What's behind Soviet withdrawal from psychiatric group

There will be some some empty seats in Vienna at this year's international convention of the World Psychiatric Association. But the vacancy left by Moscow's announcement that it is withdrawing from this international organization sends a message far louder than the voice of any delegate.

It marks the end of a ''dialogue'' within the psychiatric association over allegations of Soviet psychiatric abuse, and some view it as one more step in Moscow's withdrawal from the human-rights standards proclaimed by the Helsinki Accords of 1975.

''This is perhaps the first major statement on human rights to be sent to the West since Yuri Andropov came to power four months ago,'' maintains Dr. Walter Reich, a psychiatrist who is a fellow at the Kennan Institute for Advanced Russian Studies of the Woodrow Wilson International Center for Scholars in Washington, D.C.

In an apparently high-level decision by Mr. Andropov's government, Moscow has signaled it will no longer conduct a ''dialogue'' with non-Soviet psychiatrists. Previously Soviet psychiatrists had used WPA officials as intermediaries to receive and answer complaints that Soviet authorities are silencing political and religious dissenters by confining them to mental hospitals.

Indeed, as late as January, WPA officials in Vienna received 20 cases of documents on controversial cases from Soviet psychiatrists, according to Dr. Reich. The Soviets also settled a financial dispute by paying some $5,000 in back dues, he adds.

Then, on Feb. 8 notification was received that the Soviets would withdraw from the WPA and thus not attend the convention scheduled for July. A high-level political decision seems to have forced the organization of Soviet psychiatrists to make the move, notes Prof. Harvey Fireside, a political scientist at Ithaca College and a specialist on the Soviet Union's political misuse of psychiatry.

According to the London-based human rights group Amnesty International, since 1977 the Soviets have imprisoned or sent to psychiatric hospitals 32 members of the unofficial Helsinki monitoring groups set up by Soviet citizens to publicize abuses by their own government.

Among them is Dr. Anatoly Koryagin, a psychiatrist sentenced in 1981 to 12 years in prison. He had challenged the psychiatric diagnosis of dissidents confined in mental institutions.

Moscow's withdrawal may be aimed at heading off the publicity of a vote in Vienna on pending resolutions to suspend or expel the Soviet professional delegation because of psychiatric abuses. It removes the threat of expulsion as a lever that delegations from other nations can use to pressure the Soviets. With ''only an empty seat to talk to,'' the conference is less likely to become a forum for debate over Soviet psychiatric practices.

Moscow's desire to limit publicity may have been strengthened by Dr. Reich's Jan. 30 article in the New York Times Magazine. This account of Reich's May 1982 meetings with leading Soviet psychiatrists gave an ''inside'' view of presumed differences within the Soviet psychiatric establishment - as well as describing in detail how Soviet psychiatrists sometimes diagnose dissent as mental illness. Professor Fireside says, ''This may have been the straw that finally broke the camel's back.''

The rise in the use of psychiatry as a convenient way to silence dissidents parallels the career of Yuri Andropov as the head of the Soviet secret police (KGB) from 1967 to 1982, but it is difficult to determine whether it was promoted by Mr. Andropov or merely upheld by him when criticisms grew in the West. The present practices differ from the late 1940s, when benevolent doctors sometimes pronounced a political prisoner mentally ill to spare him almost certain death in a concentration camp.

Soviet psychiatrists today diagnose dissidents as irreversibly mentally ill using the theory of ''sluggish schizophrenia,'' created by a leading Soviet psychiatrist, Dr. Andrei Szeznevsky. Under this doctrine, if a person's dissent is judged ''bizarre,'' he can be pronounced ill even when there are no medical symptoms. Powerful drugs and other treatments are often used to manage or punish difficult-to-handle political dissidents who are judged schizophrenic and confined to mental institutions.

A ''core'' of Soviet psychiatrists endorses this approach. Many more simply acquiesce. Some risk freedom and career to actively oppose it. Dr. Reich suggests some conformity-minded doctors may genuinely see idealistic dissent as an illness. Professor Fireside suggests extra salary, prestige, rewards of advancement, and other benefits lead many doctors to acquiesce.

Allegations of ''psychiatric imprisonment'' have been leaked to the West by friends and relatives of the confined, as well as by some Soviet psychiatrists who risk their freedom and careers to disagree with colleagues. In its most recent briefing, released March 8, Amnesty reported that it had verified the forcible confinement of 193 persons to Soviet psychiatric hospitals for political reasons since 1975, and that it believed the total was higher. Amnesty says it has verified another 120 since 1969, bringing the verified number to 313 .

Professor Fireside notes there may be some 1,000 persons held for political offenses, such as for agitation and political organizing, in severe, sometimes brutal hospitals for the criminally insane. Another 10,000, committed for relatively minor complaints about jobs or public services, are held in the more humanely run ''ordinary hospitals.''

He suggests Amnesty's cautiously strict standards of verification, designed to maintain credibility, underestimate the actual numbers. A crackdown on Soviet dissidents in the last few years has made it more difficult to smuggle out abuse reports, he adds.

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