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MENTAL HEALTH 

Gilyarovsky psychiatric hospital in Mosc

Gilyarovsky psychiatric hospital in Moscow, founded 1808.

In our current times, mental health has become something we consider in everyday life. This, unfortunately, is a new phenomenon and one that still carries a heavy stigma. In the play, we see characters attempt, and mostly fail to create connections with each other. While Chekhov was a doctor, disorders were just starting to be identified. With little support and awareness, these characters are left to the mercy of their times and the perception of the audience. To fully comprehend the position Chekhov’s characters were in, let's look at mental health in Russia before, during, and after the revolution. 

Before the Revolution

  • Mentally ill people in Russia lived in monasteries 

  • In 1760 two asylums opened 

  • The year 1824 saw the opening of the psychiatric department in St. Petersburg

  • Prior to the 1917 revolution, psychiatric legislation in Russia closely followed French law

  • Between the 1880s and the 1930s, French schools developed diagnostic categories that set them apart from international classifications. The main examples are Bouffée Délirante, and the complex set of chronic delusional psychoses (CDPs), including chronic hallucinatory psychosis

During the Revolution

  • There was an increasingly decentralized approach to psychiatric care before 1917, with smaller hospitals (10 to 20 beds), more out-patient clinics, and some collaboration with private practice

  • Psychiatrists were expected to deal with general medical issues and problems relating to epidemics and infectious diseases, witness corporal punishment, and to attend executions

  • Therefore, mental illness was not a priority

1963.293_-_two_women_on_the_shore_0.jpg

Two Women on the Shore, Edvard Munch, 1898. Reflections on Schizophrenia 

Russian authors Yuli M. Daniel (left) an

Russian authors Yuli M. Daniel (left) and Andrei D. Sinyavsky sit in prisoners’ dock facing charges for publishing satirical works deemed ‘anti-Soviet’ in 1966. Anyone who opposed Soviet State was mentally ill. 

After the Revolution

  • After the 1905 Russian Revolution, there was an influx of political prisoners into asylums.

  • Local zemstvos (Local government bodies headed by the nobility) provided two-thirds of the funding for psychiatric services and the central government one third.

  • The Commissariat of Public Health established the Psychiatry Commission in October 1917. 

  • Psychiatrists were given greater control over hospitals. Psychiatric services were funded by the central government. 

  • Support services for mentally ill soldiers were provided by the Russian Red Cross Society until they were taken over by the Commissariat of Public Health in 1919. 

  • They appointed a psychiatrist/neurologist consultant for the Red Army.

Suicide Culture + Chekhov

Since the play is set loosely in the years before and after 1900, no one in the play openly comments on the mental health of the other characters. So, why is it relevant? Many of the characters comment on their hardships, such as Solyony’s uncontrollable behavior in group settings, or Chebutykin’s detachment from reality. But, to me the most interesting facet is Vershinin’s suicidal wife, and the fact that no one cares about her. To Vershinin she is merely an unfit mother and an inconvenience. Since she is never seen onstage and thus not able to enter the conversation, let’s look at suicide culture in Russia to understand her character and Vershinin’s relationship to his wife more completely. 

Age-specific suicide rates (per 100 000)

Age-specific suicide rates (per 100 000) among Russian females by birth cohort

Age-specific suicide rates (per 100 000)

Age-specific suicide rates (per 100 000) among Russian males by birth cohort

  • Before the 1860’s suicide was not really a problem in Russia. 

  • However, in the 1880s an exposé on St. Petersburg depicted suicide as a facet of everyday life

  • The exposé said that the suicide rate in St. Petersburg had tripled 

  • Men committed suicide at a 3-4x higher rate

  • Women attempted suicide at a higher rate than men 

  • It was believed that men committed suicide out of ego and women attempted it because they were the weaker sex and for “self-sacrifice” 

  • Therefore, Vershinin was probably not that worried about his wife because suicide attempts were common, he probably misunderstood the cry for help as a cry for attention.

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