By Garret J. McDonald

In mid-June 1919, Bolshevik Party leader Vladimir Lenin (1870-1924) invited “teachers, psychiatrists and others… who are knowledgeable and interested in penitentiary issues” to help his revolutionaries redesign the imperial penal system. Within the invitation, Lenin expressed his hope that the participation of experts in various fields would result in the “distribut[ion of] persons sentenced to deprivation of liberty to institutions appropriate for their correction and reeducation” (pp. 434-35). Under this scheme, psychiatrists who studied a perceived intersection between criminality and mental illness would become responsible for ensuring that “prisoners with obvious mental deficiencies” were separated into “punitive medical institutions” and gradually cobbled into the patchwork of new and existing penal institutions. The inclusion of psychiatrists in the Bolsheviks’ revolutionary quest to remake society, Dan Healey notes, “was perhaps the most radical Bolshevik innovation in any branch of forensic affairs” (p. 76). Indeed, the intersection between law and psychiatry, the unique discipline of forensic psychiatry, evolved into one of the most controversial mechanisms of Soviet policing. The Soviet forensic psychiatrist would embody, as health officials outlined, “a scientific judge of facts” dedicated to safeguarding the socialist experiment (p. 24).

This essay briefly examines how and why the forensic psychiatrist emerged from the crucible of revolution as custodians of the Soviet project who forcibly treated individuals they viewed as threats to society and the individual. Forensic psychiatrists are broadly responsible for evaluating the mental faculties of citizens suspected of committing crimes and providing expert testimony to courts. At the dawn of the 20th Century, forensic psychiatry was a burgeoning, but ill-defined academic field. Those most interested in the discipline often served as psychiatrists in prisons or asylums. Only a few months after Lenin’s invitation, a thirty-four year old prison psychiatrist, E. K. Krasnushkin (1885-1951), established Moscow’s first forensic psychiatric ward. Over the course of the next several years the ward would grow into and be absorbed by the intellectual nucleus of Soviet forensic psychiatry, the All-Union Scientific Research Institute of General and Forensic Psychiatry named after V. P. Serbskii. Not unlike their colleagues around the globe, those psychiatrists employed at the Serbskii dedicated themselves to questions regarding the legal responsibility or imputability of criminals found mentally ill, methods of curing the mentally ill, and the prevention of so-called “socially dangerous acts” by the mentally ill.

Through this work the Serbskii came to be known as the “crossroads of punitive medicine”:

The Serbskii Institute… is in the same category as such focal points of communist terror as the Lubianka Prison… it is from this institution that people are sent for compulsory [psychiatric] treatment, through it they are released… the Serbskii is where the prisoners’ fates are decided Those sentenced to death pray for the Serbskii, short-term prisoners are afraid of it; the innocent hate it… [The Serbskii] has become the most dreaded symbol of psychiatric terror in the USSR” (p. 72).

Most scholars’ interest in Soviet forensic psychiatry has been limited precisely to the so-called “political abuse of psychiatry” that dominated world headlines in the 1970s and 1980s. Few have endeavored to explore the discipline and its practitioners prior to the post-Stalin period. Of those who have, none have attempted to address the challenge to consider “that the system of psychiatric belief and behaviors” which animated Soviet involuntary psychiatric hospitalization “is so entrenched because it is so credible–scientifically, culturally, and emotionally–to [Soviet] practitioners” (p. 359).

The credibility of Soviet forensic psychiatry lies, at least partially, in the revolutionary past: who the forensic psychiatrist was at the twilight of the Russian Empire and the mission of forensic psychiatry as envisioned by Russian practitioners. As the 19th Century drew to a close, psychiatrists, like other medical professionals, were increasingly disgruntled with the imperial regime. Judicial reform in the 1860s opened the Tsarist legal process to the general public, a new reality swiftly coopted by an array of specialists ranging from psychiatrists to sexologists. The open jury trial presented these experts with a platform to advocate for their theories and scientific disciplines. Initially, psychiatrists utilized this platform to develop the sole legal link between mental illness and criminality. As psychiatrists such as V. Kh. Kandinskii (1849-1899) and V. P. Serbskii (1858-1917) reinforced the long held notion in Imperial law that criminals who were not aware of or able to comprehend their actions could not be held responsible or imputable for their crimes due to mental deficiency, they further argued only they, not lawyers or judges, could determine if criminals were mentally ill and subject to punishment or treatment.

