Psychiatric reform in Russia

OBJECTIVE: To describe the mental health care system in Russia against the background of rapid social, economic and political change since the late 1980s. METHOD: Indicators of social stress and deteriorating population mental health and official data on service provision are presented. RESULTS: In the current system of psychiatric care dispensaries take a central position. Key issues of the discussion on mental health care include ways of coping with social stress disorders, strategies to redefine psychiatric rehabilitation in a changed social-economic context and steps towards strengthening social support networks for people with mental illness. Following political abuse of psychiatry, professionals have had to face justified and unjustified accusations, and been faced with a general challenge to their role. CONCLUSION: Tackling problems of social stress, the integration of mental health care in the general medical care system and the building-up of general hospital in-patient psychiatric units are of strategic importance.