Splendid Time Reception Room Episode 346: Is it okay to lock it up? Would it be better for society to isolate the mentally handicapped?

Text / Yang Juanru

Last December, there were two family tragedies in which mentally ill patients killed their mothers. Such cases caused social panic, and the public was worried that the mentally handicapped were "time bombs". The government even amended the law to extend the custodial punishment of the mentally handicapped inmates. , which is like "enhanced isolation", but does not think about solving the root cause of the problem.

In this episode, we invite Jin Lin, Director General of the Taipei City Heart Life Association, and Liao Fuyuan, Director of the Living Fountain House of Eden Social Welfare Foundation, to dispel the myth that "if you claim to be mentally ill, you are not guilty", and that the government's populist law revision will not help solve the next The "Murder Case" appeared, and he talked about how to get along with patients and help them live and work in peace and contentment.

As long as everyone needs support, the mentally handicapped too

In one incident in Pingzhen, Taoyuan last December, a man suffered from severe depression and severe auditory hallucinations and slashed his mother. The other was a man with schizophrenia in New Taipei who was prevented from smoking by his mother And assassinated her. But are people with mental disorders really all high-violent people?

"It's not the illness that caused the patients to kill people out of control, but because they didn't get good support after the illness." Jin Lin, director-general of the Taipei City Heart Life Association, mentioned the case of a New Taipei man who had a conflict with his mother because of smoking. A population of 200,000, who regularly goes to the hospital for injections, the media reported that the man made a big mistake about killing his relatives and said frankly, "I regret it," and also said, "I don't think anyone loves me."

Jin Lin said that it is not entirely due to illness that mentally disabled patients lose control and kill. In addition to physical diseases, for example, many patients with schizophrenia have more emotional ups and downs than ordinary people, and they feel unloved by society for a long time. 100% negative thinking makes patients feel very low in life experience, and many things that are simple for ordinary people to operate, patients cannot do.

Most people, including family members, may have a stereotype of mentally handicapped people, and they dislike mentally handicapped patients who cannot work well. Therefore, they often confront patients with scolding and abuse, but ignore the need for patients to carry out daily affairs in a way that guides rehabilitation due to mental illness. There is only conflict with the patient.

The host, Guan Zhongxiang, also mentioned that he had taken classes in a mental disorder institution in the past, and asked why everyone became a patient? Nine times out of ten, they answered that they may have experienced bullying from family, school or friends as a child. The reasons may be complicated, but they generally experienced some kind of social setback. When the caregiver's family members are irritable and conflict with the patient, the mentally handicapped patients are not generally violent as imagined by the outside world, but may be an emotional rebound after encountering setbacks.

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Jin Lin said that the mentally handicapped will "explode" due to their physical frailty or genetics, coupled with the unbearable pressure and trauma of bullying the day after tomorrow. Rehabilitation after illness should also pay attention to stressors in daily life. Some patients will use all their strength to fight back before the delusional treatment is in place. It is indeed a high risk for the people around them. At this time, accidents are easy to occur, and it is more helpful to seek medical assistance.

Whether this society can accept the mentally handicapped, the support system is very important. The country pays more attention to medical treatment in terms of policies for the mentally handicapped, but forgets that they are still handicapped. Just like those with physical disabilities, they all need help and support from others, so that they can slowly go through the recovery process. However, in fact, the daily care policy for the mentally handicapped is relatively insufficient, and the mentally handicapped encounters obstacles in their lives. We call on the national policy to consider alleviating the life pressure of the mentally handicapped, so as to truly achieve the effect of reducing accidents.

Not guilty just by claiming to be mentally ill?

However, many people face major criminal cases involving mentally handicapped people. The public will stereotype that "as long as you claim to be mentally handicapped, you can reduce your sentence or even be innocent?" Just keep them in isolation and it will be fine? What is the trial procedure for criminally disabled persons?

