疑似嚴重精神病患住院過程之探討

Hospitalizing the Suspected Severely Mental Ill Patients

張珏(Chueh Chang) ； 許蓉雰(Jung Feng Hsu)

《中華公共衛生雜誌》 14卷5期 (1995/10) Pp. 438-445

https://doi.org/10.6288/CJPH1995-14-05-07

摘要

本研究希望瞭解社區中精神病患家屬與相關人員（包括衛生所護士、警察以及村里幹事）在護送疑似嚴重精神病患就醫的過程中所遇到的困難，藉此明瞭社區實際的運作情形，以提供未來修法的參考。
病患家屬資料以地段護士親自面談訪視而得，共完成175份，完訪率93%；三類相關人員則以郵寄方式，自行填答後寄回，回收結果為：衛生所護士194份(89%)、警察104份、村里幹事180份(32%)。
整體來看，護送過程出現的問題可從三方面來看，（一）行政方面：精神衛生法目前尚無有關實務細則的提出，並未詳細規定強制護送的程序，使得護送者不清楚本身應該扮演何種角色，法令規定的權責不祥，再加上相關人員隸屬不同單位，彼此間的協調聯擊更加不易；（二）個人互動方面：「病人抗拒厲害」是家屬與相關人員頭痛的問題。護送成員彼此的合作度也是護送過程常被抱怨的；（三）醫院方面：「一床難求」是最常出現的問題。
本研究結果，反應出精神衛生法自公佈至今宣導上不足，對保護人的權責也不清，由誰擔任也不明，強制護送鑑定過程的困擾與強制住院條件，皆有持釐清。因此，建請有關單位加強宣導有關精神衛生法強制護送鑑定與住院治療的知識，以及建立完善的強制護送鑑定與住院治療的體系，協助各相關單位達成共識，並成立研究機構，專文出版精神衛生法相關實務或實施手冊。

關鍵字

精神衛生法 ； 嚴重精神病人 ； 強制護送

並列摘要

This study is intended to understand the difficulties in process of hospitalizing the disturbed psychiatric patients in the community.
175 family members of psychiatric patients, 194 public health nurses, 104 police officers, and 180 neighborhood workers have been interviewed and answered by them either through one-to-one interview or through mailing questionnaires.
The problems during the hospitalizing process included: (1) administrative perspective: the Mental Health Act did not clearly indicate how personnel involved would coordinate during the compulsory escorting process; (2) Interactive perspective: ”the resistence of the patients” was the tough issue of the related persons. In addition, ”how to cooperate with other related workers” was also a problem; (3) Hospital perspective: ”difficult to get a bed for admission into the hospital” was complained by the relatd persons..
Based on these results, the needs of better publicity for the Mental Health Act, the obligations of the guardians, the conditions of compulsory hospital admission, etc. are discussed and recommendations are made for revision of the Mental Health Act in the future.

並列關鍵字

Mental Health Act ； Mental ill patients ； Hospitalization