Thursday, November 29, 2012

Involuntary Commitment: Ankang Regs vs Mental Health Laws


Security monitoring inside Tianjin’s ankang hospital. Source: Tianjin Municipal Public Security Bureau Ankang Hospital

China’s new Mental Health Law, passed by the National People’s Congress Standing Committee in October and effective May 1, 2013, has been welcomed by many as a major step forward in the protection of the rights of individuals with mental illness. Of particular note are provisions requiring that patients facing involuntary commitment in psychiatric hospitals be given the opportunity for independent review of their cases and that mechanisms for appealing involuntary commitment be established.

Some remain concerned, however, about the potential for continued use of abusive psychiatric commitment against petitioners, dissidents, and others deemed to threaten China’s social or political order. This is because the new law exempts ankang hospitals from many of its provisions.

Ankang hospitals, which fall under the jurisdiction of the Ministry of Public Security, are police-run facilities intended to provide compulsory medical treatment to persons diagnosed with mental illness who have committed serious crimes but are exempted from criminal responsibility under the law. As of 2010, there were 22 ankang hospitals located in 18 Chinese provinces, and the Ministry of Public Security had lobbied for the construction of additional hospitals to meet rising needs. During their long history in China, ankang hospitals are known to have been used to treat “political maniacs” and others holding dissident views—a practice modeled on one used widely by the Soviet Union.

As a result of a new section dedicated to compulsory medical treatment that was added to the Criminal Procedure Law (CPL) in March (translated below), new restrictions will be formally imposed on police discretion to carry out involuntary psychiatric commitment. Under these provisions, which will take effect on January 1, 2013, police recommendations regarding commitment will have to go through two levels of external scrutiny: undergoing review by the procuratorate before reaching the court, which will have sole authority to make decisions on involuntary psychiatric commitment for those who have committed serious offenses but are exempt from criminal responsibility under the law.

Until now, regulation of involuntary commitment in ankang hospitals has been governed primarily by rules enacted by local government in locations where these facilities are established. As internal institutional regulations, the procedures are not clearly subject to review by procuratorates or the court. Local regulations also vary considerably in terms of their level of detail and the degree to which they protect individual rights.

Consider, for example, two sets of commitment measures from Tianjin Municipality and Xi’an, Shaanxi Province (translated below). The Tianjin regulations, enacted in 1991 and amended in 2010, are typical of rules enacted in other cities throughout China during the 1990s and lack the mechanisms of the Xi’an measures, enacted in 2011, aimed at curbing arbitrary psychiatric commitment. For example, the Xi’an measures explicitly exempt certain categories of individuals from involuntary commitment, give persons facing commitment clear rights to challenge the decisions made against them, and require ankang hospitals to carry out periodic evaluations.

Clearly, the relatively progressive Xi’an measures anticipate the more rights-protective provisions of the new CPL, which aims to limit arbitrary police authority and establish a more uniform process for involuntary psychiatric commitments carried out within the criminal justice setting. The success of these goals awaits actual enforcement. Drafts of implementation rules being considered by the Supreme People’s Court and recently passed by the Supreme People’s Procuratorate suggest a seriousness about establishing mechanisms to prevent abusive and arbitrary commitment of individuals who are healthy or who do not pose any danger to society. The Ministry of Public Security has yet to publicize its own relevant regulations, but once the revised CPL and the new public security regulations take effect, local ankang regulations will almost certainly undergo substantial updates.



Criminal Procedure Law Excerpt: click to expand

[Criminal Procedure Law Excerpt]

Chapter 4: Procedures for Compulsory Medical Treatment of Mentally Ill Persons Excluded from Criminal Liability in Accordance with the Law

     Article 284: Where a mentally ill person commits violent acts that endanger public security or seriously endanger the personal safety of citizens and has been determined through statutory procedures to be excluded from criminal liability in accordance with the law, if he or she has the potential to continue endangering society, he or she may be subject to compulsory medical treatment.

