Paper long abstract:

The reform of psychiatric services in Kyrgyzstan that started in early 2000s brought a lot of changes in treatment and care of people with mental disorders. The struggle with previous soviet model of "repressive" psychiatry is now mixed up with new approaches of "de-institualization" and reducing number of people in mental hospitals who stay there involuntarily. New approaches are represented by NGOs and human rights activists that try to change agenda within health care and social service institutions. Still doctors and big number of relatives and friends do not agree with some of the points of these new agenda because of problematic character of free choice and personal responsibility that are demanded from people with mental problems. Co-existing approaches include an arrow of various and often contradictory and logically inconsistent understandings of psychological well-being of people with mental disorders from neoliberal interpretation of "free choice" and "community concerns about vulnerable members" to "necessity of providing help without respect of patients' inadequate subjective opinions". This mixture of positions influencing practices as well as strategies and policies in the scope. The analysis of positions of service providers will be presented at the panel.