investigative procedures.’ In practical terms, the experts said that Kosenko was effectively not responsible for his actions, despite his independent manner of life.

In answer to the question whether there was a ‘threat of the deterioration of the illness in conditions of pre-trial detention’, the experts, despite their own description of the worsening of his condition, responded that it ‘does not fall within the competence of the forensic psychiatric experts’, as though they were not psychiatrists.

The apotheosis of the rebirth of the Soviet style were the stubborn statements of the expert from the Serbsky Centre that ‘mild schizophrenia is schizophrenia al the same, which sooner or later will transform into paranoid schizophrenia as one of its stages,’ while for 15 years now ICD-10 has been accepted in our country as a standard which removed schizotypal personality disorder from the diagnosis of schizophrenia (formerly known as mild neurosis-like state and psychopathy-like schizophrenia) and chronic delirium disorder (formerly paranoid schizophrenia), demanding quite different treatment and social measures than schizophrenia. The broad diagnosis of schizophrenia (by a factor of three) in the Soviet Union easily led to the abuse of psychiatry for political purposes. The expert answering the questions, showed extraordinary nonchalance in classifying serious psychotic illnesses, saying that Kosenko had not only paranoid, but even paraphrenic delirium, and that his ideas were megalomaniac in nature. There was no basis for any of this, but it merely showed an arbitrary use of categories.

The forensic psychiatric assessment in the case of Kosenko suddenly took on the appearance of an amazingly familiar face, just like a meeting with an old friend who, unlike you, had not grown any older. Of course, not ‘suddenly’, but ‘at last’ everything has come full circle and one can say: we have entered that phase of the state of society when psychiatry is once again being used for extra-medical purposes. If on 30 August 20 13 in the case of Dmitry Vinogradov (the ‘Russian Breivik’) Judge Podoprigorov (who is on the Magnitsky list) did not allow either myself or the lawyer to speak, decisively rejecting question after question and regularly repeating : "According to the law, you do not have the right to assess or criticize state experts,’ then on 23 September 2013, in the case of Mikhail Kosenko, Judge Moskalenko gave me the opportunity to speak and patiently heard out my detailed explanations of the weaknesses of the experts’ conclusions, but dismissed a request by the lawyer to have Kosenko sent for a further assessment at a psychiatric hospital (again to the Serbsky Center, but with different experts), rejecting the argument that the reputation of the Serbsky Centre would suffer badly if our assessment were to be published in English.

Our assessment, as published in the Journal of Independent Psychiatry (2012, 4, 70-74), can be read here (in Russian).

The judge did not allow Kosenko to visit his dying mother to whom he regularly wrote heartfelt letters from the detention centre. The doctors at the Butyrka Pre-Trial Detention Centre No. 2 had been afraid to tell him of the death of his mother. As a result, according to a nurse, he learnt of her death ‘from the television’!

Such is the typical practice of our courts, investigators and prosecutors, which causes indignation even among the senior officials of the Federal Penitentiary Service.

Yury S. Savenko
Head of the Independent Psychiatric Association of Russia