《精神卫生法》为“被精神病”立规矩

2012年10月26日上午,《中华人民共和国精神卫生法》结束了27年的立法长跑,终获第十一届全国人大常委会第二十九次会议通过。该法自2013年5月1日起施行。     

《精神卫生法》对“被精神病”现象规制之评析

摘要在防止“被精神病”问题上，新出台的《精神卫生法》围绕“送、诊、治”三个环节及再次诊断和鉴定等程序作了较为详尽的规定，但仍存在一些不足。通过对其深入剖析，提出进一步完善强制送治制度、诊断制度、强制住院治疗制度及出院制度的建议。     

论《精神卫生法》的自愿原则

为了防止正常人"被精神病",更好地保护精神障碍患者的合法权益,《精神卫生法》确立了自愿原则。该原则渊源于私法领域的自愿原则而又与其不同,是在知情的条件下对精神卫生服务的单方接受自愿。它回应了要像人一样保护精神障碍患者,彰显了精神卫生法的福利法本质。它包涵自愿诊断、自愿治疗和自愿出院三个既相互区别又相互联系子原则。非自愿诊断、非自愿治疗、非自愿继续住院治疗只是自愿原则的补充,此种例外旨在寻求患者精神健康权与社会公众安全保护的平衡。     

用《精神卫生法》告别“精神病冤案”

我国70％的重度精神病患者得不到治疗。专家认为，地方法规及现行法律设计存在缺陷，无精神卫生方面的立法规范，长期经费投入不足等，都是精神病收治乱局存在的原因。     

英国精神卫生法修订评介

本文简要介绍了英国精神卫生法修订背景和主要内容,分析了该次修订的特点,即重视病人个体权利及其差异,强调病人的自主权,特别重视通过精神卫生法庭的设立等制度设计干涉和监控医务人员的精神疾病诊断和治疗权这一最基本的职业权利, 注重平衡为保护病人健康和公众安全而必须的医务人员的强制治疗权和属于病人人身自由等基本人权的病人自主权,并指出了产生这些特点的原因.     

英国精神卫生法修订评介

本文简要介绍了英国精神卫生法修订背景和主要内容 ,分析了该次修订的特点 ,即重视病人个体权利及其差异 ,强调病人的自主权 ,特别重视通过精神卫生法庭的设立等制度设计干涉和监控医务人员的精神疾病诊断和治疗权这一最基本的职业权利 ,注重平衡为保护病人健康和公众安全而必须的医务人员的强制治疗权和属于病人人身自由等基本人权的病人自主权 ,并指出了产生这些特点的原因。     

《精神卫生法》能否保障正常人的权益

历时26年,数易其稿的《精神卫生法（草案）》日前公开征求意见,该草案对精神疾患从诊断到治疗以及出院等多方面作出详尽规定,以确保患者权益,防止出现＂被精神病＂。（《新京报》6月11日）     

精神卫生法中司法鉴定的若干问题——评《精神卫生法（草案）》有关司法鉴定的规定

《精神卫生法（草案）》征求意见是我国卫生法治的一大进步，其有关精神障碍司法鉴定的内容还存在与鉴定规律、证据制度、诉讼制度相矛盾、冲突的地方，需要在立法中进一步完善与调整，保障其与现有的司法鉴定制度相衔接。     

精神卫生立法中鉴定条款的改进及相关问题研究——以《精神卫生法(草案)》为基础

以国务院最近公布的《精神卫生法(草案)》中与鉴定有关的条款为基础,结合司法鉴定学理论与实践,针对术语选用、基础理论与制度设计等问题展开评述与分析,最后提出个人建议.     

精神卫生法“踱步”27年始出台

“终于通过了!”10月26日，十一届全国人大常委会第二十九次会议表决通过了《中华人民共和国精神卫生法（草案）》。不少网友在得知这一？肖息后不约而同地发出了这样一声感叹。     

Detention under the Mental Health Act: balancing rights,risks and needs for services

Mental health law has to balance considerations of both justice, and health and welfare. In the political climate of the 1990s mental health services have become targeted on those with serious mental illness, to address the objectives of containing risks and limiting service expenditure. This paper identifies that increasing rates of detention under the Mental Health Act through the 1990s in a particular region, disproportionately involve longer-term detentions (under section 3), men, and people with serious mental illnesses. Those detained are likely to experience social difficulties. Changes in legislation are imminent, and the paper concludes that thought should be given to the amount of statutory intervention in the lives of seriously mentally ill people, and to the principle of reciprocity in relation to those coerced for lesser periods. Services should seek to address the issues of social exclusion which are reflected in the circumstances of those detained.     

Reforming the Mental Health Act 1983: an approved social worker perspective

The government green paper, 'Reform of the Mental Health Act 1983', was published in November 1999, for consultation by end of March 2000. This article offers comment on the operation of the Mental Health Act 1983 and the proposals for change, from an approved social worker perspective. Under the Mental Health Act 1983, approved social workers undertake social assessments of mental health crises, deciding upon the need for compulsory admission and treatment. To the debate on legislative change they bring a detailed social perspective on the processes and outcomes of statutory mental health intervention. Approved social workers' main concerns relate to the social context of mental health need, the availability of social resources, civil liberties, protections for people subject to statutory mental health interventions and the effective regulation of practice and services. Current proposals include options that would significantly reduce approved social worker involvement in decisions about compulsory admission and treatment; the implications of this are discussed.     

