as against 318 in 2005. stigma linked to mental disease is at the level of xenophobia. the russian public perceive the mentally sick as harmful, useless, incurable, and dangerous. the social stigma is maintained not only by the general public but also by psychiatrists. traditional values have largely endured attempts by western institutions to impose a positive image of deviant behavior. for instance, in spite of the removal of homosexuality from the nomenclature of mental disorders, in 2014 62.5% of 450 surveyed psychiatrists in the rostov region viewed it as an illness, and up to three-quarters viewed it as immoral behavior. the psychiatrists sustain the ban on gay parades and the use of veiled schemes to lay off openly lesbian and gay persons from schools, child care centers, and other public institutions. in a 2013 inverview with dozhd, russia's chief psychiatrist, zurab kekelidze, said that a part of the cases of homosexuality is a mental disorder, he counters the remark that the world health organization removed homosexuality from the list of mental disorders by stating that it is not true. homosexuality was continuously defined as a mental disorder by the independent psychiatric association of russia in 2005, when its president, savenko, expressed his surprise at the proposal by the executive committee of the american psychiatric association to exclude homosexuality as a mental disorder from manuals on psychiatry. at the time he attributed this reclassification to political pressure from western ngos and governments, called it antipsychiatric, and stated that the reasoning behind it was ideological, social and liberal rather than scientific. savenko later changed his mind about homosexuality, and in a 2014 joint paper with alexei perekhov he stated that those who continue to advocate for classifying homosexuality as a mental disorder exhibit a soviet mentality. in 1994, a conference concerning the political abuse of psychiatry was attended by representatives from several former soviet republics including russia, belarus, the baltics, the caucasus, and some of the central asian republics. dainius puras made a report on the situation within the lithuanian psychiatric association, where discussion had been held but no resolution had been passed. yuri nuller talked over how in russia the wind direction was gradually changing and the systematic political abuse of psychiatry was again being denied and degraded as an issue of "hyperdiagnosis" or "scientific disagreement." among the proponents of this revisionist view was tatyana dmitrieva, director of the serbsky institute and a close friend of the key architects of "political psychiatry." in the early 1990s, she spoke the required words of repentance for political abuse of psychiatry which had had unprecedented dimensions in the soviet union for discrediting, intimidation and suppression of the human rights movement carried out primarily in this institution. her words were widely broadcast abroad but were published only in the st. petersburg newspaper chas pik within the country. however, in her 2001 book aliyans prava i milosediya (the alliance of law and mercy), dmitrieva wrote that there were no psychiatric abuses and certainly no more than in western countries. moreover, the book makes the charge that professor vladimir serbsky and other intellectuals were wrong not to cooperate with the police department in preventing revolution and bloodshed and that the current generation is wrong to oppose the regime. in 2007, dmitrieva asserted that the practice of "punitive psychiatry" had been grossly exaggerated, while nothing wrong had been done by the serbsky institute. after that an official at the serbsky institute declared "patient" vladimir bukovsky, who was then going to run for the president of the russian federation, undoubtedly "psychopathic". while speaking of the serbsky center, yuri savenko alleges that "practically nothing has changed. they have no shame at the institute about their role with the communists. they are the same people, and they do not want to apologize for all their actions in the past." attorney karen nersisyan agrees: "serbsky is not an organ of medicine. it's an organ of power." according to human rights activist and former psychiatrist sofia dorinskaya, the system of soviet psychiatry has not been destroyed, the serbsky institute is standing where it did, the same people who worked in the soviet system are working there. she says we have a situation like after the defeat of fascism in germany, when fascism officially collapsed, but all governors of acres, judges and all people remained after the fascist regime. in his article of 2002, alan a. stone, who as a member of team had examined pyotr grigorenko and found him mentally healthy in 1979, disregarded the findings of the world psychiatric association and the later avowal of soviet psychiatrists themselves and put forward the academically revisionist theory that there was no political abuse of psychiatry as a tool against pacific dissidence in the former ussr. he asserted that it was time for psychiatry in the western countries to reconsider the supposedly documented accounts of political abuse of psychiatry in the ussr in the hope of discovering that soviet psychiatrists were more deserving of sympathy than condemnation. in stone's words, he believes that snezhnevsky was wrongly condemned by critics. according to stone, one of the first points the soviet psychiatrists who have been condemned for unethical political abuse of psychiatry make is that the revolution is the greatest good for the greatest number, the greatest piece of social justice, and the greatest beneficence imaginable in the twentieth century. in the western view, the ethical compass of the soviet psychiatrists begins to wander when they act in the service of this greatest beneficence. according to st petersburg psychiatrist vladimir pshizov, a disastrous factor for domestic psychiatry is that those who had committed the crime against humanity were allowed to stay on their positions until they can leave this world in a natural way. those who retained their positions and influence turned domestic psychiatry from politically motivated one to criminally motivated one because the sphere of interests of this public has been reduced to making a business of psychopharmacologic drugs and taking possession of the homes of the ill. in soviet times, all the heads of departments of