The Mental Health Law Will Stipulate That The Person Responsible For "Mental Illness" Should Be Investigated For Criminal Responsibility

The 23rd meeting of the Standing Committee of the 11th National People's Congress began to consider the draft mental health law for the first time yesterday. The draft stipulates the three links of referral, diagnosis and treatment, as well as the re diagnosis, identification, supervision and evaluation of mental disorders. The draft stipulates that the principle of voluntariness shall be applied to the hospitalization of patients with mental disorders. Those who intentionally send patients with non mental disorders to medical institutions as patients with mental disorders, which constitutes a crime, will be prosecuted for criminal responsibility.

Compared with the previous draft for comment, the conditions for the application of involuntary hospitalization medical measures have changed significantly, and the controversial "disturbing public order" clause has been deleted.

Entrusted by the State Council, Chen Zhu, Minister of Health, said when explaining the draft mental health law to the Standing Committee of the National People's Congress, mental health is not only a major global public health problem, but also a relatively serious social problem. The seriousness of mental health problems is very prominent in China. Mental illness ranks first in the total burden of disease in China, accounting for about 20% of the total burden of disease. There are about 16 million patients with serious mental disorders. Chen Zhu pointed out that at present, China's compulsory admission of patients with mental disorders is lack of procedures, and cases of compulsory admission in individual places have aroused strong doubts of patients and their relatives, and "being mentally ill" has become a hot topic of public opinion from time to time. In order to put an end to the occurrence of "mental illness", the draft sets strict legal responsibilities for the related acts.

The draft proposes that in any of the following circumstances, a person shall bear civil liability according to law, and if a crime is constituted, his criminal liability shall be investigated according to law: a person who carries out a medical examination against his own will to determine whether he is suffering from mental disorder; Deliberately sending a non mentally disabled person to a medical institution as a mentally disabled person; Illegally restricting patients with mental disorders from leaving medical institutions.

In addition to bearing civil and criminal liabilities according to law, the staff members of administrative organs shall also be given sanctions according to law; If any staff member of an administrative organ has any of the circumstances listed in the preceding paragraph and is in violation of the law in exercising his functions and powers, the administrative organ to which he belongs and himself shall be liable for compensation in accordance with the provisions of the State Compensation Law.

In addition, the draft also proposes that the judicial administration department of the people's government at the provincial level shall cancel the registration if the judicial expert for mental disorders intentionally issues false expert opinions for mental disorders; If a crime is constituted, criminal responsibility shall be investigated according to law. While protecting the personal rights of patients with mental disorders, the draft also makes relevant provisions on the low level of rescue and relief in China's current mental health work, and proposes legislation to strengthen the prevention, rehabilitation and relief of mental disorders.

Interpretation of the draft

focus

1 Who is qualified to send patients with mental disorders to hospital?

Different patients have different medical subjects

According to the draft, in addition to individuals who go to medical institutions for mental disorder diagnosis, the close relatives of suspected patients can send them to medical institutions for diagnosis; The local administrative department concerned shall, according to the division of duties, help to send the vagrant and beggar patients with suspected mental disorder who cannot find their close relatives to medical institutions for diagnosis.

If a suspected mental disorder patient has an act of harming himself or another person's safety, or is in danger of harming himself or another person's safety, his close relatives, his unit, and the local public security organ shall take measures to stop him and immediately send him to a medical institution for diagnosis.

focus

How to diagnose mental disorder?

Written diagnosis conclusion shall be made within 72 hours

Who has the right to diagnose patients with mental disorders and suspected patients? The draft clarifies the subject of implementation: the diagnosis of mental disorders should be made by licensed psychiatrists.

As for the diagnosis procedure, the draft also clearly stipulates that the medical institution shall not refuse to make a diagnosis for the suspected patient who has been sent for diagnosis, and shall immediately appoint more than 2 psychiatrists to make a written diagnosis conclusion within 72 hours; The diagnosis of mental disorder shall be based on the state of mental health. Unless otherwise provided by law, they shall not conduct medical examination against their own will to determine whether they are suffering from mental disorder.

focus

3 Under what circumstances can compulsory admission be made?

There are two cases of involuntary hospitalization

In June this year, when the draft was first published by the Legislative Affairs Office of the State Council and solicited opinions from the public, it stipulated the conditions for the application of involuntary hospitalization medical measures, that is, only patients with mental disorders could not recognize or control their own behavior, and there was a danger of harming themselves, endangering public safety or the personal safety of others, and disturbing public order, Only then can they be involuntary hospitalized.

Among them, the provision of "disturbing public order" has been widely discussed, and some experts believe that the provision is in danger of being abused.

