“New Psychiatry” and Traditional Healing in Kyrgyzstan: Attempts to Develop Culturally Sensitive and Community-Based Treatment

Abstract

Healthcare in post-Soviet Central Asian countries, and mental healthcare in particular, has still preserved many characteristics of the previous Soviet system. In the Kyrgyz Republic, a wide-ranging reform of the healthcare system, which started in the second half of the 1990s, has not included psychiatric services in its priorities. In the face of severe deficiencies in the system, such as an over-institutionalisation of mental healthcare and a lack of adequate financing, a group of local psychiatrists, aware of the standards of contemporary psychiatry, have tried to implement an approach promoting culturally sensitive and community-based treatment of mentally ill patients. They notice a great popularity of traditional healers and their role in local communities, based on a worldview shared with their patients and competence in values and norms of social life. Moreover, these psychiatrists understand that healers’ interventions can be effective in the cases of non-psychotic mental health disorders, and attempt to develop some kind of cooperation with Kyrgyz healers, especially in crisis situations. In this article, grounded in the publications of this group of psychiatrists and my own fieldwork in Bishkek between 2011 and 2013, I discuss these achievements and show how globally promoted ideas and directives of contemporary psychiatry have been adapted to the local conditions.