MDAC calls on Russia to honour the dead in psychiatric hospital fire

The Russian government should honour the memory of the 38 people who died in a fire in a psychiatric hospital last night by dismantling the country’s gulag system of mental health institutions.

MDAC is deeply saddened by the news from Russia where 38 people were killed in a fire at 2–3 am local time. They died in Psychiatric Hospital No. 14 in Ramensky, north Moscow region. 36 patients and two doctors died; only two patients and one nurse survived. The windows of the hospital had bars, making it very difficult for people to escape. According to Murat Shahov, the medical director of the facility, “there were patients with acute psychosis, alcoholics and one drug addict … [and] also … patients with schizophrenia.” Patients ranged in age from 20 to 76.

This tragic event reveals not only the inadequacy of fire regulations in the hospital but much more widespread, systemic problems in Russia’s psychiatric system. Patients are frequently warehoused for many years in wholly inadequate institutions where human rights violations are routine: it is the reliance on institutions which needs to change, not merely improving the fire regulations and blaming the fire service for a slow response.

Emergency response team working on the fire scene at a mental hospital in the village of Ramensky. (RIA Novosti/Andrey Stenin)

Don’t blame the fire regulations

The hospital was for patients with so-called “severe mental disorders”. It is therefore likely that many were formally detained under the mental health law. All were actually detained, because the doors were locked and they could not get out. MDAC has established, through its extensive legal casework on the mental health system in Russia, that court reviews of the lawfulness of a person’s detention routinely do not meet fair trial rights established by binding international law. 

We do not know if any of the patients in Psychiatric Hospital No. 14 were physically restrained to their beds, or were medicated to an extent that they were not able to fully comprehend what was happening. MDAC has ascertained that such practices are common across the Russian psychiatric system. Whether this was the case in Psychiatric Hospital 14 can be determined only if there is a full investigation of what caused the fire and why there were so many fatalities.  Such an investigation must be conducted entirely independently of both the health ministry and local government.


Human rights standards need to be enforced

The Russian government’s chronic failure to establish community-based mental health services mean that psychiatric institutions often serve as “social housing”. In reality mental hospitals become prisons for thousands of patients due to the lack of political will to set up adequate social support in community. Here, the physical conditions are often appalling, patients are frequently locked up for months, if not years, and their right to refuse treatment is routinely ignored. No independent inspectorate monitors the rights of people detained here. All of this is unlawful under the UN Convention on the Rights of Persons with Disabilities, which Russia ratified in May 2012.


Where is the political will?

Sometimes it takes a tragedy to kick-start action. Russia will need to report to the UN about its progress in implementing the Disability Convention in September 2014. The government should honour those who died last night by taking action now.

MDAC calls on the Russian government to: (1) conduct an independent investigation into why these deaths occurred; (2) require directors of all psychiatric hospitals in Russia not to detain any ‘voluntary’ patients; (3) decrease the numbers of beds in psychiatric and social care institutions; (3) take measurable steps to establish a range of community-based services as alternatives to institutionalisation; and (5) involve Russian and international NGOs in reforming the system.

To ensure that the terrible events last night do not happen again means ensuring that there is in Russia no future of any kind for institutions like Psychiatric Hospital No. 14. 

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