This draft submitted to the Standing Committee of the National People's Congress for deliberation has been revised to state that: if the diagnosis conclusion and disease assessment indicate that the patient is a patient with serious mental disorder and has the following two situations, he/she should be hospitalized: first, the patient has committed acts that hurt himself/herself, or is in danger of hurting himself/herself, or not being hospitalized is not conducive to his/her treatment; Second, the patient has committed acts endangering the safety of others or is in danger of endangering the safety of others.

The draft stipulates that in the first case, medical institutions can implement hospitalization for patients with the consent of close relatives who are responsible for guardianship; If the close relatives who are responsible for guardianship disagree, the medical institution may not conduct hospitalization. In the second case, if the patient or his close relatives who have the duty of guardianship do not agree to the hospitalization of the patient, but still need to be hospitalized after further consultation and appraisal, the close relatives who have the duty of guardianship shall agree to the hospitalization of the patient; If a close relative who is responsible for guardianship does not agree to be hospitalized, or a patient with mental disorder leaves the hospital without authorization, the public security organ may assist the medical institution in taking compulsory measures to implement the measures.

focus

How to guarantee personal freedom?

Specify two kinds of follow-up

Twice identification system

The admission of patients with mental disorders involves personal freedom. In order to prevent the phenomenon of "being mentally ill", the draft law on mental health stipulates two systems of return visits and double identification for mental disorders.

The draft distinguishes between different involuntary inpatient treatment situations and stipulates two kinds of return visit systems: if a patient needs involuntary inpatient treatment due to his own injury or other circumstances, the patient who does not agree to receive inpatient treatment can request the medical institution to conduct a return visit within three days from the date of receiving the diagnosis conclusion, A medical institution shall assign 2 psychiatrists who are not the first doctors to have a further consultation and make a conclusion within 5 days.

If the patient needs involuntary hospitalization because of the situation that endangers the safety of others, the patient who does not agree to the hospitalization or the close relatives who have the responsibility of guardianship may, within 3 days from the date of receiving the diagnosis conclusion, choose other qualified medical institutions in the provincial administrative region where they are located to carry out a further diagnosis, and make a conclusion within 5 days.

In addition to the two systems of reexamination, the draft also stipulates two systems of identification: those who disagree with the conclusion of reexamination and require identification shall independently entrust a judicial identification institution for mental disorders that has obtained professional qualifications according to law to conduct identification; If there is any objection to the expert opinion, the judicial authentication institution may be required to designate more than three other judicial authenticators for re authentication.

　 Mental Disease Diagnosis and Judicial Embarrassment

Suggestions of the National People's Congress

The Education, Science, Culture and Health Committee of the National People's Congress said that the draft introduced the judicial expertise system to ensure that citizens' legitimate rights and interests would not be infringed due to the abuse of involuntary hospitalization treatment measures. However, during the survey, it was learned that some departments and experts had different opinions on this.

Among them, judicial expertise is a problem at the litigation level, while the diagnosis of mental illness is a problem at the technical level. The judicial appraisal institution is an independent legal person, not a judicial or administrative organ, and its expert opinions only provide evidence. According to the provisions of the draft, the judicial expertise institution makes the final judgment on whether there is a mental disorder and decides whether to be hospitalized, which is lack of rationality and authority. In legal facts, it may cause disputes or disputes on whether the diagnosis is fair or not. Therefore, it is suggested that the relevant departments of the State Council should further study the judicial expertise of mental disorders.

Full financial appropriation of funds for mental hospitals

The Education, Science, Culture and Health Committee of the National People's Congress said that it learned from the survey that the current prevention and treatment system for mental disorders in China is not perfect, and the government investment is seriously insufficient, especially the funding gap for grass-roots prevention and treatment institutions is large, and the infrastructure and equipment are poor. There is a serious shortage of mental health professionals and their treatment is generally low. "The draft has made some principled provisions on the guarantee of mental health work, but the draft provisions are very principled and difficult to implement."

In this regard, the person in charge proposed to further strengthen the construction of mental health work and prevention and control system at the grass-roots level, support the mental health prevention and control work in poverty-stricken areas and ethnic minority areas, and the local people's governments at all levels should guarantee the funds for urban communities and rural grass-roots mental disease prevention and control.

At the same time, the psychiatric hospital is the main body of the mental health service network, which undertakes the main outpatient and inpatient services, and is responsible for the technical guidance of community mental health services. Therefore, it is suggested that the personnel funds, business funds and development and construction funds of psychiatric hospitals should be determined as full financial allocation in the draft, and the contents included in the financial budget of the government at the same level should be further clarified to enhance the operability of the law.

In addition, considering the particularity of mental health work, it is suggested that the issue of improving the treatment of medical staff should be clearly stipulated in the law, such as setting up special post allowance, etc., and increase the regulations of governments at all levels on the training and investment of mental health professionals.