     Article 285: According to this chapter, decisions to subject a mentally ill person to compulsory medical treatment shall be made by people’s courts.
     If a public security organ discovers that a mentally ill person meets the conditions for compulsory medical treatment, it shall make a suggestion for compulsory medical treatment in writing and submit it to the people’s procuratorate. Where the people’s procuratorate finds, either at the [suggestion] of the public security organ or during the process of pre-prosecution review, that a mentally ill person meets the conditions for compulsory medical treatment, it shall submit an application for compulsory medical treatment to the people’s court. Where the people’s court finds during the hearing of a case that a defendant meets the conditions for compulsory medical treatment, it may issue a decision to impose compulsory medical treatment.
     Where a mentally ill person has committed an act of violence, the public security organ may impose temporary, protective restrictive measures [upon that person] before the people’s court [issues] a decision on compulsory medical treatment.

     Article 286: After the people’s court accepts an application for compulsory medical treatment, it shall form a collegiate bench to review [the application].
     Where a people’s court reviews a case involving compulsory medical treatment, it shall notify the legal representative for the subject of the application or the defendant to appear in court. If the subject of the application or the defendant has not engaged legal counsel, the people’s court shall notify a legal aid agency to assign a lawyer to provide legal assistance.

     Article 287: Where, in the course of its review, the people’s court [finds that] the subject of the application or the defendant meets the conditions for compulsory medical treatment, it shall issue a decision for compulsory medical treatment within one month.
     Where the person subject to a decision for compulsory medical treatment, the victim, or their [respective] legal representatives or immediate relatives do not accept the decision for compulsory medical treatment, they may apply to the people’s court at the next higher level for reconsideration.

     Article 288: Facilities for compulsory medical treatment shall periodically carry out diagnostic evaluations of persons receiving compulsory medical treatment. Where there is no longer any risk to personal safety and it is no longer necessary to continue compulsory medical treatment, a facility shall promptly recommend revocation and report to the people’s court that made the decision on compulsory medical treatment for approval.
     Persons receiving compulsory medical treatment and their immediate relatives have the right to apply for revocation of [said] treatment.

     Article 289: People’s procuratorates shall oversee decisions on and enforcement of compulsory medical treatment.


Chinese Source(原文): 
[刑事诉讼法摘选]
http://www.china.com.cn/policy/txt/2012-03/18/content_24922812_28.htm
Click on icon to expand

[刑事诉讼法摘选]

第四章 依法不负刑事责任的精神病人的强制医疗程序

        第二百八十四条 实施暴力行为,危害公共安全或者严重危害公民人身安全,经法定程序鉴定依法不负刑事责任的精神病人,有继续危害社会可能的,可以予以强制医疗。

        第二百八十五条 根据本章规定对精神病人强制医疗的,由人民法院决定。
        公安机关发现精神病人符合强制医疗条件的,应当写出强制医疗意见书,移送人民检察院。对于公安机关移送的或者在审查起诉过程中发现的精神病人符合强制医疗条件的,人民检察院应当向人民法院提出强制医疗的申请。人民法院在审理案件过程中发现被告人符合强制医疗条件的,可以作出强制医疗的决定。
        对实施暴力行为的精神病人,在人民法院决定强制医疗前,公安机关可以采取临时的保护性约束措施。

        第二百八十六条 人民法院受理强制医疗的申请后,应当组成合议庭进行审理。
        人民法院审理强制医疗案件,应当通知被申请人或者被告人的法定代理人到场。被申请人或者被告人没有委托诉讼代理人的,人民法院应当通知法律援助机构指派律师为其提供法律帮助。

        第二百八十七条 人民法院经审理,对于被申请人或者被告人符合强制医疗条件的,应当在一个月以内作出强制医疗的决定。
        被决定强制医疗的人、被害人及其法定代理人、近亲属对强制医疗决定不服的,可以向上一级人民法院申请复议。

        第二百八十八条 强制医疗机构应当定期对被强制医疗的人进行诊断评估。对于已不具有人身危险性,不需要继续强制医疗,应当及时提出解除意见,报决定强制医疗的人民法院批准。
        被强制医疗的人及其近亲属有权申请解除强制医疗。

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Tianjin Measures [1991] No. 47: click to expand

Tianjin Measures for Commitment, Treatment, and Management of Mentally Ill Persons Who Endanger Social Order

[Tianjin] People’s Government Order (1991) No. 47

(Approved by the [Tianjin] People’s Government on December 8, 1991, and amended in accordance with the Decision on Amending Certain Municipal Government Regulations passed at the 59th Standing Committee meeting of the [Tianjin] People’s Government on November 8, 2010.)

