2013年開始我國全面對於精神疾病嚴重病人施行強制社區治療,但是現行《精神衛生法》對於強制社區治療之規範,無論是危險性預測、病人自主權保障、治療項目均有可議之處。本文先對強制社區治療制度作概略的介紹並進行比較法觀察,再研析強制社區治療相關問題,最後提出《精神衛生法》修正建議:一、嚴重病人在沒有傷害他人之虞的狀況下,不應受到國家強制力介入治療,建議強制社區治療與強制住院相連結,俾有預測危險性之基礎。二、為保障病人醫療自主權,如果病人表達拒絕接受社區治療時,必須有傷害他人之虞,才有強制治療的必要;如果病人屬於有自傷之虞且無能力作決定者,則由保護人代為同意。三、強制社區治療項目,治療與篩檢應予區分,必須是與治療相關之監測才可以強制,「強制社區治療得以不告知嚴重病人的方式為之」完全不尊重病人主體性,應予刪除。
Since 2013 this country has fully implemented mandatory community treatment for patients with severe mental illness, but there is much to be desired in danger prediction, patient's autonomy, and treatment items for mandatory community treatment of the current Mental Health Act. In this paper, we firstly introduce a brief description of mandatory community treatment system, and conduct a comparative observation, and then analyze related issues of mandatory community treatment, and finally propose the Mental Health Act amendments.