With your bowler hat: who cares about the mental health of Russians
The mental health of Russians is one of the priorities of Russian healthcare. Over the past few years, the network of state psychological centers has expanded, and psychological and psychiatric care has been provided within the framework of compulsory medical insurance. What programs are available for anxious citizens who are increasingly seeking support from free consultations, and how accessible they are, can be found in the Izvestia article.
How has the state of Russians changed
According to the Ministry of Health, 3.9 million people with mental disorders were registered in 2023, which is 3% less than ten years earlier. Nevertheless, at the same time, there is an increase in the number of requests for psychotherapeutic help. Thus, in the first quarter of 2023, the number of consultations with psychologists increased by 15%, and in 2024, the growth was already 25%.
According to the Institute of Psychology of the Russian Academy of Sciences, published in 2024, about 39% of Russians experience symptoms of depression, and 24% — anxiety, indicating the widespread occurrence of anxiety-depressive disorders among the population.
In 2025, VTsIOM concluded that the number of requests for psychological help had doubled over the past 15 years, indicating increased awareness and willingness to seek professional support. Most of the complaints are related to anxiety disorders: in 2023, complaints of anxiety attacks remained at the level of 42-44% throughout the year. In addition, there is a high level of professional burnout: 64% of Russians have experienced its symptoms over the past year, and 24% regularly face chronic stress at work.
Younger disorders
Psychologist and psychoanalyst Tasha Vyazemsheva said that the current state of mental health of Russians can be described in one word — tension due to prolonged stress, social instability and overwork. The expert noted that people increasingly come not with one symptom, but with a whole tangle of problems: insomnia, apathy, loss of interest in life, burnout at work and a breakdown in relationships.
— According to my observations, in practice, especially over the past three years, the number of referrals with anxiety disorders has increased at least twice. Young people complain of panic attacks and "emptiness," while middle—aged people complain of chronic fatigue and a feeling that they no longer have the strength, she says.
Elizaveta Skorodumova, associate professor at the I.I. Dzhanelidze Research Institute of Emergency Medicine, added that the number of referrals to psychologists and psychiatrists began to increase after the COVID-19 pandemic, but official morbidity statistics are not yet transparent and complete enough, as many cases remain undetected or hidden due to stigmatization.
At the same time, mental problems began to "get younger" catastrophically quickly, as Alexey Onosov, the author of the book "Happinomics," told Izvestia.
"Child psychologists say that children who are not even ten years old are brought to them, and they are already showing serious behavioral and emotional disorders," Onosov said.
Anton Shestakov, a psychiatrist and forensic expert in the field of psychiatry, shared with Izvestia that over the past five years he has observed noticeable changes in the mental health of the Russian population.
— As a specialist working both in the clinic and in forensic examination, I can say that the problem has become more urgent and noticeable. I am most often approached by patients with chronic fatigue, sleep problems, panic attacks and a general decrease in vital energy. Professional burnout has become a common problem, especially among healthcare workers, educators and social workers," said Shestakov.
Yulia Kovalchuk, head of the department of the ON CLINIC International Medical Center and a psychotherapist and sexologist, added that the consumption of antidepressants increased by 17% compared to the previous year and broke a five-year record.
— Younger patients began to apply more often. Young people are more likely to have borderline or bipolar personality disorder. In patients over the age of 25, the most common diagnoses are eating disorder, obsessive-compulsive disorder, and anxiety-depressive disorders. Previously, psychotherapy was preferred, but now it is pharmacotherapy, and for the more educated population it is combined with psychotherapy," Kovalchuk said.
Coach Igor Poyurov said that the psychological state of citizens is largely related to the stress level. According to him, the psyche cannot be stable if a person has been living in chronic stress for years.
Stress is the body's reaction to external or internal situations that a person cannot "digest" or change. Chronic stress depletes the body, creates a constant background of anxiety, apathy and irritability," explained Poyurov.
Free of charge and under compulsory medical insurance
According to experts, the government is actively working to improve the mental health situation in the country. Among the steps being taken are the creation of psychological emergency hotlines, such as a Helpline, the expansion of a network of specialized support services, and the training of medical professionals so that they can recognize signs of mental illness. Information campaigns aimed at raising public awareness about the importance of mental health are also being conducted.
Tasha Vyazemsheva said that over the past five years, more crisis centers, hotline services, and compulsory health insurance programs have appeared, but in practice, the dynamics are more quantitative than qualitative.
— Yes, consultations on compulsory medical insurance have become more accessible, but the level of personnel training and real opportunities vary greatly from region to region. Unfortunately, there is a feeling that the state system is catching up with the need, rather than ahead of it," concluded Vyazemsheva.
Anton Shestakov added that the existing state programs for the prevention of mental disorders operate in several directions. According to him, the main burden is placed on district neuropsychiatric dispensaries, where everyone has the right to free consultation within the framework of compulsory medical insurance.
