The Republican Psychiatric Hospital with Intense Observation stands in the isolated settlement of Aktas, about 40 kilometers northeast of Almaty. The only Kazakh high-security psychiatric facility of its kind, the heavily fortified compound sits on the western edge of a sprawling industrial mining and quarry complex.
According to the country's Health Ministry, more than 80 percent of patients at the institution have committed "grave crimes against others" and are being held under a court-ordered compulsory medical regime.
Until now, little information has been publicly available about what happens behind the guarded walls of the Aktas hospital.
But recently, a former patient leaked multiple videos on social media, sparking widespread discussion. The footage, consisting of secretly recorded interviews, was subsequently shared with Azattyq, RFE/RL's Kazakh Service. Some videos have been published on social media. Some of the videos obtained by Azattyq are new.
The former patient who provided the footage asked Azattyq not to disclose his name, while most of those he interviewed identified themselves in the recordings. He said he was a patient at the hospital from 2022 until February this year and that the footage was recorded in 2025–2026. RFE/RL was unable to independently verify the dates on which the footage was recorded.
One after another, the patients interviewed in the videos described remarkably similar experiences of what they said they had been forced to endure.
One of the patients, Ruslan Kemelov, said he was tied to a bed for refusing an order from hospital staff and was subsequently given an injection against his will.
Asked what had prompted the restraint, he answered simply: "I refused to wash the sink."
The hospital declined to comment on Kemelov's individual case, citing medical confidentiality.
Other former patients described similar experiences.
Former patient Samat Sattarov described the effects of being forced to take an antipsychotic drug, including being restrained afterward.
"After decanoate, a person can neither walk, nor sit, nor lie down normally. Your whole body is in a state of torment. Imagine: I lay tied to a bed for 10 days."
Another patient, Alisher Karimov, described how frequently he was subjected to these injections.
"Six injections a day -- I received 60 injections in 10 days. What's even worse is that they tie you to the bed. You lie there tied up for 10 whole days and cannot move. They don't even untie you to let you go to the toilet. You have to relieve yourself where you are."
Sattarov said he believes such treatment is intended to frighten patients into submission.
"After all these 'executions,' a person completely loses the desire to live. You can no longer think normally; you become like a vegetable."
Involuntary detention on mental health grounds, according to rights groups, should only be possible in exceptional circumstances clearly defined in law, based on a determination by qualified health-care professionals that a person poses a serious and imminent risk to themselves or to a third party.
Human rights activist Elena Semenova, who received some of the videos, said the accounts described by patients warrant serious investigation.
"This is the suppression of a person's will, instilling fear in them in order to achieve a desired result, to make them perform certain actions. That is torture."
The patients who spoke in the video interviews described more than just physical restraint. They said they were routinely forced to perform manual labor to keep the facility running and that being discharged was extremely difficult. According to their accounts, full obedience to staff was the only way to secure release.
One patient, filmed washing toilets with his bare hands, was asked why he was doing it. He answered simply: "For discharge."
When asked whether staff explicitly told him he would not be released if he refused, he replied: "Yes, yes."
Another patient described being ordered to work at a garbage dump where waste was handled entirely by patients.
"If you say you won't go, they put you in the observation ward and give you injections."
Former employees verified the accounts.
"They make them wash toilets and sinks. They force them," said Baizhan Sagyndykov, a former hospital staff member.
"If patients say anything about wanting to defend their rights, they threaten them, saying, 'I'll tie you up, I'll put you on injections,' and that they will take other measures as well. I'm telling you this based on what I personally witnessed."
Another former employee, Nagima Nurbekova, said patients who could barely walk were made to perform such work and were tied up and given injections if they objected.
In response to an inquiry from Azattyq, the hospital denied the forced-labor allegations, saying patients do not perform employees' duties and that cleaning, kitchen work, and maintenance are carried out by staff.
The hospital's director, Dulatbek Dauylbekov, also rejected the suggestion that restraints are used as punishment.
"Physical restraint measures are used only when there are medical indications and are not used as punishment or disciplinary measures," Dauylbekov stated, maintaining that restraint is a last resort utilized only if there is a direct threat of violence.
Ward No. 9
Some of the most serious allegations involve Ward No. 9. Patients and former staff describe it as one of the harshest departments in the institution.
Former patient Alexey Alekseev described seeing a fellow patient, Yuri Prikhodchenko, repeatedly restrained and heavily medicated there.
"For 10 days, the person is forced to relieve himself where he is because they do not untie him at all. He experiences terrible torment. I am speaking about this openly because I went through it myself."
Another patient, Timur Nauanov, also mentioned Prikhodchenko.
"Prikhodchenko is currently in the ninth ward, the tuberculosis ward, although he does not have tuberculosis. They put him there deliberately because he began openly speaking about his rights and freedoms. I am afraid for my health and my life because there have been cases of patients dying, and not just once."
In an official response to Azattyq, the hospital's director denied that such a ward currently exists, even though patients described its exact location in detail.
Contrary to the director's statement, Kazakhstan's sanitary authorities confirmed that the institution has a 60-bed ward for patients with tuberculosis, as well as an isolation room for people suspected of having the disease.
The hospital not only denied the existence of Ward No. 9; it also refused to provide information about patients said to be held there, citing medical confidentiality, even to their families.
Prikhodchenko's mother, Olga Petrova, told Azattyq that she had repeatedly struggled to get through to the hospital and was often unable to see her son.
"I don't know at all what is happening or what is happening to my son," she said.
During their last brief visit, her son managed to tell her that his medication doses had been dramatically increased following the arrival of a new department head. Shortly after, Petrova learned her son had severely injured himself.
"He can't speak. Of course he can't. If he tells the truth…" she said.
Testimonies from current and former patients also raise questions about deaths and incidents of self-harm inside the institution.
Officially, the hospital reported only one patient death during the first half of 2026, while saying cardiovascular disease accounts for the largest share of deaths among its patients.
However, the facility did acknowledge 10 official cases of patients severely injuring themselves within the past 18 months. The staff did not say whether these incidents were attempted suicides or what the medical outcomes were.
Former patient Sattarov, who witnessed multiple incidents of self-harm, argued that the statistics demand external oversight.
"The statistics simply need to be checked: how many patients died and from what actual causes," he said.
Several government bodies are now looking into the claims.
The Talgar District Prosecutor's Office announced it had reviewed the social media videos and launched comprehensive inspections regarding the legality of medical care, sanitary compliance, and the overall quality of services at the facility.
Kazakhstan's Health Ministry and the Commissioner for Human Rights have also initiated internal investigations.
Beksultan Dildabekuly, the ombudsman's representative in the Almaty region, issued a strict warning following the publication of the videos.
"The use of these measures as a means of punishment, pressure, or coercion is absolutely not permitted under the law," he said.
