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Psychiatry in Latvia throughout the centuries

 

Psychiatry in Latvia has a long and eventful history. A sensitive attitude towards the mentally ill in Riga was formed already during the medieval period. As there were quite a few of them, the need arose to have the afflicted in one place.


The beginnings of psychiatry


Psychiatry in Latvia has a long and eventful history. A sensitive attitude towards the mentally ill in Riga was formed already during the medieval period. As there were quite a few of them, the need arose to have the afflicted in one place. In 1786, the madhouse (Tollhaus) was established. It was located in a fortress known as the Riga Citadel, but the conditions there were so deplorable that Emperor Alexander I of Russia, while inspecting it in 1818, felt deeply disgusted and ordered a new institution to be built.


The place was found on the right bank of the Sarkandaugava canal on a steep hill, from which during the siege of Riga in 1710 Russian troops under the leadership of Knyaz Alexander Menshikov fired cannons at the city. Thus, after the opening of the new building on the 21st of September 1824, the institution acquired the name of Aleksandra Augstumi or Alexander’s Heights.


Alongside prisoners, convicts, the disabled and venereal disease patients, 52 places were allocated for the placement and supervision of patients with mental illness. The attitude towards these patients was more humane than towards other categories of supervised persons, as whips and rods were not used to treat them.


The development of the science of psychiatry


The origins of psychiatry as a clinical discipline dates back to the foundation of the state of Latvia in 1918 and the establishment of the University of Latvia in 1919. All medical students at the university also studied psychiatry. In 1920, the Department of Psychiatry was established. It was led by Hermanis Buduls who is one of the most prominent figures in Latvian psychiatry. Hermanis Buduls is the author of textbooks in psychiatry (“Psychiatry. General part”, “Psychiatry. Special part”). He developed clinical training, theory of development of neurogenic diseases, terminology, and created a laboratory for histological, biological and chemical examinations. The students of Hermanis Buduls (V. Krauklis, H. Saltups a.o.) attained significant scientific achievements at the European and at world level. Among them was presenting papers at the 1937 International Congress of Psychiatrists in Bern (Switzerland).


 Hermanis Buduls is the author of textbooks in psychiatry (“Psychiatry. General part”, “Psychiatry. Special part”). Image by Wikimedia Commons.
Hermanis Buduls is the author of textbooks in psychiatry (“Psychiatry. General part”, “Psychiatry. Special part”). Image by Wikimedia Commons.

In 1924, the Latvian Association of Neurologists and Psychiatrists was founded, which is considered to be the beginnings of the Latvian Psychiatric Association. In 2024, we will be celebrating the Association’s centenary!


War and occupation period


During the Second World War, several psychiatric establishments were closed in Riga and their patients and staff suffered a tragic fate – they were killed, cemeteries were created near psychiatric hospitals.


In the post-war period, the field of psychiatry in Latvia was influenced by the trends of Soviet psychiatry, which were based more on the defense of public interests as opposed to individual interests. Unfortunately, in the Soviet Union psychiatry was used to persecute dissidents and to maintain the ideas of the illegal political regime. These were difficult times for Latvian psychiatrists who tried to preserve humanity towards patients. The attitude of doctors has remained positive and understanding in the memories of dissidents as well. Unfortunately, psychiatry was used in the interests of the regime.


Despite the difficulties, the field of psychiatry continued to evolve, the number of hospital beds decreased, and the specialties of occupational and social psychiatry developed.


Inclusion in European and world psychiatric community


Following the restoration of Latvia’s independence in 1991, Latvian psychiatry rapidly and irrevocably entered the European and world psychiatric community. The Latvian Psychiatric Association became a member of the World Psychiatric Association, the European Psychiatric Association and the Nordic Psychiatric Association. Active and productive cooperation with psychiatrists from Germany, Canada, Sweden, Norway and other countries was formed.


On June 6th and 7th of 2024, Latvia will host the Congress of the Nordic Psychiatric Association for the first time with speakers and an audience from Finland, Sweden, Norway, Denmark, Iceland, Lithuania, Estonia and Latvia.


Modern psychiatry in Latvia and future perspectives


Modern psychiatry in Latvia is based on a biological, psychological and social approach, providing patients with medical treatment, social support and psychotherapeutic help. The availability of the latest medications in the world and also in Latvia has enhanced the capacity to provide effective control of symptoms, affecting the quality of life of patients as little as possible.


Nowadays, assistance to psychiatric patients is based on their maximum inclusion in society while respecting patients’ wishes and interests.


Work in the field of psychiatry more often goes beyond the competence of just one psychiatrist, it involves also other specialists such as art therapists, occupational therapists, psychologists, and physiotherapists.


Today, psychotherapeutic knowledge is an everyday part of the education and daily work of psychiatrists. More and more psychiatric patients are treated outside the walls of hospitals, closer to their homes, on an outpatient basis and in day care clinics.


During the last decades, there has been asignificant decrease in the number of psychiatric hospital beds in Latvia, treatment time has been shortened, day care clinics are used, the number of patients attending day clinics is increasing, and the environment is becoming more welcoming for patients (clinics “Pārdaugava” and “Veldre” in Riga). It facilitates the timely start of treatment and cooperation during the post-hospitalization period, and promotes continuity of treatment. Community-based treatment methods such as the early intervention program in Daugavpils and Riga are being developed. □

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