— In recent years, the material and technical base of psychiatric institutions has improved significantly. New treatment methods are being introduced, and modern medicines are being provided as part of preferential treatment. However, the key problem remains the shortage of specialists," Shestakov stressed.
Dmitry Vashkin, chief physician of the Marshak Clinic, said that since 2024, consultations of medical psychologists have become available under the compulsory medical insurance policy. Patients at the dispensary, combat veterans, pregnant women and women who have recently given birth can consult a psychologist for free. By law, patients must be admitted within 14 days.
In 2025, Russian citizens can check their mental health at the second stage of medical examination, if doctors see the need for it. In-depth counseling is provided by a psychotherapist, psychologist, clinical psychologist or a trained preventive medicine doctor.
— There is a positive trend in the provision of psychiatric and psychological care, and yet there is still much to strive for. It takes a long time to wait for help, especially since you can't make an appointment on your own, a therapist or neurologist should give you a referral. Free care often comes down to basic medical treatment and brief consultations with a narrow range of methods," Vashkin shared with Izvestia.
From cabinet to online consultation
Elizaveta Skorodumova added that the organization of psychological centers varies between regions. Most consultations are conducted on an outpatient basis or remotely via telemedicine platforms. Despite the increased financing of the healthcare system, the volume of services provided significantly lags behind the needs of patients.
— The dynamics of the last five years has been positive and shows an increase in the number of specialists, but the growth rate is insufficient to meet the growing demand for services. Psychiatric care is also available under the compulsory medical insurance policy, but the availability of qualified professional doctors remains limited, especially in remote areas of the country," Skorodumova said.
According to her, it is possible to get free specialist advice, but the process is associated with certain difficulties: insufficient awareness of the population about the procedure for applying for such services, a shortage of staff and a shortage of qualified professionals in some regions, long queues and waiting for initial admission.
Anton Shestakov explained that in large cities the average waiting time is two to three weeks, which can be critical for acute cases. In the regions, the situation is a bit more complicated — the wait can be up to two months.
— Psychological assistance within the framework of compulsory medical insurance is much less developed. Free psychological consultations are mostly available as part of special programs or in the process of complex treatment in a hospital," the expert noted.
Is it easy to find a psychologist in the outback
Tasha Vyazemsheva stated that small towns and villages are the most vulnerable area in mental health issues. In her opinion, the situation there is close to critical. In small towns, there is often no psychologist or psychotherapist, at most one psychiatrist in a polyclinic, to whom it is almost impossible to get.
— People are left alone with their problems. Most often, they either go into self—destructive habits - alcohol, addiction, or seek "advice on the Internet." The state system has not yet found a working answer to this challenge. This gap between the capital and the regions remains the key problem of the system," she argues.
Elizaveta Skorodumova noted that in order to solve the problems of accessibility of psychotherapeutic care, additional investments are needed in the development of telecommunications technologies, the expansion of remote counseling and the training of local doctors in the basics of diagnosis and treatment of common mental disorders.
Dmitry Vashkin, Chief physician of the Marshak Clinic, recalled that the government plans to increase the number of psychologists through retraining specialists. In 2025, the international program "Mental Health: current trends and Prospects" was launched.
It is expected that in the next five years there will be more specialists who will deal with the prevention, treatment and rehabilitation of mental disorders. And today in the regions there is a state program of online consultations for psychologists who have received special training.
Taking care of yourself
Alexey Onosov stressed that the government responds systematically to existing challenges. However, according to him, it is necessary to deal not only with the consequences, but also with the causes. To do this, in his opinion, it is worthwhile to provide children with appropriate skills at an early age.
— Why not start implementing emotional self-regulation practices from kindergarten after an appropriate examination? Imagine: a child in the garden learns not only to draw and count, but also to understand his emotions, cope with anger, and find joy in simple things. Instead of running around psychologists all his life, a person initially gets basic mental health skills. Let children know from an early age how to manage their emotions, how to build healthy relationships, and where to look for internal resources when things get tough," Onosov suggested.
According to him, in order to achieve systemic results, a comprehensive strategy is needed, which will include not only the expansion of the treatment base, but also a fundamental revision of approaches to the prevention of mental disorders. At the same time, the expert added that it is necessary to start from childhood — to teach people to be happy and emotionally stable, and not to wait until they break down and come for help.
Anton Shestakov noted that the existing stigma remains the main barrier. Many fear that going to a psychiatrist will affect their career or social status. Despite the legal protection of patients, the psychological barrier remains high.
He recalled that it is important to understand that seeking psychological or psychiatric help is a manifestation of self—care, not a sign of weakness. Modern medical methods can effectively treat most mental disorders.
— If you notice signs of a persistent decrease in mood, sleep problems, increased anxiety or other symptoms affecting your quality of life, do not delay visiting a specialist. The sooner treatment begins, the better the prognosis will be. Remember: your mental health is an investment in quality of life, relationships with loved ones, and professional achievements. Take care of yourself and don't hesitate to ask for help when you need it," the expert concluded.
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