Late last month, a man assaulted a clerk at a convenience store in Pingtung County, trying to gouge her eyes out when she reminded him that he had to wear a mask inside the store.
This shocking incident caused an uproar. Although the offender had undergone long-term treatment at a psychiatric hospital, he often returned to his community, where the tragic incident occurred.
What went wrong? Let us look at it from a legal and a practical perspective.
Although Taiwan is not a UN member, human rights are universal, and Taiwan has for years followed the spirit of the UN Convention on the Rights of Persons with Disabilities to protect their freedom and safety.
The convention says: “States Parties shall ensure that persons with disabilities … [a]re not deprived of their liberty unlawfully or arbitrarily, and that any deprivation of liberty is in conformity with the law, and that the existence of a disability shall in no case justify a deprivation of liberty.”
Article 41 of the Mental Health Act (精神衛生法) states: “Regarding severe patients harming others or themselves or having the danger of harm, who have been diagnosed by specialist physicians such that it is necessary for them to be hospitalized full day, their protectors shall assist the severe patients to go to psychiatric institutions for going through hospitalization formalities. When the severe patients refuse to accept full day hospitalization, the competent authorities may designate psychiatric institutions to enforce emergency placement and assign them to more than two specialist physicians designated by the competent authorities for mandatory examination.”
It also states: “When there is still necessity of full day hospitalization, and when asked for their opinions the severe patients still refuse to accept hospitalization or are unable to express their decisions, the designated psychiatric institutions shall file application to the Community Treatment Review Committee for its permission of mandatory hospitalization.”
This shows that the strict hospitalization process is to protect the freedom of the disabled person. Does such a process truly safeguard their human rights, or does it delay the best timing for treatment? This issue is open to dispute.
Moreover, Article 38 states: “When patients are in stable conditions or recover and continuous hospitalization is no longer needed, psychiatric institutions shall notify the patients or their protectors for going through discharge formalities, and shall not detain the patients without reasons.”
In practice, people diagnosed with schizophrenia lack insight into their illness, as they are either unaware or unwilling to admit that they are ill. When they return to their community after receiving treatment at a mental hospital, they might stop taking medicine or suspend treatment for fear of the medication’s side effects.
If this happens, it can worsen their illness, and they might no longer distinguish between optical and auditory hallucinations, or other delusions. This makes it difficult for them to make the right judgements. They might even become violent or harm themselves.
Faced with these people refusing to receive treatment or take medication regularly, the authorities, as well as the legislature, should promptly implement rules and set up a mechanism for mandatory treatment.
Legislation should also be passed mandating that patients be given long-acting injections once a month to control their illness. This would not only protect their right to medical treatment and avoid stigmatization, it would also ensure social safety.
Yeh Yu-cheng is a secretary at the Pingtung Public Health Bureau.
Translated by Eddy Chang
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