From punishment to treatment: forensic psychiatry and prison mental health services in Ukraine

Mar 24, 2016

Kyiv, 18 March 2016 – The Office of the Ombudsperson held an expert discussion regarding future reform of the forensic psychiatric and prison mental health services in Ukraine based, in part, on the recommendations of an independent scoping report commissioned by UNDP Ukraine.

“Some 700 patients were locked up in an antiquated prison converted into a strict regime forensic hospital, with prison guards roaming the corridors in full uniform and armed, and with patients locked in their cells for 23 hours a day with severely restricted communication with the outside world. To make matters worse, the length of stay in the hospital was not related to the mental state of the patient, but to the crime committed,” reflected Professor Robert Van Voren, a member of the international expert team, who visited Ukraine in December 2015 to monitor the issue.

Prison mental health services in Ukraine is a problematic and sensitive issue, which crucially requires reformation in conformity with international human rights standards. Considering this necessity, joint initiatives and the efforts of UNDP Ukraine and the Office of the Ombudsperson resulted in the report “Forensic Psychiatric and Prison Mental Health Services in Ukraine”, aimed at collecting information that would help to develop good practices and lead to a plan of reform in this sector.

As experts examined the sitation, they were faced with penitentiary-type facilities instead of healthcare establishments, punishment of patients instead of treatment and reintegration, and a number of other shameful legacies of the Soviet correctional approach.

“We are speaking about those who are deprived of liberty because they committed crimes; they committed crimes because they have mental health problems and they require medical treatment but get penitentiary punishment. They or their relatives are eager to change this but the law provides no option; the circle is complete,” said UNDP Democratic Governance Adviser Marcus Brand.

The area of forensic psychiatric and prison mental health services remains, by some accounts, one of the least reformed. One of the reasons for this is the isolatednature of the area, which has allowed it to stay frozen in its practices over decades of independence. At the same time, the number of patients undergoing what may hardly be termed treatment is about 1,700.

Ukrainian Parliament Commissioner for Human Rights Valeriya Lutkovska stressed that it is time to switch from punishment to treatment in prison mental health services, and that people with mental health problems must be considered and treated as human beings.

“One patient I met I will never forget,” says Robert Van Voren. “She was a 25-year-old girl, who five years ago stabbed another woman in a department store. Her diagnosis was the famous “sluggish schizophrenia”, the trademark of Soviet psychiatry. Here she was, already five years inside, outwardly aged some twenty years instead of five, and still at least another five years of incarceration to go. Her biggest wish: to learn English, so she could do something by the time she is discharged. But that was forbidden, because she was not permitted to have an MP3 player. We saw destroyed lives, and all because of a system that looks at the crime instead of at the person.”

Findings of the monitoring group point out systemic violations of the international human rights standards and declared harmonization with European values. The report is a key that opens a door for the first steps on the roadmap to institutional transformation in this realm.

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