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. Last Updated: 07/27/2016

Preparing the Mentally Ill for a Role in the Community

Dangerous, useless and unintelligible: That is how most people still regard the mentally ill, according to Igor Donenko, whose Human Soul charity has been fighting such attitudes for the last eight years. "In fact, aggressiveness among mental patients is a lot lower than among most other groups of the population," Donenko, 35, a psychiatrist, says. "Haven't you ever been dangerous? Or incapacitated?" Donenko's charity seeks to provide training for mental patients to offer them the chance to find a place in the community and fulfill a useful role -- something that would have been unthinkable in the Soviet era. Certainly, none of the characteristics commonly attributed to the mentally ill are to be found in Lyuba, 27, a patient in the room next door to Donenko's run-down office. When the phone rings she answers in a perfect secretarial manner: "To whom would you like to speak? Could you leave your name and telephone number?" In fact, and as Lyuba was well aware, the phone call came from the next-door office, where Natalya Ulezkina, a social worker, is helping train Lyuba and 44 other patients to become secretaries. Another patient in the room, Alexei, is less adept with the telephone. When he learns a reporter wants to talk to him, Alexei quietly slips away. In terms of social life "mental patients are not different from any other type of patients," Donenko says. "It is just more difficult for them to establish communication." It is especially difficult if nobody takes the trouble to explain to the patients what their problems are and what rights they have. Donenko did take the trouble in 1986 when he began giving lectures about psychiatry to visitors at a district psychiatric out-patient clinic. "Of course any patient can understand the nature of his illness, it is only a matter of the level on which you explain it," he said. Donenko also organized a council for his out-patients, who had to come to the clinic every day to get their pills and spend hours folding envelopes -- a typical Soviet method of labor therapy. The council meant that they could take their own decisions on who would water the flowers, or sweep the floor, or whether it was worth obeying the nurse who was abusing her position by ordering them to go shopping for her. Both moves clashed with the Soviet psychiatric traditions and Donenko was forced to continue his experiment outside the clinic. The Russian tradition, which existed until the 1920s, stressed social rehabilitation for mental patients. The Russian word for "mental patient," dushevnobolnoi, translates roughly as "sick in the soul." But the materialist philosophy introduced by the Bolsheviks reduced the problem of psychiatry to a range of biological disorders and the treatment to powerful drugs and restraint. Lyuba, speaking in an unusually loud voice, said she comes to the clubhouse whenever she can -- unless she is having fits of hysteria, depression, or any other type of attack, all of which she sums up as "the twists." She said she has been suffering from "the twists" since she was born. She was diagnosed as schizophrenic and declared handicapped as a teenager. Coming to the clubhouse, which officially opened in June, is not obligatory for patients like Lyuba whom Ulezkina and other volunteers teach to do regular clerical work so that they can qualify for office jobs. Following the experience of about 250 clubhouses worldwide, Human Soul aims to obtain contracts for its members to work for ordinary companies. Social workers at the clubhouse will ensure a patient's work is done even when he or she is unable to attend. The patients, or members as they are called by the volunteers, also study English "because we intend to travel, and we are going to have guests from abroad in August," Ulezkina said. One of the expected guests is a member of a similar clubhouse in Munich in Germany who managed to rehabilitate herself to the point where she was able to qualify as a social worker in the United States. In Moscow she will teach members of the Human Soul clubhouse computer skills. Yury Savenko, the president of the Independent Psychiatric Association, said several similar programs are developing in the Russian provinces, but that efforts were at a very early stage. In most hospitals, he said, the humiliation of patients still prevails.