On October 26th, 212, the 29th session of the 11th National People's Congress passed the Mental Health Law of the People's Republic of China (hereinafter referred to as the Mental Health Law). Starting from safeguarding the legitimate rights and interests of patients with mental disorders, this law implements the concept of human rights guaranteed by the Constitution, tries to protect and balance the legitimate rights and interests of the public and patients with mental disorders, and maximizes the interests of all parties, highlighting the advanced concept of humanistic medical care.
Protecting the legitimate rights and interests of patients with mental disorders and safeguarding their personal dignity
Protecting the legitimate rights and interests of patients with mental disorders is the primary goal of the Mental Health Law. Incidents of illegal possession, deprivation and transfer of patients' property by close relatives of patients with mental disorders are common, and the property rights of patients with mental disorders are violated; Patients with mental disorders are discriminated against in the process of further education and employment, and the rights to education and labor are infringed everywhere; It is not uncommon that the conditions of psychiatric institutions are poor, medical staff do not respect patients, and the personal dignity of patients with mental disorders is violated. In view of these problems, the Mental Health Law clearly stipulates that the personal dignity, personal safety and property safety of patients with mental disorders are inviolable, and strives to protect the legitimate rights and interests of patients with mental disorders from the following two aspects:
On the one hand, it increases the investment in mental health undertakings and guarantees the right of patients with mental disorders to receive medical treatment. According to relevant reports, there are about 16 million patients with severe mental disorders in China, but there are only 1,468 mental health medical institutions and 2, psychiatrists in China, which is difficult to meet the medical needs of patients with mental disorders. In view of this, the Mental Health Law strengthens the capacity building of prevention, treatment and rehabilitation services for mental disorders from three aspects: human, financial and material. The law clearly stipulates that comprehensive medical institutions should set up psychiatric clinics or psychotherapy clinics in accordance with the regulations of the health administrative department of the State Council, so as to improve the ability of prevention, diagnosis and treatment of mental disorders. The medical expenses of patients with mental disorders shall be paid by the basic medical insurance fund in accordance with the provisions of the state on social insurance. For patients with mental disorders who still have difficulties in paying medical expenses through basic medical insurance, or cannot pay medical expenses through basic medical insurance, the civil affairs department shall give priority to medical assistance. These measures guarantee the right of patients with mental disorders to receive timely and effective treatment.
On the other hand, provide special protection and respect the personal dignity of patients with mental disorders. The Mental Health Law clearly implements the principle of voluntariness in hospitalization for mental disorders, fully respects patients' opinions, strictly limits the conditions and procedures for involuntary hospitalization, limits the qualification of judging subjects, and sets clear judgment standards. During hospitalization, medical institutions and their medical staff should respect patients' rights of communication and meeting visitors. Except in the period of acute onset or in order to avoid obstructing the treatment, the patient's rights of communication and meeting visitors shall not be restricted. In view of the weak position of patients with mental disorders in society, the Mental Health Law gives them certain special protection, stipulating that no organization or individual may discriminate against, insult or abuse patients with mental disorders, or illegally restrict their personal freedom.
define the criteria for compulsory hospitalization, protect the public interests and maintain social security
While protecting the interests of patients with mental disorders, the Mental Health Law also takes protecting the public interests from the infringement of patients with mental disorders as one of its important goals. Although hospitalization for mental disorders is voluntary, there are exceptions in principle. The diagnosis conclusion and condition evaluation show that the patient is a patient with severe mental disorder and has already done harm to himself or is in danger of doing harm to himself; Or if there have been acts that endanger the safety of others, or if there is a danger of endangering the safety of others, they should be hospitalized. This clause defines the implementation conditions of compulsory hospitalization. This is of obvious significance for safeguarding the interests of the public and maintaining social security.
Living in society, patients with severe mental disorders will inevitably infringe on their own and others' safety, especially others' personal safety. Statistics show that the risk of violence in schizophrenic patients is 4~7 times higher than that in normal people. In 211, a young mother with a history of intermittent mental illness in Guangzhou suddenly had epilepsy and hacked her two-year-old daughter to death, which caused a tragedy. This is just one of many tragedies.