Liao Fuyuan, director of the Living Fountain Home of the Eden Social Welfare Foundation, said that the judicial trial procedures for the mentally handicapped are the same as those of ordinary people, except that they will go through the "psychiatric appraisal" procedure. Identification and behavioral skills.

Article 19 of the "Criminal Law": A person who is unable to recognize the illegality of his behavior or lacks the ability to act according to his recognition due to a mental disorder or other mental defect during his conduct shall not be punished. For the reasons mentioned in the preceding paragraph, if the ability to recognize the violation of the law or to act according to the recognition is significantly reduced, the punishment may be reduced. The provisions of the preceding two paragraphs shall not apply to those that are self-inflicted by intention or negligence.

Jin Lin believes that the purpose of punishment is to make a person know his mistakes and make corrections. The reason why Article 19 of the Criminal Law holds that a person with a mental disability is not guilty is because he does not know that this is a wrong thing in his mental state. When the mentally handicapped person does not know this behavior, the punishment is meaningless.

It is very difficult for Liao Fuyuan to refute the claim that he can be acquitted or have his sentence reduced by claiming that he is a mentally handicapped person. First, the litigation is a long process. It is very uncomfortable for ordinary people to pretend that they are sick, hallucinations and other symptoms for a long time. Appraisal is professionally certified. For example, schizophrenia will only be diagnosed after half a year of confirmation. "Pretending to be sick and commuting" will not be professionally recognized by doctors and judges.

Among the judgments related to the mentally handicapped, there are very few sentences with commutation or exoneration. In the case of the Taiwan Railway Police Killing Case, the final client Zheng Nan was sentenced to 17 years in prison, plus at least 5 years of guardianship. 22 years of isolation.

Liao Fuyuan said that if an ordinary criminal has served his sentence, the punishment will end, but the label and stigma of a mentally handicapped person will last for a lifetime. Even if a mentally handicapped criminal receives a commutation, he will still be treated in isolation in a treatment center. Let him go unpunished, and most people should not use this method to achieve immunity and commutation.

How does the prison system respond to inmates with mental disabilities?

The general public has a very shallow understanding of the mentally handicapped, plus the stigma of the mentally handicapped, they keep away from it, and it is even more difficult to think of the various situations that criminals with mental disabilities face after entering prison. When the mentally handicapped has the dual identities of patients and prisoners, is there any way for the current prison system to deal with it?

"Patients with mental illness must bear criminal responsibility and receive proper treatment." Jin Lin said, according to the information released by the prison's concern group, the Supervision Yuan has conducted investigations in various prisons and found that mentally ill patients have not received good treatment in the prisons. arrange. Some are incarcerated without treatment for mental illness, let alone referred for treatment.

The attention group of the prison mentioned a case where a patient was involved in labor work while serving his sentence. Because of his mental illness, he was not instructed in his work operations, and his movements were slower than others. In such a high-pressure environment, he was disgusted by the inmates, and he often cried when he was visited by his family. , until his family helped him report to the prison, the patient's condition was relieved.

If a prisoner suffers from a serious heart disease, he should also receive treatment when he is sentenced. The right to life cannot be violated by serving the sentence. Therefore, the militia group also advocates that the mentally handicapped should be given equal treatment rights, not only for physical and mental illnesses. Treat properly.

Opposition to amending the law to extend the guardianship period of inmates with mental disabilities and isolation will not solve the problem

Due to the social panic caused by the killing of a police officer by the Taiwan Railway and the eye gouging case in Pingtung, the Ministry of Justice and the Judicial Yuan want to amend the law to extend the time of guardianship for the mentally handicapped to "extend the quarantine". Is there really a way to make the society safer?

Regarding the "Draft of Guardianship Sanction System", Liao Fuyuan explained that Article 87 of the current Criminal Law stipulates that guardianship sanctions are up to 5 years. The Ministry of Justice and the Judicial Yuan are expected to propose amendments to Articles 87 and 98 of the Criminal Law, expressly extending the period of guardianship sanctions. , The extension period is less than 3 years each time, there is no limit on the number of times, etc., and the provisional resettlement system before the judgment is added, etc., and the prosecutors and judges are empowered to use judicial means to force the defendant to be admitted to the hospital for treatment during the investigation and trial procedures. Attention from all walks of life.