     Article 1: In order to strengthen protective custody, management, and treatment of mentally ill persons who endanger social order; to protect social order; to safeguard the lives, property, and safety of the people; and protect the lawful rights and interests of mentally ill persons; these measures are hereby enacted in accordance with the relevant national regulations and in combination with the actual circumstances in this municipality.

     Article 2: Any mentally ill person who carries out one of the following acts, whether he or she is from this city or an outsider who has come to this city, shall be compulsorily committed for treatment by the municipal public security bureau’s ankang hospital:

  1. Murder, arson, rape, setting explosions, or other acts;
  2. Serious disruption of official work order at party, government, or military organs [or] of the production or work order of enterprises;
  3. Serious disruption of public order or endangering of public safety;
  4. Other [acts] that affect social stability and cause serious consequences;
  5. Having once committed one of the aforementioned acts, again showing an obvious onset of symptoms after release [from compulsory treatment] following remission of symptoms.

     Article 3: The ankang hospital of the municipal public security bureau is the institution of the municipality dedicated to compulsory commitment for treatment of mentally ill persons who endanger social order. It has the dual functions of public order management and treatment under protective custody.
     The ankang hospital provides admitted mentally ill persons with compulsory treatment under protective custody according to the principles of: management in accordance with the law, scientific treatment, integrated governance, and service on behalf of social order and the patient.

     Article 4: Where it is necessary to place a mentally ill person covered under Article 2 of these measures under compulsory commitment for treatment, the branch (county) public security bureau shall report the case and, following arrangement of a mental illness forensic medical evaluation by the ankang hospital, conduct admission formalities pursuant to the issue of a “Notice of Hospitalization for Commitment and Treatment of a Mentally Ill Person Who Endangers Social Order” by the ankang hospital. Under special, emergency situations where it is necessary to immediately carry out compulsory commitment for treatment, a mental illness forensic medical evaluation shall be carried out promptly after commitment and intake formalities conducted after the fact.

     Article 5: With respect to the medical expenses of hospitalized mentally ill persons subjected to compulsory commitment for treatment: for those with work units, [the expenses] shall be handled in accordance with labor insurance and public health service regulations; for those employees who are under labor contract, [the expenses] shall be handled in accordance with relevant national regulations; for those without fixed employment or income, a guardian shall assume responsibility; where there is no guardian, the civil affairs department shall assume responsibility.

     Article 6: A mentally ill person who has been subjected to compulsory commitment for treatment may be discharged after obtaining approval from the ankang hospital if he or she has been cured through treatment, his or her symptoms have stabilized, and he or she is basically no longer able to endanger social order or has other serious illnesses.

     Article 7: Where a mentally ill person receives approval to be discharged, his or her guardian or work unit shall conduct discharge formalities in accordance with the notification of the ankang hospital. Where discharge is refused without legitimate reason, the branch (county) public security bureau that originally reported hospitalization for the compulsory commitment for treatment shall order a guardian to retrieve [the person refusing discharge]. Where there is no guardian and no fixed employment or income, the civil affairs department shall take custody and arrange for placement.

     Article 8: When a mentally ill person dies during the period of compulsory commitment for treatment, an evaluation of [the cause of] death shall be performed and notice given to the guardian or work unit to go to the ankang hospital to handle post-mortem affairs. Where there is refusal without legitimate reason or there is no guardian and no work unit, the body of the deceased shall be handled by the ankang hospital in accordance with relevant national and local regulations.

     Article 9: During the period of compulsory commitment for treatment, the guardian or relatives of a mentally ill person shall actively cooperate with treatment. Guardians or relatives who go to the hospital to create serious disruptions or disturb order shall be dealt with by the public security organ in accordance with the law and in light of the seriousness of the circumstances.

     Article 10: The public-order units of each branch (county) public security bureau and the security units of enterprises shall, under the direction of the ankang hospital, implement prevention-responsibility systems aimed at mentally ill persons who endanger social order and implement measures for custody, control, and management of mentally ill persons who endanger social order.

     Article 11: A mentally ill person’s guardian, work unit, and local residents’ committee or village committee shall strengthen protective custody over the mentally ill person, protect his or her personal and property rights and other lawful rights and interests, and prevent the mentally ill person from causing trouble and endangering social order.