As eminent psychiatrists, such as I. M. Balinskii (1827-1902) and S. S. Korsakov (1854-1900), proclaimed that courts should not “brand such people… with the name ‘criminal,’” the first forensic psychiatrists further distinguished themselves from clinical psychiatrists and suggested only forensic psychiatrists should participate in court proceedings. Considering the ill-defined nature of forensic psychiatry, however, psychiatrists of all inclinations continued to participate in the Empire’s new open jury trial and deployed this public facing platform to paint a startling portrait of not just the criminal, but of modernity. Modernization, they argued, correlated directly with an increasingly mentally ill population. With the imperial bureaucracy pursuing an ongoing program of modernization the message was clear: psychiatric expertise needed to become an essential pillar of state development and rule.

In the decades that followed, Russian psychiatrists proclaimed that the science of the mind could solve any number of the social ills suffered in the Empire, including criminality, to no avail. Instead the Empire’s burgeoning system of regional asylums swiftly faced severe overcrowding and miserable living conditions. Even active participation in rewriting imperial legal codes to adhere to up-to-date psychiatric theories yielded no fruit for those psychiatrists laboring over forensic issues. Their revisions were not adopted until nearly a decade later, in 1903, and were never enacted by imperial authorities. As political threats to the regime mounted, asylum beds filled with revolutionaries and radicals, while the Tsar’s soldiers occupied the halls. Psychiatric institutions, not unlike the Empire’s prisons and sites of Siberian exile, became centers of underground political activity as a result. Viewing the presence of military guards as an invasion of their workplaces by a faltering and backward regime, psychiatrists, Healey notes, “eagerly seized the opportunity to… reconstitute the state upon modern and technocratic lines” (pp. 71-72).      

Thus, the forensic psychiatrist at the twilight of the Empire became an enemy of the imperial state. When the first assembly of the newly formed Russian Union of Psychiatrists and Neuropathologists met in 1911 the scientists, including the father of Russian forensic psychiatry Vladimir Serbskii, lambasted the state to such a degree that the police shut down the meetings. Resuming under the condition that “unlawful” activities ceased, the psychiatrists in attendance argued that the Tsar’s regime sought to utilize their asylums “as places of detention for certain categories of individuals deemed by it to be dangerous” (p. 282). In other words, rather than allowing psychiatrists to deploy their latest theories and examinations to determine which individuals merited involuntary psychiatric treatment, the Tsar monopolized psychiatric agency. Without the autonomy to deploy their expertise as they saw fit, Russian forensic psychiatrists’ mission to secure society from the threats of mental illness and the mentally ill was frustratingly impossible to pursue.

The Revolutions of 1917 and Lenin’s subsequent invitation to redesign the fledgling socialist state’s penal apparatus emboldened and empowered psychiatrists knowledgeable and interested in penitentiary issues. Prisons were newly imagined as sites of rehabilitation that were capable of “reforging” the individual for life in a socialist society. Prisoners under this paradigm were viewed ill or “unconscious” individuals who required medical intervention and a steady hand to guide them. As a result, early Bolshevik legal codes were modeled on forensic psychiatrists’ revisions of imperial law and psychiatric hospitals fell back under the control of the practitioners. The question of agency, then, reconciles the simultaneous rejection of imperial involuntary hospitalization and the embrace of psychiatry as an instrument of Soviet policing. Communism promised that psychiatrists, not the Tsar or his police, would decide the forms and functions of forensic psychiatry. For their part, the Bolsheviks held fast to that promise. After establishing the Russian People’s Commissariat of Health, the Bolsheviks transferred all forensic medical matters away from the police. As the revolutionaries complained of overcrowding in prisons and the placement of mentally ill prisoners alongside other inmates, the agency and authority of forensic psychiatrists grew.

