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Published Online:https://doi.org/10.1176/ajp.125.5.665

In the determination of criminal responsibility, Soviet psychiatrists insist that they base their judgments solely on medical factors, with primary emphasis on evidence of organicity. The author believes, however, that in practice sociocultural factors may also be taken into account. In regard to civil commitments, the law provides no judicial review of commitment practices; Judge Bazelon feels that this policy is open to criticism on several grounds. In general, he feels the Russian mental health services, or all their accomplishments, depend upon a social system which is difficult for an American to accept.

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