4 Dissident ‘Patients’ May Be Freed : Soviet Change Seen in Mental Treatment as Punishment

MOSCOW —  In what may mark a turning point in the Soviet Union’s use of psychiatric facilities to punish dissent, Moscow’s chief psychiatrist said Thursday that he has recommended the release of the last remaining patients detained for anti-Soviet activity.

Vladimir A. Tikhonenko, the chief psychiatric physician for the Soviet capital, said in an interview with The Times that an official commission has examined four inmates of Moscow mental clinics Thursday and recommended their release.

“The final conclusion of the commission is that these people do have mental problems, but their condition does not warrant their continued isolation and forced treatment,” Tikhonenko said.

He said he could not order the release of the inmates, which would be left to the courts that had ordered them confined. However, the confinement orders are based on professional recommendations, and it seemed likely that the four would soon be freed.

Tikhonenko said he could not identify the inmates because of the pending legal questions. The four had been confined for violating Soviet penal code sections 70 and 190, which prohibit anti-Soviet propaganda and dissemination of slander against the Soviet state, respectively.

The two sections were widely used in the past to justify jailing political and religious dissenters. The government last year asserted that there no longer were any prisoners in jail for violations of the code, leaving only those in mental institutions.

Amnesty International, the London-based human rights organization, has said that the practice of confining dissidents in mental institutions has dramatically declined since 1987, with about 45 people being released from asylums.

While Tikhonenko said he had no information about mental hospitals outside of Moscow, Vladimir F. Yegovov, head of the psychiatry department at the Soviet Ministry of Health, confirmed that similar “reviews” are now being conducted of confinement orders around the country.

“Since we are now changing our views of psychiatry, we no longer think they should be kept in confinement,” Yegovov said. “Remember, we are releasing sick people, not rehabilitated ones.”

Yegovov said that the “certain category of persons,” his euphemism for patients held for anti-government activity, was “rather a small number.”

He said the government has established panels of “territorial psychiatrists” in all 180 administrative areas of the country to review and monitor the work of mental institutions.

Last year, the government issued a decree stipulating that a person’s threat to himself and society--in terms of violent behavior--should be the sole criteria for forced confinement. According to Yegovov, an accused person may now have his own lawyer present at every stage of the confinement process and challenge the recommendations of government psychiatrists.

The Soviets still deny having used confinement to a mental institution as a means of punishing dissent. But Western estimates on the number of dissenters who are being held in such institutions range from 20 to 100.

In an unprecedented move, the Soviets agreed last year to allow a delegation of American psychiatrists and human rights observers to visit Soviet mental institutions and examine patients for the purpose of “assessing new developments in psychiatric practice in the Soviet Union.”

The American group sent an advance team in November to prepare for the visit, which is now expected to take place in February.

The Soviet move comes at a time when the Kremlin is promoting the holding of a human rights conference in Moscow in 1991. President Reagan announced Wednesday that the United States has decided to attend the meeting if the Soviets continue the current trend toward progress in the human rights field.

In 1983, the Soviets decided to withdraw from the World Psychiatric Assn. when it appeared likely they would be expelled because of their abuses of psychiatry for political purposes. Last year, the Soviets said they wanted to be readmitted.