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This paper examines a shift in Soviet medical and political discourse in the 1950s and early 1960s, showing how the category of “the mentally ill” came to be constructed as inherently prone to criminal disruption of social order, despite the long-held Soviet ideological prescription against “biologizing” criminal acts. Using previously unstudied conference proceedings, archival reports, and published papers by forensic psychiatrists, KGB officials, and Party leaders, the paper shows how medical expertise and large-scale data collection was used to convince Party officials and state officials to agree to structural changes in the law and administration of psychiatric patients, resulting in the creation of a country-wide mental health surveillance system and a legal process that enabled psychiatrists to forcibly commit a patient even if they had never committed a “socially dangerous act. The paper argues that these policies were not narrowly aimed at political dissidents but rather intended to establish population-wide social control mechanisms to defend the social body of “developed socialism” from the inherent criminality of the mentally ill.