The Folk Judicial Reform Foundation questioned the government's "just want to lock up people, not to improve the situation of the mentally handicapped", etc., but amend the law to restrict the mentally handicapped people's return to society and other populist responses. The Society of Psychiatry and Judicial Psychiatry has made solemn statements on many occasions, and citizens and social welfare groups have issued statements on many occasions to directly oppose the revision of the law.

"If a drunk driver is imprisoned and it is judged that he will commit the crime again after being imprisoned, can he continue to imprison him? Or if the underworld criminal has served his sentence after committing a crime, if he is considered to commit the crime again after being released from prison, can his sentence be extended?" Liao Fuyuan believes that the mental retardation Criminals are the same as crimes committed by the general public. Only prolonging the sentence of the mentally handicapped is not for treatment, but for isolation.

If the mentally retarded criminals have not been fully treated, their isolation period will be extended for reasons such as fear of recidivism. According to several judicial psychiatrists, the mentally retarded persons will become stable after half a year of treatment, and the focus is on follow-up long-term follow-up. If everyone thinks the above case is inappropriate, why can the isolation be extended for the mentally handicapped? He reiterated that the "Draft of Guardianship Sanction System" is an amendment that lacks social fairness and justice, and the militia group strongly opposes it.

"Everyone says they can kill or shut down, so the government has revised the law to isolate the mentally handicapped prisoners as much as possible? Forgot that the mentally handicapped also have human rights?" Jin Lin said that the mentally handicapped group and the families of the patients are more eager to solve the problem than the government, but such Amending the law will exacerbate the problem.

Judging from the case of the police killing by the Taiwan Railway, no one knew that Zheng Nan was ill before the accident; he suffered failure after starting a business, his wife fell ill, and finally he also fell ill. At the same time, due to the financial situation of his family, he could not seek medical treatment, and he was in a high-pressure environment. Suffering from persecution delusions, but still went to 5 places for help before the incident, including the social bureau, the police station, and the councillor's service office. Resources to help this middle-aged man who is unemployed and has no money to see a doctor.

After committing the crime, Zheng Nan, according to the current law revision logic, can be detained in the judicial mental hospital indefinitely, but he cannot solve the next police assault case. Jin Lin said: "The current direction of law revision can neither prevent crimes committed by patients, nor treat patients properly."

What to do after the custodial sanction expires?

In addition, in order to cooperate with the revision of the "Criminal Law", the relevant provisions of the "Security Punishment Enforcement Law" are also revised this time. "Transition Mechanism". The execution method may be changed according to the specific circumstances of the parties. In addition to being admitted to a judicial psychiatric hospital, it can also be transferred to a regional medical institution for continued treatment, or transferred to family members and adjusted to outpatient treatment.

Liao Fuyuan criticized that the so-called "multiple treatment" for inmates with mental disabilities is completely useless. The current reception work is a single community and lacks diversified treatment, and the government has not increased substantial resources due to the revision of the law. Article 46-1 of the "Security Punishment Enforcement Law" stipulates that there is an evaluation team composed of experts and scholars during the guardianship of the parties, but the evaluation team does not have the participation of the parties or family members, and cannot actually understand the needs of the parties and caring family members. The militia group believes that family members, parties, and even community support and personal management social workers should be included.

For example, Liao cited a friend who works in a hospital. He mentioned that an inmate with infertility could be discharged from the hospital after evaluation after the custodial sanction period expires, but his family was not allowed to go home because he was afraid, and he could not be discharged from the hospital. If the assessment team does not include the disciplinary action made by the family's voice, it will not apply to the family.

