There are different types of patients in psychiatric hospitals. It depends on the institution but usually the majority of them are not psychotic at all but rather have affective disorders, personality disorders or addictions (or a combination). They can exist in the outside world just fine if there's a fitting place for them, think of a cocaine or alcohol addict that even manages to keep up with their high income career. There just wasn't a place for him - until he was repatriated.

It is really shocking that he never picked up Russian. I understand that Russian and Hungarian are almost as different as Japanese and Hungarian, but he should be able to learn the language just by hearing it.

> A Czech linguist of Slovak descent, Karol Moravčík, identified him as Hungarian, and on 11 August 2000, Toma arrived back in Hungary where his family was identified through DNA matching.

Someone else recognized the language he was speaking, and that it wasn't actually gibberish (and so he wasn't some crazy old man).

He was let go to Hungary after fifty-three years, when a Czech visitor coincidentally discovered that he spoke Hungarian.

Presumably after the collapse of the USSR Russia stopped using psychiatric hospitals as alternatives to gulags/prisons?