political repression. There was no compelling requirement to develop an alternative and more expensive psychiatric substitute. The abuse of psychiatry was a natural product of the later Soviet era. From the mid-1970s to the 1990s, the structure of the USSR mental health service conformed to the double standard in society, being represented by two distinct systems which co-existed peacefully for the most part, despite periodic conflicts between them: system one was that of punitive psychiatry. It directly served the authorities and those in power, and was headed by the Moscow Institute for Forensic Psychiatry named in honour of Vladimir Serbsky; system two was made up of elite, psychotherapeutically oriented clinics. It was headed by the Leningrad Psychoneurological Institute named in memory of Vladimir Bekhterev. The hundreds of hospitals in the provinces combined elements of both systems. If someone was mentally ill then, they were sent to psychiatric hospitals and confined there until they died. If his mental health was uncertain but he was not constantly unwell, he and his kharakteristika [testimonial from employers, the Party and other Soviet institutions] were sent to a labour camp or to be shot. When allusions to socialist legality started to be made, it was decided to prosecute such people. Soon it became apparent that putting people who gave anti-Soviet speeches on trial only made matters worse for the regime. Such individuals were no longer tried in court. Instead they were given a psychiatric examination and declared insane. The Joint Session, October 1951 In the 1950s, the psychiatrists of the Soviet Union turned themselves into the medical arm of the Gulag State. A precursor of later abuses in psychiatry in the Soviet Union, the "Joint Session" of the USSR Academy of Medical Sciences and the Board of the All-Union Neurological and Psychiatric Association took place from 10 to 15 October 1951. The event was dedicated, supposedly, to the great Russian physiologist Ivan Pavlov, and alleged that several of the USSR's leading neuroscientists and psychiatrists of the time (among them Grunya Sukhareva, Vasily Gilyarovsky, Raisa Golant, Aleksandr Shmaryan, and Mikhail Gurevich) were guilty of practicing "anti-Pavlovian, anti-Marxist, idealistic [and] reactionary" science, and this was damaging to Soviet psychiatry. During the Joint Session, these eminent psychiatrists, motivated by fear, had to publicly admit that their scientific positions were erroneous and they also had to promise to conform to "Pavlovian" doctrines. These public declarations of obedience proved insufficient.