Implementing the Mental Health Act 2007 in British general practice: Lessons from Ireland

Changes in mental health legislation (e.g. Mental Health Act 2007 in England and Wales, Mental Health Act 2001 in Ireland) have generally improved adherence to international human rights standards, but also present challenges to primary care providers. When mental health legislation was substantially reformed in Ireland, 62.9% of general practitioners (GPs) felt the new legislation was not user-friendly. Majorities of GPs who felt the legislation affected their practice reported increased workloads (85%) and various other difficulties (53%). GPs who had received training about the legislation were more likely to find it user-friendly (43% versus 30.9%), and informal training (e.g. from colleagues) was just as likely as formal training to be associated with a GP finding it user-friendly. With similar changes to mental health legislation being introduced in England and Wales, it is significant that informal training is just as good as formal training in helping GPs work with new mental health legislation.     

Regional psychiatric boards in Israel: expectations and realities

As laid down by Israeli legislation, the Regional Psychiatric Board constitutes one of the chief instruments in the monitoring of compulsory hospitalization, of compulsory outpatient treatment and of the quality of all inpatient care of the mentally ill. This article presents the findings of a study into the working of these boards. Taking a sample of every second application (N=168) over a 6-month period to one of Israel's six existing Regional Psychiatric Boards, an examination was made of the decisions issued by the board and of other aspects of its functioning. Explanations for the findings of this analysis are suggested, and generalizing from these findings, recommendations are offered for the improvement of the future functioning of all six Boards.     

Planning for incapacity by people with bipolar disorder under the Mental Capacity Act 2005

The Mental Capacity Act 2005 provides a variety of legal mechanisms for people to plan for periods of incapacity for decisions relating to personal care, medical treatment, and financial matters. Little research has however been done to determine the degree to which these are actually implemented, and the approach to such advance planning by service users and professionals. This paper looks at the use of advance planning by people with bipolar disorder, using qualitative and quantitative surveys both of people with bipolar disorder and psychiatrists. The study finds that the mechanisms are under-used in this group, despite official policy in support of them, largely because of a lack of knowledge about them among service users, and there is considerable confusion among service users and professionals alike as to how the mechanisms operate. Recording is at best inconsistent, raising questions as to whether the mechanisms will be followed.     

The Law and Incapacity Determinations: A Conflict of Governance?

This article will consider the highly charged questions raised by two major sets of law reforms in England and Wales, the Mental Capacity Act 2005 and the Mental Health Act 2007, which, although applying to closely related clinical populations, proceeded along entirely separate legislative paths. By justifying its proposals for reform of mental health legislation on the grounds of 'risk', the Government failed to take into account the implications of enforced treatment on patients who may retain decision-making capacity.     

41例具有危害行为的精神发育迟滞者司法精神病鉴定分析

目的　探讨精神发育迟滞者发生危害行为的相关因素。　方法　对 1992至 2 0 0 1年司法精神病鉴定为精神发育迟滞的危害行为人 41例进行分析。　结果　精神发育迟滞者发生危害行为的以盗窃占首位 ,凶杀、纵火次之 ,多见于家庭监护能力差、明显受社会歧视的 30岁以下的未婚青年男性。　结论　精神发育迟滞者引起违法行为是社会不安定的因素之一 ,应尽快建立健全相关的法律法规 ,确实加强监护、管理。     

Youth Mental Health First-Aid: Juvenile Justice Staff Training to Assist Youth with Mental Health Concerns

Many youth in juvenile justice settings meet criteria for a mental health condition. Front line staff need to be able to recognize and respond to their needs, but training is often lacking. Youth Mental Health First Aid (YMHFA) is an 8-hour training for adults without mental health education to recognize and assist distressed youth. This study surveyed 1,279 [State blinded] DJS front-line staff trained in YMHFA. Of 338 returned surveys (26% response), 44% reported using YMHFA skills at work, 56% in preventing a crisis, 25% during crises. Respondents rated YMHFA as significantly improving their responsiveness to distressed young people.     

Mental Capacity Act,Anorexia Nervosa and the Choice Between Life‐Prolonging Treatment and Palliative Care: A NHS Foundation Trust v Ms X

The Court of Protection decided in A NHS Foundation Trust v Ms X that an anorexia nervosa patient lacked the capacity to refuse treatment for her eating disorder, but that it was not in her best‐interests to be subject to force‐feeding to prolong her life. The Court, vindicating previous judgments in similar cases, considered that the eating disorder rendered the patient incapable of deciding on nutrition and, therefore, that she lacked the capacity to refuse treatment for anorexia nervosa. This paper questions the narrow way in which the patient's decision was characterised by the Court in this and previous cases, which led to an application of the Mental Capacity Act 2005 that is incompatible with the UN Convention on the Rights of Persons with Disabilities because, based on a diagnosis only, anorexia nervosa patients were denied the right to decide where the balance lies between quality and duration of their own lives.