     Article 12: These measures take effect from the day of announcement. At that time, the “Several Temporary Provisions for Custody and Management of Aggressive Maniacs [sic],” approved for implementation by the Tianjin People’s Committee on August 9, 1965, shall cease to be effective.

Chinese Source(原文): 
天津市收治管理危害社会治安精神病人办法
http://www.tjzb.gov.cn/system/2011/02/18/000251112.shtml
Click on icon to expand

天津市收治管理危害社会治安精神病人办法

市人民政府令1991年第47号

(1991年12月8日经市人民政府批准 根据2010年11月8日市人民政府第59次常务会议《关于修改部分市政府规章的决定》修正)

        第一条 为加强对危害社会治安精神病人的监护、管理和治疗,维护社会秩序,保障人民生命财产安全,保护精神病人的合法权益,根据国家有关规定,结合本市实际情况,制定本办法。

        第二条 凡本市及外地流入本市有下列行为之一的精神病人,由市公安局安康医院予以强制收治:

  1. 实施杀人、放火、强奸、爆炸等行为的;
  2. 严重扰乱党政军机关办公秩序和企事业单位生产、工作秩序的;
  3. 严重扰乱公共秩序,危害公共安全的;
  4. 其他影响社会安定,造成严重后果的;
  5. 曾实施上述各种行为,病情缓解出院后,又有明显发病症状的。

        第三条 市公安局安康医院是本市强制收治危害社会治安精神病人的专门机构,具有治安管理和监护医疗的双重职能。
        安康医院按照依法管理、科学治疗、管治结合、为社会治安和病人服务的原则,对住院精神病人实行强制性监护治疗。

        第四条 本办法第二条所列精神病人需强制收治的,由公安分(县)局申报,经安康医院组织精神病司法医学鉴定后,凭安康医院签发的《收治危害社会治安精神病人入院通知书》,办理入院手续。遇有特殊紧急情况,需立即强制收治的,收治后应及时做出精神病司法医学鉴定,并补办入院手续。

        第五条 强制收治入院精神病人的医疗费用,有工作单位的,按劳保、公费医疗规定办理;实行劳动合同制的职工,按国家有关规定办理;无固定职业和收入的,申报由监护人承担,无监护人的,由民政部门承担。

        第六条 强制收治的精神病人,经治疗痊愈的、病情缓解稳定的、基本丧失危害社会治安能力的或有其他严重疾患的,经安康医院批准可以出院。

        第七条 经批准出院的精神病人,由监护人或工作单位,按照安康医院的通知办理出院手续。无正当理由拒不出院的,由原申报强制收治入院的公安分(县)局责令监护人领回。无监护人又无固定职业和收入的,由民政部门收容安置。

        第八条 精神病人在强制收治期间死亡,应当做出死亡鉴定,并通知监护人或其工作单位到安康医院办理善后事宜。没有正当理由拒不办理或者无监护人又无工作单位的,死者尸体由安康医院按国家及本市有关规定处理。

        第九条 精神病人在强制收治期间,其监护人或亲属应积极配合治疗。监护人或亲属到医院寻衅滋事、扰乱秩序的,由公安机关视情节轻重依法处理。

        第十条 各公安分(县)局的治安部门和企事业单位的保卫部门,应当在安康医院指导下,对危害社会治安的精神病人实行防治工作责任制,落实对危害社会治安精神病人的监护控制及管理措施。

        第十一条 精神病人的监护人,精神病人的所在单位和住地的居民委员会、村民委员会应当加强对精神病人的监护,保护其人身和财产等合法权益,并预防精神病人肇事,危害社会治安。

        第十二条 本办法自公布之日起施行。一九六五年八月九日经天津市人民委员会批准执行的《关于收容管理武疯病人的几项暂行规定》同时废止。

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Xi'an Order No.93: click to expand

Xi’an People’s Government Order
No. 93

     The “Xi’an Measures on Commitment for Treatment of Persons with Mental Disorders Who Seriously Endanger Social Safety” were passed at the 153rd meeting of the 14th [Xi’an] People’s Government Standing Committee on July 11, 2011. They are hereby published and will become effective on August 30, 2011.

