Inspections reveal appalling conditions in psychiatric institutions in Russia

Inspections reveal a lack of sanitation in psycho-neurological residential institutions (PNRIs)




On 28 March, a meeting was held in Moscow of the Council of Guardianship in the Social Sphere. Representatives from the Federal Labour Service (FLS), the Federal Service on Surveillance in Health Care (FSSHC) and the Federal Service for Oversight of Consumer Protection and Welfare (FSOCPW) presented the results of inspections carried out in psycho-neurological residential institutions (PNRIs) operating in Russia.


160,000 people currently live in these institutions, 112,000 of whom are classed as having limited or no legal capacity, with the remainder capable of adapting to society, said Vsevolod Vukolov, Head of the FLS.


“During our audit, we identified numerous violations both of human rights and in the provision of social and medical care. As a rule, five to seven people were living in one room where they should be four to six. On average, there was one toilet for 16 people. In 25% of institutions, there was no private space, no chairs or bedside tables, or even a screen to separate a sick person from others”, said Vukolov.


Most of the residential buildings were in a dilapidated state and many had no hot water. Institutions in 13 Russian regions had no toilets, with people forced to use public facilities outside the building.


Inspections of residential children’s homes also revealed that residents had no warm winter clothes to wear for going for a walk outside. Hygiene regimes were practically non-existent in adult and child institutions, with residents’ hair and nails very rarely cut by staff.


Irina Bragina, Deputy Chair of FSSHC, confirmed that 80% of PNRIs inspected had committed human rights infringements, with the greatest number (43%) related to non-observance of sanitary, hygiene and epidemiological regimes, including regular cleaning and disinfection of rooms.


“The second most common group of violations was non-compliance with food standards recorded in 47 Russian regions, including improper food storage, products whose shelf-life had expired and dining room staff without the necessary health permits”, said Bragina.


Bragina also stated that residents didn’t always have good quality drinking water. Living conditions in some institutions were appalling. For example, in some Ulyanovsk and Archangel PNRIs, experts witnessed 15-20 residents living together in one room.


Inspections conducted by FSSHC saw administrative violations that will cost more than one million roubles to put right.


Medical help


Patients’ rights have also been violated in the provision of medical health care, according to Mikhail Murashko, Head of the FSSHC. Residents are unable to receive timely medical care or advice from a doctor. Calling an ambulance from institutions located far from major cities was a problem. Clinical assessments were rarely carried out and follow-up detailed specialist examinations never undertaken. Drug storage was totally inadequate, with many products having gone past their expiry date.


The institutions were short of personnel, with, on average, one member of staff for 12 PNRI residents during the day, and one for 16 on the night shift. In 27 Russian regions, there were no psychologists or social workers on the staff roster.


Another problem concerns medical certification. Often, residents living in PNRIs are unable to have timely examinations to establish their state of health and these were only carried out on half of those living there. According to Vukolov, 2,500 people (6% in all) have left PNRIs to live an independent life.


Training and employment


According to the head of the Federal Labour Service, around 3,500 people are recognised as being officially in employment, 2,000 of whom have completed further education. However, not all institutions have decent working conditions which was confirmed by those taking part in the Moscow meeting.


PNRIs remain a closed shop – even relatives are unable to gain access, with volunteers admitted by prior arrangement at best. Residents are not ready to live independently but the main thing experts noted was that their human rights were being grossly violated.


Those present at the meeting said that it hadn’t been possible for the inspection teams to obtain feedback or elicit the views of residents during the audit. The head of each institution is responsible for their charges by law.


50 billion roubles for new PNRIs


During discussions at the Moscow meeting, mention was made of 50 billion roubles which apparently have been set aside from the federal budget for the construction of new PNRIs.


“I know that plans are being discussed for the “Older generation” project to invest 50 billion roubles in new PNRIs. However, this is not entirely correct as some of the funds will go to work involving a team of experts who will advise on how many PNRIs should be retained in Russia, how many people should live in them and where they should be located. So please don’t worry about this because the “Older generation” programme, as you know, is aimed at encouraging people to be active in old age”, said Russia’s Deputy Prime Minister, Tatyana Golikova.


“If departments are intending to draw up new regulations for these institutions, it might be better to put these expensive construction plans on hold to ensure these buildings conform to new rather than old standards”, suggested Dmitry Polikanov, President of the Support Foundation for the Deaf and Blind “Con-nection”.


Individual research


According to Tatyana Golikova, a roadmap and new monitoring system for the protection of PNRI residents are to be drawn up in the near future.


“Given the PNRI audit has revealed disturbing systemic failures, we, together with specialists from the Serbian Institute, have decided to conduct individual surveys with all PNRI residents over a four month period to get a clear idea of what level of support they need”, said Golikova.





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