Mental illness is on the rise in Russia, where economic and social instability have chipped away at the community and state structures that once assuaged the fears of citizens and also served as an outlet for their frustrations. Now, official statistics say, some 30 percent of the population may be suffering from various mental disorders. Galina Stolyarova reports from St. Petersburg that most Russians are reluctant to seek professional counseling -- suggesting the actual numbers may be even higher.
St. Petersburg, 2 July 2001 (RFE/RL) -- In its annual report, the Moscow-based Serbsky Institute for Social and Forensic Psychiatry says nearly 6 million Russians are currently registered as being affected by some type of mental illness.
Even more alarming, Russia's younger generation appears to be suffering most. While the number of adults with mental illnesses like depression and schizophrenia has grown 1.5 times over the past 10 years, the rate of increase for mental disorders among children and teenagers is nearly double that.
Karina Kashirina is a psychologist for a private school in St. Petersburg. She links the increase in both mental and physical disorders to the general decline in Russia's economic and social conditions:
"The physical health of both adults and children has become dramatically worse over the past few years. It is a result of the worsening of the social situation, ecology and economics, and general instability in the country. It produces a serious impact on human health, and women give birth to children with a weakened nervous system."
Kashirina says that even healthy children may eventually succumb to illness. She cites Russia's growing poverty, violence -- and what she calls an overall "aggressive atmosphere" -- as having a long-term impact on both people's mental and physical health.
Police statistics last year showed that nearly half of all crimes reported in St. Petersburg were committed by teenagers under the age of 18. Such figures, Kashirina says, show that children, more and more often, are being exposed to "adult" levels of stress:
"Very often a 14-year-old child develops illnesses which would normally occur in people over 30 or even 40. It is not uncommon for 16-year-olds to develop ulcers by the time they graduate [from high school]."
Lyudmila Rubina, the chief psychiatrist for St. Petersburg's Health Committee, is responsible for supervising the city's mental health clinics and state-funded crisis hotlines. She says the country's chronic instability has contributed to a feeling among Russians that they have no control over their lives -- and that the state can do little to help them:
"People have to know and sense that [the state] is willing to help, and is, in fact, helping them. Nothing can be done [in the country] if people constantly feel like every minute of their life is bringing them only despair."
Nearly 40 percent of all cases of mental illness in St. Petersburg have their roots in social problems. Rising rates of drug abuse, poverty, and unemployment are contributing to the problem. But therapists and crisis-hotline workers cite the sharp rise in street crime and domestic violence as the most alarming trend in the city's declining mental heath.
Tatyana Fedorova is a psychotherapist working in a St. Petersburg center for victims of domestic violence and sexual abuse. She says many people, sensing a growing brutality in the country's political affairs -- particularly President Vladimir Putin's hard line on Chechnya -- are too quick to see violence as the only answer for their own problems:
"If the head of the country says he will 'wipe [Chechen rebels] out in the outhouse,' then the heads of families may wonder why they can't do the same and punish members of their own families for disobedience. They find it quite appropriate."
In St. Petersburg, a number of clinics and hotlines have begun to fill the gap left by dwindling government involvement and resources. But according to Fedorova, a lingering reluctance to confront mental health issues keeps many Russians from seeking help:
"Wealthy people think it's shameful to be unsuccessful in any way. And they think that seeing a psychotherapist is admitting that they're weak and can't cope with problems by themselves. Poor people won't go either, because most of them believe that their first priority should be getting some money, and that then their life will automatically improve as a result."
Even those Russians who do seek professional help are not always able to verbalize their fears and worries. Therapist Kashirina says the anxieties associated with daily life in Russia mean many people are afraid to even think about the future:
"One of my clients -- a woman -- couldn't sleep for three months after the [August 2000] Pushkin Square explosion in Moscow [that killed 13 people]. She was thinking, 'What if something happens to my child or my husband?' People are afraid of the future, and they are afraid of the present. Their worst fear is not that they will lose their money. It's that they will lose their loved ones."
Since Russia's social climate is unlikely to improve soon, most mental health experts say they expect problems to grow worse, and call on the government to help restore public trust by improving its public welfare institutions.
Some warn the government's failure to address the problem will have dangerous social and economic consequences for Russia in the future. As head St. Petersburg psychiatrist Rubina says, "people don't want to be involved in anything. They have completely lost faith."