Due to the limitation of their physical conditions, patients with mental disorders often have deviations in their cognition of themselves and the outside world, lack a clear understanding of their actions and consequences, and some patients with mental disorders lack control over their actions. These factors have led to mental disorders, especially those with violent tendencies, which are very easy to cause harm to people around them. Moreover, most of these injuries are emergencies, and it is impossible to prevent them. This kind of safety hazard is also easy to cause public panic. It can be seen that in order to effectively reduce the infringement of mental disorder patients on the interests of the third party and the public, and avoid the occurrence of similar tragedies mentioned above, under the principle of voluntary hospitalization, it is a realistic need to safeguard the interests of the public and has become the same choice of mental health laws in various countries.
The procedure of twice diagnosis and appraisal is strictly guaranteed, so as to avoid the abuse of compulsory admission procedure.
It is expected that the Mental Health Law will play an important role in preventing normal people from being forcibly admitted to psychiatric institutions for some reason, and the law makers have also made efforts in this regard. Normal people are frequently "mentally ill", and some people are retaliated just because of family property disputes, personnel disputes and other personal grievances, or because of petitions and other acts, and are forced to be sent to psychiatric institutions for treatment, and their personal freedom is restricted in disguise. The experiences of Xu, a farmer, Guo, a nurse, Chen Mou, a businessman and many "mentally ill people" make the public eagerly hope that the Mental Health Law can play a role in putting an end to this phenomenon. On the one hand, this is due to the public's sympathy for those who suffer from "mental illness", on the other hand, it is also due to concerns about their own safety. In a society with diversified interests, disputes are inevitable. If the compulsory admission procedure for patients with mental disorders becomes a means to blame and retaliate at will, it will make everyone face the danger of being restricted freedom and deprived of some rights for no reason. Therefore, there is an urgent need for the public to prevent the phenomenon of being mentally ill.
It is gratifying that the Mental Health Law has made a certain breakthrough in this respect, stipulating a number of measures to prevent the abuse of the compulsory admission procedure.
First, the principle of voluntary hospitalization is the fundamental guarantee to prevent the abuse of compulsory admission procedures. The principle of voluntary hospitalization fully respects the opinions of patients with mental disorders, endows patients with mental disorders with the freedom of voluntary hospitalization and voluntary discharge, and takes patients' requirements and feelings as the ultimate goal, excluding the final decision of the third party under normal circumstances.
Second, the two-time appraisal system is a procedural guarantee to prevent the abuse of the compulsory admission procedure. According to the Mental Health Law, patients with mental disorders and their guardians have objections to the diagnosis conclusion that they need hospitalization. If they disagree with hospitalization, they may ask for a second diagnosis and appraisal. If there is any objection to the conclusion of re-diagnosis, you can independently entrust an appraisal institution that has obtained professional qualifications according to law to conduct medical appraisal of mental disorders; Medical institutions shall publicize the list and contact information of the announced appraisal institutions. The entrusted appraisal institution shall designate two or more appraisers with the qualification of the appraisal matters to conduct the appraisal together, and issue the appraisal report in time. The two-time appraisal system in this rule ensures the accuracy of medical appraisal, allows patients and their guardians to entrust medical institutions for appraisal by themselves, and prevents the subjectivity and one-sidedness of appraisal by specific institutions.
Third, it is clear that the accountability mechanism provides effective relief for preventing the abuse of compulsory admission procedures. Chapter VI of the Mental Health Law clarifies the administrative and civil liabilities for abusing the compulsory admission procedure, so that victims can obtain effective legal relief and safeguard their legitimate rights and interests.
the art of balance: to maximize the protection of overall interests
Like other laws, the Mental Health Law is a law with the ultimate goal of protecting rights, and the subjects of rights it protects involve patients with mental disorders and the public. On the one hand, it is necessary to protect the legitimate rights and interests of patients with mental disorders and prevent the abuse of compulsory admission procedures in accordance with the principle of voluntary admission; On the other hand, public safety must be considered to prevent patients with severe mental disorders from causing unnecessary harm to others. It is not easy to give consideration to the interests of all parties and seek to maximize the overall interests without excessively infringing on individual interests. This requires that under the premise of strictly enforcing the law, in the specific technical operation process, we should treat each individual with humanistic spirit and balance the interests of all parties in individual cases, so as to realize the dynamic balance of the interests of all parties in general. This is the public's expectation of the Mental Health Law, and it is also the mission of mental health workers and legal workers.