Mayor Chen Baogen
July 22, 2011

Xi’an Measures on Commitment for Treatment of Persons with Mental Disorders Who Seriously Endanger Social Safety

     Article 1: In order to strengthen [the system of] commitment for treatment and the management of persons with mental disorders who seriously endanger social safety, to safeguard social public order and public safety, and protect citizen’s personal rights and public and private property, these measures are enacted in accordance with the provisions of the Criminal Law of the People’s Republic of China (PRC), the People’s Police Law of the PRC, and other laws and regulations and in combination with the actual circumstances in this city.

     Article 2: These measures are applicable to the commitment for treatment and management of persons with mental disorders who seriously endanger social safety within the administrative region of this city.

     Article 3: Commitment for treatment of persons with mental disorders who seriously endanger social safety shall be incorporated into the city’s plan for mental health work. The funds necessary for undertaking commitment for treatment work are to be included in the budget.

     Article 4: The public security organ is the competent authority with respect to commitment for treatment of persons with mental disorders who seriously endanger social safety and is responsible for arranging the implementation of these measures. Departments responsible for the administration of health, civil affairs, human resources and social insurance, finances, and other matters, along with mass organizations such as the China Disabled Persons’ Federation, shall, in accordance with their own functional responsibilities, assist with the proper commitment for treatment of persons with mental disorders who seriously endanger social safety.
     The city ankang hospital is responsible for carrying out clinical treatment and management of those persons with mental disorders who seriously endanger social safety [and] that the public security organ has decided to commit for treatment.

     Article 5: Where a person with a mental disorder meets both of the following conditions, the public security organ at or above the county level shall decide to commit that person for treatment:

  1. While unable to distinguish or unable to control his or her actions, commits an act that seriously endangers society and is suspected of a crime [but] is confirmed by an evaluation in accordance with statutory procedures not to bear criminal responsibility;
  2. Does not have a guardian or has a guardian who lacks the ability to look after [him or her], or, although having a guardian, is a person with severe mental disorders who could potentially continue to endanger society if commitment for treatment is not imposed.

     Article 6: [Where a person with a mental disorder] meets any of the following conditions, the public security organ may not issue a decision to commit for treatment:

  1. Suffers from a serious contagious illness;
  2. Suffers from a serious, life-threatening physical illness;
  3. Is no longer able to endanger society;
  4. Is pregnant or nursing one’s own infant under the age of one;
  5. Meets other conditions for which laws, regulations, or rules provide that it is inappropriate to issue a decision to commit for treatment.

     Article 7: Where a public security organ at or above the county level makes a decision to commit for treatment, it shall produce a written commitment decision and notify the guardian of the person being committed for treatment as well as the police station in that person’s place of household registration. Where it is impossible to determine the identity of the person being committed, notification shall be made in a timely manner after [the identity] is determined.

     Article 8: Where the person being committed for treatment or his or her guardian does not accept the commitment decision made by the public security organ, application may be made for administrative reconsideration in accordance with the law or an administrative lawsuit may be filed.

     Article 9: The public security organ that issues the decision to commit for treatment shall take the commitment decision and other relevant documents and escort the person being committed for treatment to the city ankang hospital to conduct admission formalities.

     Article 10: After hospitalization, where a person committed for treatment meets any of the conditions listed in Article 6 of these measures, the city ankang hospital shall suspend treatment and notify the public security organ that issued the commitment decision to collect the person committed for treatment and deliver him or her to the care of his or her guardian or transfer him or her to another relevant medical facility for treatment. In urgent situations where it is impossible to give timely notification, the city ankang hospital may directly transfer the person to another medical facility and promptly notify the public security organ that made the decision to commit for treatment.
     During the period in which commitment [at the ankang hospital] is suspended, the public security organ that issued the commitment decision is responsible for supervising the person that was committed for treatment. Once the conditions necessitating suspension of commitment cease to exist, the public security organ that issued the commitment decision shall immediately return the committed person to the city ankang hospital to continue to receive treatment.

     Article 11: The city ankang hospital shall respect and protect the lawful rights and interests of persons committed for treatment and ensure their safety; discrimination against and humiliation and abuse of persons committed for treatment is prohibited.

     Article 12: In carrying out commitment for treatment work, the city ankang hospital shall follow the technical specifications and operational procedures for medical treatment as established by the health administration authorities and conduct periodic assessments of the mental state of persons committed for treatment and prepare assessment records.

