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This paper will revisit the question of how far psy-professionals were complicit in collaboration with the security services in Eastern European states during the Communist period. It focuses on primary material from Czechoslovakia, where a small amount of evidence exists to indicate that there was political abuse of psychiatry, bit that this was limited to individual cases. The paper will also evaluate the most recent secondary literature across the region to consider a comparative perspective, and will reflect on the legacies that this difficult history presents for trust in contemporary mental health services.