"Some fall ill for no apparent reason": life inside a psychiatric hospital.

People often view psychiatric hospitals with fear. Those who have undergone treatment frequently find themselves isolated from society. This is largely due to the portrayal of mentally ill individuals as dangerous in films and other media. However, not all patients fit this description. In fact, mental disorders are a type of illness that can be treated if one seeks medical help in a timely manner. We confirmed this by speaking with doctors and patients at the Tashkent City Branch of the Republican Specialized Scientific-Practical Medical Center for Mental Health.

“When psychiatric hospitals are mentioned, people tend to feel a bit of fear. It is associated with a lifelong stigma, a certain humiliation among relatives, or a family break-up. We call this ‘stigma,’ which means setting boundaries regarding such individuals. But this is incorrect, as mental illnesses are similar to any other diseases. It can happen to anyone. Today, the rapid pace of life and the difficulties of adapting to changes create challenges for individuals, often leading to mental health issues.

As a result of various stresses, illnesses, and traumas, every person is vulnerable. Much depends on the level of knowledge and understanding of people. Some families begin to take action at the first signs. For example, in the case of children, they consult teachers, school psychologists, and others around them to address the issue collectively, preventing the illness. However, in some families, as mentioned earlier, the problem is ignored, with the hope that it will resolve itself,” says Osiyahon Kasimova, head of the department at the Tashkent City Branch of the Republican Specialized Scientific-Practical Medical Center for Mental Health.

The psychiatrist noted that the duration of treatment depends on the patient's condition and averages about one and a half months. All expenses are covered by the state. This is due to the fact that mental illnesses are characterized by unusual behaviors, statements, and even instances of aggression. Such patients can harm not only those around them but also themselves.

“Some mental disorders can be hereditary”

“In our department, the proportion of patients with congenital disorders is about 2%. The rest are acquired over a lifetime. Among them, there are diseases that can be passed down from generation to generation. The most important factor is resilience to stress. People cope with losses differently. For instance, some have lost four or five children but continue to hold on. From the outside, it may seem they do not grieve at all. But when you start talking to them, it turns out they have endured losses that not everyone can handle. On the other hand, there are those who fall into stress over job loss, demotion, or losing a car in an accident. Ultimately, the person’s mental state deteriorates, leading to conditions such as depression or neurosis. In such cases, the individual primarily needs support from family and loved ones. We often see cases where people end up in the hospital due to stress, and this evokes great sympathy from us. The main problem is the stigma, meaning the alienation of those with mental illnesses. Some families struggle to accept such patients and even leave them in the hospital for years. However, there are good families who care for their relatives and treat them,” says psychiatrist Osiyahon Kasimova.

The psychiatrist emphasized that stress is one of the factors that can cause mental illnesses and advised parents to give their children freedom and independence during upbringing.

“Excessive care and attention do not foster resilience to stress, and the child cannot be independent. They give up at the first difficulties and start blaming their failures on their parents or others, which becomes a habit,” added Osiyahon Kasimova, head of the psychiatry department at the Tashkent City Branch of the Republican Specialized Scientific-Practical Medical Center for Mental Health.

At the Tashkent City Branch of the Republican Specialized Scientific-Practical Medical Center for Mental Health, the proportion of women among patients is about 45%. The remainder consists of men. “It is easier to treat men than women,” notes Gulnoza Ruziyeva, head of the 8th closed department.

“The diagnoses for mental illnesses are the same for both men and women. However, there are factors that can worsen the condition, such as alcohol consumption or smoking in men. Although there is a strict regime in the hospital, some patients are dissatisfied with it. The regime suits some but not others. However, without a regime, treatment may not yield good results. Those patients who come to us again already know that they will be treated properly here.

Mental health patients cannot always objectively assess their condition, so they often believe they do not need treatment. Relatives seek help only when the patient’s condition worsens. When working with new patients, we use not only medication but also the assistance of a psychotherapist. Various types of therapy are applied,” said the psychiatrist working in the men's department.

According to Gulnoza Ruziyeva, there are currently 57 patients aged between 25 and 65 in the 8th closed department of the clinic. She noted that mental health disorders are not always caused by stress. For example, among the patients are those who studied at universities or defended scientific papers. Some of them may experience unexplained mental changes. To date, it remains impossible to identify all the causes of such changes.

“Therefore, our task is not so much to eliminate the cause as to improve the patient’s condition. After discharge, treatment continues in the outpatient clinic. Each district has assigned doctors, and the patient consults a doctor at their place of residence. If the condition remains stable, the same medications are continued. If the condition changes, the doctor can adjust the treatment or, if necessary, refer the patient back to our hospital,” Gulnoza Ruziyeva explained.

She also shared with Kun.uz one of the most unpleasant moments of her work.

“When a patient recovers, we send them home. But what do their relatives say? ‘The doctor didn’t treat them completely; they should have discharged them when we wanted,’” and they file complaints. It’s not so much about complaining about improper treatment or incomplete examination, but rather that we discharged the patient not at the moment they deemed appropriate. After such complaints, the situation has to be clarified, relatives have to be found, and if necessary, apologies must be made. Because the issue needs to be resolved. For me, this is the most unpleasant moment,” Gulnoza Ruziyeva admitted.

The psychiatrist notes that even after recovery, relapses can occur. Each patient experiences this differently. If the patient follows the doctor’s recommendations after returning home, they may not need to seek help for 20 years.

Kun.uz also spoke with nurse Maftuna Urinboeva, who has been working in this closed department for 5 years. According to her, patients need care and attention.

“Initially, there were many difficulties, but now I have to work faster, as various situations may arise. Everything needs to be completed: documents must be processed, and patients’ conditions must be monitored. For example, when one patient is improving, another's condition may worsen.

They need kind words. If you speak softly and attentively to patients, it can help them recover. The most honorable aspect of our work is that we perform good deeds. For instance, after discharge, many patients do not return home but end up on the streets. There are those who have no home at all. Patients behave differently: at home, they are alone, while in the hospital, they are quite different. Even if they speak beautifully, they do not want to share what happened to them and hide their problems.”

According to statistics, approximately 50% of patients in Uzbekistan acquire mental illnesses for various reasons, including stress, trauma, or infections. In other cases, the illness may be congenital or independent of external influences. Many patients in the open department of the hospital also note that their mental disorders developed during their lives.

“13 years ago, I suffered a micro-stroke due to a heat stroke. Because of this, I am currently undergoing treatment here. To be honest, I was afraid of the name of the hospital and everything else at first. But for the past 5-6 years, I have been coming here once a year for treatment. Everything is fine.”

Another patient told Kun.uz that her mental state deteriorated due to stress.

“During the COVID-19 pandemic, I experienced severe stress. At that time, 50% of my lungs were affected. Then my husband passed away, and I fell into depression. This was 4 years ago, and this year, in the summer, the depression returned. I had a headache, my shoulders burned, and I couldn’t speak. By this time, I had stopped taking pills.”

Some congenital mental disorders can be caused by marriages between close relatives. In such cases, mental retardation is observed. In these situations, some parents think it will pass or try to fix the situation by overloading the child with additional activities. As one of the doctors explained, parents only come to the hospital when the child shows signs of developmental delays or behavioral issues.

People fear being placed on record

“When a person goes to the hospital or sees a psychiatrist, it does not mean they will necessarily be registered. Often, at early stages, if a person seeks help in time, severe incur