Yang Nan in the Pingtung eye gouging case was discharged after being forced to be hospitalized for many times. Why does it still happen? Liao Fuyuan believes that it is related to whether the transfer resources are kept up after discharge. The draft amendment to Article 46-3 of the "Security Disciplinary Enforcement Law" requires that a transition meeting be held two months before the expiration of the guardianship penalty period. The militia group believes that at least six months before the expiration of the term, the social workers who take over the community and personal management should go directly to the prison or hospital to establish a relationship with the client, and there must also be a treatment plan for the client. After the person is released, it is difficult to trace.

However, it seems that the transition meeting held by the government is a one-time meeting, and the parties, family members, social workers or personal managers will not be invited to the meeting.

Liao believes that the transition plan will not only be held half a year ago, but also hold regular meetings as the punished person leaves the guardianship, provide different resources according to social changes, and allow the family and social workers to become a social support network for the punished person, rather than a social support network. A meeting of the treatment plan is all it takes.

For example, there was a mentally handicapped person whose parents couldn't bear the harassment of his symptoms and asked him to move out. Later, he attacked his roommate due to the delusion of persecution, which was considered to be an attempted murder, but the follow-up guardianship sentence sentenced him to "home guardianship". It can be seen that the transfer conference did not recognize the original situation of the person and his family, and still decided to "home guardianship", which could not solve the problem.

Covering hospital isolation and investing resources in the daily life of the mentally handicapped

At the end of July, the Executive Yuan will pass the "Strengthening Social Safety Net Phase 2 Plan". In the next five years, more than NT$40.7 billion will be invested in setting up a judicial mental hospital and increasing government and private social worker-related manpower. Jin Lin said that in addition to building hardware hospitals and other facilities, hundreds of millions of funds should be used to develop diversified services for the mentally handicapped and pay attention to support in the lives of patients.

Jin Lin believes that the government needs to strengthen policies in three areas, one is community multi-service, the second is to support family group services, and the third is to establish a help system.

She mentioned that the traditional fixed-point service is the social worker's home visit. There is also a need for a lot of "home-based services". Many patients need to be relieved of life pressure and dilemma. They lack simple home-accompanying services such as doing housework, going out shopping, etc., so as to meet the living needs of patients as much as possible.

In addition, there is no service for the family members of the mentally handicapped from all walks of life in the country. For decades, the Xiangxin Life Association has launched a dedicated line service for family members. Every year, the source of government subsidies cannot be found. "Millions of families rely on each other in private, struggling for more than a decade without knowing there are resources such as New Life, Friends of Recovery, or Eden."

Finally, the most important thing is to establish a substantial help system for patients. Jin Lin described the mentally handicapped like a person who fell into the sea. To allow him to float to the surface to breathe, this is drug treatment, but he still can't go back to the shore directly. He needs someone or tools to help him get back to the shore. , This is the long-term support of the society in their psychology, emotions and life, so that patients can live and work in peace and contentment, and the public can also live and work in peace and contentment.

Liao Fuyuan mentioned that the more isolated people with mental disabilities are from society, the more serious their condition will be. He gave an example of a patient he served who lived in a nursing home for 8 years. Even though he took regular medication, his unrealistic delusional symptoms became more and more serious every year, and he couldn't even go to the grocery store dozens of steps away. "The mentally handicapped need to return to the level of treatment, taking into account the physical, psychological and social aspects. Isolation in a medical institution makes it impossible for them to check reality."

Liao Fuyuan shared: "Sometimes a patient will say that I speak ill of him, I will discuss it with him, provide support in life, fully intervene in real life, and gradually let him know that it is an auditory hallucination before helping him to improve. "

In the end, the host Guan Zhongxiang said, "The government can't solve the problem, it will solve the people who create the problem; but the machine that creates the problem is still creating 'the people who create the problem'." Address the root cause of the problem that creates more people with disabilities.

The militia groups concerned with the mentally handicapped patients all believe that the government should not solve the problem from the end, but should make up the social safety net from the front.

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