By the 1920s Health Commissariat’s chief forensic medical expert declared that the forensic physician and psychiatrist’s tasks were dedicated to “the study and prevention of criminal acts so frequently coming hand in hand with somatic or mental disorders” (pp. 56-57). Legal instructions codified “punitive medical institutions” and “compulsory medical treatment” as measures of “social protection” (p. 12). Criminologists and psychiatrists spoke of a pre-existing “natural prophylaxis” which “swept out… [a]ll of the unbalanced, mischievous, unfortunate, and criminal minded” from society and into closed institutions (pp. 73-74). In an effort to reproduce that prophylaxis punishment for crimes, psychiatrists argued, was actively being replaced “by the assertion of measures of social defense from harmful and dangerous antisocial elements” (p. 85). They praised compulsory psychiatric hospitalization as a humane step that prevented mentally ill criminals from suffering in prisons.

When the Second All-Russian Psychiatric Conference met in November 1923 practitioners restated their concerns that modernization produced mental illness. They envisioned a future where psychiatrists would “search out… citizens who were having trouble adjusting to the demands of citizenship in the socialist utopia” and administer swift treatment (p. 5). Psychiatrists reconciled the coercive power of forensic psychiatry and involuntary hospitalization with this mission. If “mental illness distorts the individual’s capacity to understand his situation and his interests, rights, and obligations,” Soviet psychiatrists explained, then mental illness “deprives him of the right to autonomously decide his own actions” (p. 8). Therefore, the fate of such individuals should and would be decided by the psychiatrist. As Soviet legal theorists and judges emphasized “whether one was redeemable (and hence subject to detention and correction) or incorrigible (and hence subject to elimination” forensic psychiatrists argued all were curable and that “[p]eople who manifest anti-social reactions and are therefore enemies of society should be isolated with the aim of coercively healing or reeducating them” (pp. 194-95).

As punishment shifted towards measures of social defense, criminality shifted towards the all-encompassing category of “socially dangerousness.” In Soviet psychiatry, social dangerousness generally correlated to “social reactions” that “boil down to permanent conflicts with, and frequent violations of, the existing legal order” (p. 113). For some psychiatrists, however, social dangerousness extended even further to consider any “attitudes and tendencies that pose a threat to the health of society” (p. 19). Gradually Soviet society was positioned, as Anastasia Beliaeva has recently documented, as a society that “consists of, and actually included, only healthy people who embody the rationally arranged Soviet lifestyle” necessitating the removal of all ill and potentially contagious individuals into medical instiutions (p. 943). Once placed under medical treatment, psychiatrists and other scientists of the mind would inculcate the Soviet way of life into their willing and unwilling patients.

This logic of involuntary and forensic psychiatric intervention resulted in criminals of all stripes flowing in and out of the Serbskii Institute. Sex offenders, murderers, dissidents, drug addicts, alcoholics, and even bureaucrats and agents of the secret police who threatened the legitimacy of the socialist experiment through their abuse of office faced involuntary psychiatric intervention in the 1920s. Forensic psychiatry as a discipline and set of institutions continued to grow throughout the Soviet period, and not without reason. Foreign visitors to the Soviet Union lavished praise on the socialist psychiatric system and policymakers around the globe presented a persistent call for forensic psychiatrists to exit “the ivory tower” and take up a greater role in the prevention of crime and maintenance of society (p. 19).

Examining the forensic psychiatrist in the final years of the Russian Empire and the formative years of the Soviet Union thus provides a window through which the historical roots of an ongoing problem can be viewed. By examining how and why the forensic psychiatrist became part of and participated in the Soviet project the credibility of Soviet forensic psychiatry to its contemporary practitioners gradually becomes more apparent. Rather than simply dismiss Soviet and Russian psychiatric practices as “political abuse,” scholars must turn towards the historical development of those practices and the simultaneous construction of a psychiatric mission to safeguard society from the mentally ill and the mentally ill from themselves.

Garret J. McDonald is a PhD Candidate in Modern History at Fordham University in New York City. His work examines the history of involuntary psychiatric hospitalization in the Soviet Union. His primary research interests are the intersections of criminal investigations and science, Tsarist and Soviet prisons, natural sciences and imperialism, as well as Central Asian history.

Edited by Tom Furse

Featured Image: The Serbskii Institute of Forensic Psychiatry (Early 1980). Courtesy of Harvard University Houghton Library, Peter Reddaway Photograph Collection.