The RCMH argues it has a lack of “sufficient financing” and states that “everything is going in accordance with plan developed up to the year 2010. Those issues that did not require money have already been resolved”. An official inquiry “on the condition of mental health in the south of the Kyrgyz Republic and the activity of RCMH” shows that “despite work on the improvement of the mental health service, its reforming and quality remains unsatisfactory”.

The mental health system started to develop in Kyrgyzstan due to the formation of the Soviet Union. However, as chief psychiatrist of Bishkek city, Kenesh Usenov, said, in view of the ideological war between communism and the rest of the world, Soviet doctors practiced different treatment methods and approach to mental health. Thus, the ideas of Freud, Jung and of other prominent psychiatrists were ignored and not practiced at all.

Earlier, patients gathered to the large centralized hospitals, where they were isolated from the community. They were treated with large doses of first generation neuroleptics and “correctors”. These drugs had negative side effects on patients’ health; however, the strong side of the mental health system in Soviet Union was sufficient financing.

According to the recent official inquiry, the system had not changed. “Patients are held in hospitals not only due to objective reasons, but also to an archaic manner of doctor-patient relationship, due to which patients’ rights to take decisions and actions independently are not admitted, even if the psychotic symtomatology has not been revealed. Such unjustified holding of patients in hospitals has led to the transformation of large psychiatric hospitals to long term “shelters” where almost two thirds of patients do not need permanent treatment, according to the document.

After independence, new problems and challenges arose. The focus of the government was on more vital “issues” to the country. Thus 1991-1998 were stagnant years to the mental health system. Only in 1998m a national program for the reform of the mental health system scheduled for the years 2000-2010 was developed; the required legislation was passed in 1999. Experts, overall, think the law on “psychiatric service and human rights” is good, but has not been implemented.

The basic goals of the national reform program is to destigmatize the mental health system, decentralize it, and integrate it into the general medical system.

According to RCMH, the implementation is going well and the only problem is insufficient financing, which is not provided by the Ministry of Healthcare. However, international organizations and mass media claim the human rights of patients are violated. The staff of “Psychic Health and society” said in an interview that “doctors will continue to violate human rights, because they do not know any other way of patient treatment; they are not trained for it”. Most specialist working with RCMH studied in Soviet schools of psychiatry. Representatives of RCMH said that “in some places, human rights are still violated, but we gradually train them”.

Together with the International Helsinki Bureau on Human Rights, “Psychic Health and society” proposed to RCMH to educate personnel on how to observe the human rights of patients. Already, in the Kyrgyz State Medical Academy, future specialists are since two years trained in a program that fit international standards of work in the mental health system.

Decentralization has not happened; in fact in 2000, two of three large mental health institutions were centralized under one leadership. The Ministry of Healthcare defended this with a reduction administrative costs.

The Executive director of RCMH, Mr. Nazarkulov stated in an interview that “by the year 2010 we plan to open 5-10 bed psychological centers in 70-80% of local hospitals. We have already cut twice the number of beds in large hospitals and will further decrease it. However, on a local level, we face resistance, because they do not want to work with mentally ill patients”.