The organization of psychiatric care in Zemstvo medicine (to 150th anniversary Zemstvo reform)
In Russia, the organization of curative institutions for insane persons was initiated by prikaz (department) of public charity in the end of XVIII century. After the zemstvo self-government was introduced in 1864, curative institutions were assigned to zemstvo organizations. Since that time, psychiatric departments of zemstvo gubernia hospitals began to be selected as independent institutions headed by psychiatrists. The number of psychiatric beds augmented. Such methods as non-constraint of insane patients and occupational therapy received wide propagation in zemstvo psychiatric hospitals. In 1884, the first suburban colony for charity of chronically insane persons was organized in the Tverskaia gubernia. Up to beginning of XX century zemstvo psychiatric care transformed into independent specialized type of medical care provided in hospitals and in out-patient conditions (rural patronage).