St. Petersburg’s 5th Mental Hospital, Russia

Alexander II had the Reform Hospital built in the 1860’s in the area of Prince Potemkin’s former hunting lodge.  After 1917 the name was changed to the Revolution Hospital.  Decades ago it was rejected as a somatic hospital, due to its very poor condition, and it was given to St. Petersburg’s 5th mental hospitals and then the name changed again to Fifth Mental Hospital.  The mental patients conditions were improved by the move as their previous hospital used to be a rejected jail.  Since 1918 not a single new mental hospital has been built in St. Petersburg, and currently there are only seven mental hospitals left. 

The hospital’s stone walls rise up from the banks of the Fontanka Canal.  From the windows one can see the beautiful blue cupolas of the Holy Trinity Church.  The hospital buildings are large and dilapidated internally and externally.  In the courtyard is a garden where tall grass grows.  The patients are not allowed outside without supervision, because the hospital is in the center of the city.  In practice the patients seldomly get out due to the staff shortage.

The 500 patients are in wards of one to three, 30 bed, dormitories and each ward has a dining hall.  The dormitories are cramped and most of the patients do not have any private space beyond their own beds, neither a table nor even a cupboard.  Yet, in the men’s wards space has been found to keep cats, which they are allowed to pet.  The community is battling against the reduction in production, standard of living, social program, the weakening of health service and the increase in unemployment.  The most shocking of these are reflected in the mental patients.  In the last few years the number of mentally ill has increased.  Poverty within the community has increased alcohol related psychoses.

Sanatoriums have been reduced and the mentally ill are kept at work as long as they can manage.  The lack of activity is a big problem for patients.  The hospital has facilities for 100 at occupational therapy there is also music therapy and art therapy, out patients also come to these therapies.

At Fifth Mental Hospital psychotherapy, social services and psychologist services are being developed.  In the near future it will be attempting to get more clinic space in order to treat outpatients more often.

In 1990 Kellokoski Mental Hospital and Fifth Mental Hospital struck up a friendship, with the idea to co-operate directly with officials in between, encouraging exchange of information and visits between the two hospitals.

Since the collapse of the USSR, Russians have gained the freedom to choose, and practice, a religion or some form of spiritual expression.  For the last five years Orthodox Mass has been held daily at Fifth Mental Hospital.  Patients willingly attend, claiming that hearing the word of the Lord helps them to understand values in life, their place in society and to come to terms with their illnesses.

I step through a small door into a large hospital.  The smell of the forsaken hangs in the air.  Ward Seven is encountered first.  There is a corridor lied by three dormitories full of beds.  On one of the dormitory walls is a mural, a lake scene complete with a painted frame.  Around the landscape are stripes which look like a magnified wallpaper.  Against this background the bed’s headboards appear small.  Serfei approaches me and reads from a book; I do not understand a word.  Anatola is pretending to make coffee and hands me a cup, but not to Serfei.  I pretend to drink even though there is nothing more than a coffee stain in the cup. 

The corridor leads to the dining hall, where there are long tables and fewer beds.  Runny mashed potatoes are served on metal plates.  Dimitri is bound to his bed.  He is sweating and starts to thrash around.  Vladimir, Leo and Andrei leave their food and go to Dimitri.  They remind me of guardian angels as they stand around him, looking at him.  Dimitri screams and arches, pulling at the ties until they snap.  Leo calls to the nurse for help.  Ri is given a pill with water which splashes onto his pillows.  Dimitri’s boxer shorts turned red from his sweat.  The nurse covers Dimitri with a blanket.

Each ward is on a different floor, separated by steep steps.  In the Fast Ward the dressing downs weigh down on the patients shoulders.  Jelena sits in the shadows and sniffs the wrap left over from her sandwich.  Natalila leans against the window bars.  Nadja counts out aloud, the stripes on her day cover.  Her voice sounds distressed.  Even though talking tires her, she asks me if I have ever cried because of an orange. 

The corridor’s windows are tall.  From these windows one can see the garden that inmates are seldom allowed to visit.  An old woman “stakes” in her woolly socks along the corridor.  Her teeth are black and worn, yet when she smiles gold can be seen.  She bumps into Irina, who is whispering secrets to her own reflection in the door’s window glass.

On the Women’s ward, Tatjana pushes her face so close to mine that my reverie is broken.  The smell of her breath makes me feel faint.  She fingers her Monna-madallion, which is pinned with a safety pin to her breast, and demands of me:  “Do you believe in Jesus?”  She believes that Jesus has just gone away and that he will be back, and everything will be fine again. 

Thirteen years ago Pjotr drew in chess against Anatoli Karpov.  Now he is standing on his head in the corner of Ward Eight.  He greets me and informs that from his point of view the world is upside down.  Juri challenges him to a game of chess.  Juri messes around with the pieces and tries to make the first move before all the pawns are in place. 

Pjotr’s eyes stray to the cracks in the walls and Juri makes his on his behalf.  When Pjotr’s eyes momentarily look at the chess board he concentrates and makes a decisive move.  Juri returns the pieces to their previous places and eats the black knight.  Pjotr checks with his bishop.  Juri again tries to reverse the move and in the process topples both kings.