     Article 13: Where the condition of a person committed for treatment shows obvious improvement and it is no longer necessary to continue treatment, the city ankang hospital shall produce a notice revoking commitment for treatment and deliver it to the public security organ that issued the commitment decision.
     Within seven days of receiving the notice, the public security organ that issued the commitment decision shall meet with the guardian of the person committed for treatment to conduct discharge formalities. Where there is no guardian or the guardian refuses to conduct the formalities, the public security organ that issued the commitment decision shall conduct the discharge formalities.

     Article 14: Where a person committed for treatment dies while hospitalized, the city ankang hospital shall produce a death certificate and the public security organ that issued the commitment decision shall notify the person’s guardian to handle post-mortem affairs.
     Where the guardian does not agree with the cause of death, he or she may appoint a body with the appropriate qualifications to carry out an evaluation of the death. If the guardian disagrees with the conclusion of the evaluation, he or she may apply for a re-evaluation in accordance with the law.
     Where the guardian does not agree with the cause of death and does not appoint [anyone to conduct] an evaluation, the public security organ that issued the commitment decision shall arrange for an evaluation to be carried out, complete a death notice, and notify the guardian to retrieve the body.
     Where the guardian refuses to retrieve the body within the stipulated period of time, the public security organ that issued the commitment decision shall, after taking photos [of the body], handle the matter in accordance with the law.

     Article 15: Treatment expenses incurred by the city ankang hospital for patients committed for treatment in accordance with Article 5 of these measures, as well as mental illness treatment expenses incurred during [the patient’s] treatment period at other medical facilities when commitment for treatment is suspended in accordance with Article 10 of these measures, shall be handled according to the following provisions:

  1. For [patients who are] participants in the urban worker basic medical insurance and urban resident medical insurance schemes, [expenses] shall be handled according to the relevant regulations concerning the urban worker basic medical insurance and urban resident medical insurance schemes;
  2. For [patients who are] employees of work units that do not participate in the urban worker basic medical insurance scheme, expenses are to be assumed by their work unit;
  3. For [patients who are] participants in the new-style rural cooperative health insurance scheme, [expenses] shall be handled according to the relevant regulations concerning the new-style rural cooperative health insurance scheme.

     Where none of the aforementioned [payment] channels are applicable to the medical treatment expenses of a person committed for treatment, or where one of the aforementioned [payment] channels applies but there is a portion that is not covered, responsibility for [such expenses] shall be assumed by the patient or his or her guardian. Where [these parties] are truly unable to cover [the expenses], the public security organ that issued the commitment decision or the relevant medical facility shall report to the finance authority at the same administrative level and resolve the matter in accordance with relevant policies.

     Article 16: The public security organ shall recommend that inpatient treatment at an appropriate medical facility be sought by persons with mental disorders who, while unable to distinguish or control their own actions, violate public order management and, without hospitalization and treatment, will continue to endanger public safety or the personal safety of others or disturb public order, as well as those persons with mental disorders for whom, under Article 6 of these measures, a commitment decision cannot be made.

     Article 17: After a person who has been committed for treatment is discharged, the police station and his or her local mental health agency or community health service institution shall establish cooperative relations with his or her family and jointly carry out proper follow-up treatment and rehabilitation work.

     Article 18: Public security organs at all administrative levels shall, in conjunction with township or town people’s governments or sub-district offices, register persons with mental disorders who seriously endanger social safety within their jurisdictions and establish joint management mechanisms to prevent the occurrence of acts that seriously endanger social safety.

     Article 19: Abuse of authority, dereliction of duty, or self-seeking misconduct by personnel of the public security organs or city ankang hospital shall be subject to administrative punishment by their work unit or a superior responsible authority; if [their conduct] constitutes a crime, criminal responsibility shall be pursued in accordance with the law.

     Article 20: These measures take effect from August 30, 2011. At that time, the “Xi’an Measures on Compulsory Commitment for Treatment of Mentally Ill Persons Who Seriously Endanger Social Safety” (Gov’t Notice [1997] No. 7) issued by the [Xi’an] People’s Government on January 9, 1997, will cease to be effective.

