A History of Mental Health Laws in Taiwan

台灣精神衛生法修正版的演繹

徐瑋澤(Wei-Tse Hsu)；吳慧菁(Hui-Ching Wu)；周煌智(Frank Huang-Chih Chou)

Mental Health Act (MHA) ； severely mental illness (SMI) ； compulsory treatment ； Psychiatric Illness Mandatory Appraisal and Community Treatment Review Panel (PIMACTRP) ； 精神衛生法 ； 嚴重病人 ； 強制治療 ； 嚴重病人強制鑑定及強制社區治療審查會

台灣精神醫學

31卷3期（2017 / 09 / 01）

195 - 203+ii

英文

Taiwan Mental Health Act with 52 articles was established in 1990. Based on the first edition of Mental Health Act (MHA), it was intended to balance between the patients’ rights and the society’s harmony. Following a few minor modifications and a substantial revision in 2007, the revised version of the MHA was formally enacted on July 4, 2008. This MHA Amendment includes 7 chapters and 63 articles. Its aims are (A) to protect and prohibit discrimination against psychiatric patients; (B) to help patients and their families with recovery, as well as to help mental health providers and goverment in research and treatment decisions. (C) to ensure that the final decision on the compulsory admission of severe mental illness (SMI) patients should be approved by the Psychiatric Disease Mandatory Assessment and Community Care Review Committee (PDMACCRC); (D) to encourage patients to return and stay in the community; and (E) to enhance preventive psychiatric medicine for mental health promotion. One of the most important articles is procedure changes of compulsory treatment. Basically, it is to protect psychotic patients’ rights and to encourage patients to return to community. After the 2007 MHA Amendment of Taiwan, patient with SMI who is dangerous to self or others and if he/she should receive compulsory psychiatric treatment which should be reviewed by the Psychiatric Illness Mandatory Appraisal and Community Treatment Review Panel (PIMACTRP), in addition to evaluation by two designed licensed psychiatrists. Otherwise, mandatory community treatment was established in this MHA Amendment. The alternative treatment offers another compulsory treatment with lower limitation for patient’s freedom.

台灣在1990 年建立52 條的精神衛生法，第一版的精神是在尋求病人的權利與社會和諧。經過了幾次小修法，在2007 年大幅翻修，而於2008 年七月四日實施的修正法案，共有七章63 條。基本的重點有：(A) 保護及禁止歧視病人；(B) 協助病人與家屬復原並且協助精神衛生提供者及官方進行研究與治療決策；(C) 要嚴重病人強制住院，必須讓強制鑑定及強制社區治療審查會（審查會）做決定；(D) 鼓勵病人回歸與住在社區；以及 (E) 提升預防精神醫學做精神健康促進。這些重要條文的其中一項是強制治療，基本上該法是保護病人權利，並且鼓勵病人回歸社區，在2007 年版的法案中，不願意住院，但具有傷害行為或之虞的嚴重病人，除了由兩位指定精神科專科醫師鑑定外，另外需要由審查會審查同意後方能強制住院。另外，強制社區治療也同時在修正法案立法，這是提供限制病人自由較少的另一種強制治療方法。

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