Redesigning Mental Health Policy in Post-Soviet Russia A Qualitative Analysis of Health Policy Documents (1992-2006)

摘要

This article analyzes developments in the mental health policy of post-Soviet Russia. It is based on a qualitative analysis of health policy documents of the Russian Federation published between 1992 and 2006. The developments are considered in the context of their social and historical background with due reference to the current World Health Organization (WHO) guiding principles on mental health policy. We analyze how the post-Soviet documents discuss aspects of mental health policy such as patients' rights, the integrative model of mental health and illness, the reorganization of mental health services toward deinstitutionalization and community-based care, the social inclusion and participation of mentally ill people, and measures to prevent their stig-matization. The results indicate that the post-Soviet documents increasingly articulate an intention to follow the international state-of-the-art in terms of civil and patients' rights, as well as an attempt to overcome conventional approaches related to the ineffectiveness of the existing mental health services system. Although the WHO mental health policy principles constitute the basis of post-Soviet legislation, this study reveals a lack of attention to the problem of stigmatization of mentally ill people. The results also show that mental service users are regarded mostly as objects of care and support rather than as active participants in the recovery process.