In a cramped room that smells of stale food and body odor two dozen old ladies are packing pieces of colored plastic into small cellophane bags. On closer inspection, the pieces turn out to be toy soldiers -- some red, some black, all somewhat misshapen.One of the ladies absently picks up a red figure and puts it in her mouth. An orderly notices it a second before it's too late and, unclasping the patient's teeth, fishes in her mouth for the toy. The old lady sits up straight and, not protesting, lets the orderly poke about."We've got to give them something to do," explains Olga Doronina, the head doctor of geriatric ward 28 at the Alexeyev mental hospital.The monotonous, unskilled jobs given to mental patients in Russian hospitals, known as labor therapy, have been part of the treatment process for decades. Factories traditionally farmed out some of their duller jobs to mental hospitals, providing patients with a way to while away the time and to earn a little money.Younger patients at the Alexeyev hospital do work that requires more skill, assembling miniature electric motors or sewing bedclothes. Doctors say some of them earn up to 100,000 rubles a month, supplementing their meager allowances.But doctors acknowledge that some of the factories that used to provide the work have stopped doing so because of economic difficulties. Moreover, the efficiency of labor therapy has been questioned."It's not very effective," said Vladimir Kozyrev, head doctor at the Alexeyev hospital and Moscow's chief psychiatrist. "Labor has made people what they are, but not all labor is useful."Kozyrev said he put more stock in what he termed "art therapy." The hospital has an art studio and amateur theater, and a dancing class will be organized in the near future, Kozyrev said. He is also planning exhibitions of patients' paintings.This year, the Alexeyev hospital published a collection of prose and poetry by 48 patients. The volume, called "A Step Beyond the Horizon," is a striking display of anguish, rebellion, frustrated love and jealousy sometimes put into brilliant form by the amateur writers.Olga Goncharova wrote in a poem called "Suffering:""Please leave alone, just leave me!I don't want your compassion.Just cross me off your list --There's no path from hell to heaven."While many contributors to the collection praised their doctors for helping them get back to normal, others, like Olga Popova, rebelled: "The nurse's ratty eyes brushed over my back As she swept the floor with her broomAnd fear wandered in forbidden tearsAlong the corridors of this hospital pit." Acknowledging the evident bitterness in much of the patient's work, the hospital called the foundation it formed to promote the creativity of mental patients "Outcasts' Creations.""Though it is a somewhat elitist form of therapy -- not everyone can paint or write poetry -- it draws people's attention to the fact that mental patients should be treated as equals," Kozyrev said.To some patients, the contest held by the hospital to select material for the collection was a welcome chance to break free from the drudgery of "labor therapy.""I might die of boredom making packages for disposable syringes," Alexander Grishechkin, 37, confessed in a short story published in the collection."When I saw the notice about the literary contest, I decided to try," he wrote in another story. "I submitted eight short stories and 30 poems and my apathy and sadness were gone."I had wanted to commit suicide and I even slashed the veins on my left wrist. But it turned out that life was only just beginning."