精神障碍患者社区强制医疗制度评析

Analysis of Community Compulsory Medical Treatment System for Patients With Mental Disorder

目的了解国外精神卫生法中关于社区强制医疗的规定,以期对我国精神障碍患者的社区治疗和康复管理有所启示。方法采用文献阅读法,梳理美国、英国及日本精神卫生法中关于社区强制医疗的内容。结果美国纽约州《肯德拉法(Kendra's Law)》提出协助门诊治疗(AOT)概念;英国提出监督社区治疗(SCT),在最新修订的精神卫生法(Mental Health Act 2007)中又引入了社区治疗令(CTOs);日本并未真正全面采取社区强制医疗。结论美国采取协助门诊治疗,由法院依程序以命令的方式,指导精神障碍患者必须接受治疗和服药,以避免受到不当对待;英国的社区强制医疗则是针对出院后的精神障碍患者不愿意接受后续治疗时,所采取的强制行为;日本虽未真正全面采取社区强制医疗,但强调住院治疗形态多元化。

Objective To investigate the stipulations about community compulsory medical treatment in foreign mental health acts,in order to provide enlightenments for the community treatment and rehabilitation of patients with mental disorder in China. Methods Using literature reading method, we made a review of the content about community compulsory medical treatment in the mental health acts in the US,Britain and Japan. Results NY Kendra＇s Law proposed the concept of Assisted Outpatient Treatment（ AOT）;the British came up with the idea of Supervised Community Treatment（ SCT）,and in the latest version of Mental Health Act 2007,Community Treatment Orders（ CTOs）were introduced. Japan has not comprehensively put community compulsory treatment into action. Conclusion Given by the court＇s order in due process,AOT in the United States guide people with mental illness who must be treated with medication to avoid mistreatment. British compulsory community treatment is mandatory acts against mental illness people when they are unwilling to accept post - discharge follow - up treatment. Japan has not taken a comprehensive community compulsory treatment,but the diverse forms of hospital treatment is its shining point.