psychiatry, all the directors of psychiatric research institutes, all the head doctors of psychiatric hospitals were the cpsu nomenklatura, which they remained so far. the representative of nomenklatura in psychiatry had the scheme of career that is simple and often stereotyped: for one to two years, he run errands as a resident, then joined the party and became a partgrouporg. his junior colleagues (usually non-partisan ones) collected and processed material for his dissertation. its review of literature, particularly in a research institute for psychiatry, was often written by patients, because only they knew foreign languages, and their party comrades were not up to it, the natural habitat did not stimulate learning a foreign language. robert van voren also says russian psychiatry is now being headed by the same psychiatrists who was heading psychiatry in soviet times. since then russian psychiatric system has not almost changed. in reality, we still see a sort of the soviet psychiatry that was in the late 1980s. russian psychiatrists do not have access to specialized literature published in other countries and do not understand what is world psychiatry. staff training has not changed, literature is inaccessible, the same psychiatrists teach new generations of specialists. those of them who know what is world psychiatry and know it is not the same as what is happening in russia are silent and afraid. the powerful core of the old nomenklatura in psychiatry was concentrated in moscow, and it was clear that the struggle inside their fortress would be not only difficult, but also it would be a waste of time, energy and resources, so the global initiative on psychiatry has been avoiding moscow almost completely for all the years. instead, the global initiative on psychiatry took active part in projects for reforming the mental health service in ukraine, donated a printing plant to ukrainian public, organized a publishing house, helped print a huge amount of medical and legal literature distributed for free, but the ukrainian tax police accused the publishing house of manufacturing counterfeit dollars, and a significant part of humanitarian aid that the global initiative on psychiatry had gathered in the netherlands for ukrainian psychiatric hospitals was stolen in kyiv. many of the current leaders of russian psychiatry, especially those who were related to the establishment in soviet period, have resiled from their avowal read at the 1989 general assembly of the wpa that soviet psychiatry had been systematically abused for political purposes. among such leaders who did so is aleksandr tiganov, a pupil of snezhnevsky, full member of the russian academy of medical sciences, the director of its mental health research center, and the chief psychiatrist of the ministry of health of the russian federation. in 2011, when asked whether ill or healthy were those examined because of their disagreements with authority, tiganov answered, "these people suffered from sluggish schizophrenia and were on the psychiatric registry." according to tiganov, it was rumored that snezhnevsky took pity on dissenters and gave them a diagnosis required for placing in a special hospital to save them from a prison, but it is not true, he honestly did his medical duty. the same ideas are voiced in the 2014 interview by anatoly smulevich, a pupil of snezhnevsky, full member of the russian academy of medical sciences; he says what was attributed to snesnevsky was that he recognized the healthy as the ill, it did not happen and is pure slander, it is completely ruled out for him to give a diagnosis to a healthy person. in 2007, mikhail vinogradov, one of the leading staff members of the serbsky center, strongly degraded the human rights movement of the soviet era in every possible way and tried to convince that all political dissidents who had been to his institution were indeed mentally ill. in his opinion, "now it is clear that all of them are deeply affected people." in 2012, vinogradov said the same, "do you talk about human rights activists? most of them are just unhealthy people, i talked with them. as for the dissident general grigorenko, i too saw him, kept him under observation, and noted oddities of his thinking. but he was eventually allowed to go abroad, as you know... who? bukovsky? i talked with him, and he is a completely crazy character. but he too was allowed to go abroad! you see, human rights activists are people who, due to their mental pathology, are unable to restrain themselves within the standards of society, and the west encourages their inability to do so." in the same year, he offered to restore soviet mental health law and said it "has never been used for political persecution." human rights activists who claim it did, in vinogradov's words, "are not very mentally healthy." russian psychiatrist fedor kondratev not only denied accusations that he was ever personally engaged in soviet abuses of psychiatry; he stated publicly that the very conception of the existence of soviet-era "punitive psychiatry" was nothing more than: "the fantasy of the very same people who are now defending totalitarian sects. this is slander, which was used for anti-soviet ends, but is now being used for anti-russian ends." he says that there were attempts to use of psychiatry for political purposes but there was no mass psychiatric terror, he calls allegations about the terror a propagandistic weapon of activists of the cold war. as alexander podrabinek writes, psychiatrists of punitive conscription and namely kondratev are relatively indifferent to the public's indignation over illegal use of psychiatry both in soviet times and now, they do not notice this public, allowing themselves to ignore any unprofessional opinion. in response to the article by podrabinek, kondratev instituted a suit against podrabinek under russian civil code article 152 on protecting one's honor, dignity and business reputation. according to valery krasnov and isaak gurovich, official representatives of psychiatry involved in its political abuse never acknowledged the groundlessness of their diagnostics and actions. the absence of the acknowledgement and the absence of an analysis of made errors cast a shadow upon all psychiatrists in the ussr and, especially, in russia. as russian-american historian georgi chernyavsky writes, after the fall of the communist regime, no matter how some psychiatrists lean over backwards, foaming