Chinese Source(原文): 
西安市人民政府令 第93号
http://www.xa.gov.cn/ptl/def/def/index_1121_2560_ci_trid_9963.html
Click on icon to expand

西安市人民政府令
第 93 号

        《西安市收治严重危害社会安全精神障碍患者办法》已经2011年7月11日市政府14届153次常务会议通过,现予公布,自2011年8月30日起施行。

市长 陈宝根
二〇一一年七月二十二日

西安市收治严重危害社会安全精神障碍患者办法

        第一条 为了加强严重危害社会安全精神障碍患者的收治和管理,维护社会治安秩序和公共安全,保护公民人身权利和公私财产,根据《中华人民共和国刑法》、《中华人民共和国人民警察法》等法律、法规的规定,结合本市实际,制定本办法。

        第二条 本市行政区域内对严重危害社会安全精神障碍患者的收治及其管理,适用本办法。

        第三条 严重危害社会安全精神障碍患者收治工作应当纳入全市精神卫生工作规划。开展收治工作所需经费纳入财政预算。

        第四条 公安机关是严重危害社会安全精神障碍患者收治工作的主管机关,负责组织本办法的实施。卫生、民政、人力资源和社会保障、财政等行政主管部门和残联等人民团体,按照各自职责,协同做好严重危害社会安全精神障碍患者的收治工作。
        市安康医院负责对公安机关作出收治决定的严重危害社会安全精神障碍患者进行治疗和管理。

        第五条 精神障碍患者同时具有下列情形的,由县级以上公安机关作出决定对其进行收治:

  1. 在不能辨认或者不能控制自己行为的时候实施严重危害社会的行为,涉嫌犯罪,经法定程序鉴定确认,不负刑事责任的;
  2. 无监护人,或者有监护人但监护人无能力看管,或者虽有监护人但不进行收治可能会继续危害社会的重性精神障碍患者。

        第六条 有下列情形之一的,公安机关不得作出收治决定:

  1. 患有严重传染性疾病的;
  2. 患有严重躯体疾病危及生命的;
  3. 丧失继续危害社会安全能力的;
  4. 怀孕或哺乳自己不满一周岁婴儿的;
  5. 法律、法规和规章规定不宜作出收治决定的其他情形。

        第七条 县级以上公安机关作出收治决定,应当出具收治决定书,并通知被收治人员的监护人及其户籍所在地公安机关派出机构。无法确认被收治人员身份的,应当在查明后及时通知。

        第八条 被收治人员或者其监护人对公安机关作出的收治决定不服的,可以依法申请行政复议或者提起行政诉讼。

        第九条 作出收治决定的公安机关应当持收治决定书及其他相关材料,护送被收治人员到市安康医院办理入院手续。

        第十条 被收治人员入院后出现本办法第六条所列情形之一的,市安康医院应当中止收治,并通知作出收治决定的公安机关将被收治人员送交其监护人看护或者转至其他有关医疗机构治疗。情况紧急无法及时通知的,由市安康医院直接将其转至其他医疗机构,并及时通知作出收治决定的公安机关。
        中止收治期间,被收治人员的监管工作由作出收治决定的公安机关负责。被收治人员中止收治的情形消失后,作出收治决定的公安机关应当立即将其送回市安康医院,继续接受治疗。

        第十一条 市安康医院应当尊重和保护被收治人员的合法权益,保障被收治人员的安全,不得歧视、侮辱、虐待被收治人员。

        第十二条 市安康医院在收治工作中应当执行卫生行政主管部门制定的医疗技术规范和操作规程,并定期对被收治人员进行精神状态评估,制作评估记录。

        第十三条 被收治人员病情显著好转,不需要继续治疗的,市安康医院应当向作出收治决定的公安机关出具解除收治的通知书。
        作出收治决定的公安机关应当在接到通知书后七日内会同其监护人办理出院手续;无监护人或者监护人拒绝办理的,由作出收治决定的公安机关办理出院手续。

        第十四条 被收治人员住院期间死亡的,由市安康医院出具死亡诊断证明,并由作出收治决定的公安机关通知其监护人办理善后事宜。
        监护人对死亡原因有异议的,可以委托具有相应资质的机构进行死亡鉴定。监护人对鉴定结论有异议时,可以依法申请重新鉴定。
        监护人对死亡原因有异议又不委托鉴定的,由作出收治决定的公安机关组织进行鉴定,填写死亡通知书,通知监护人认领尸体。
        监护人在规定期限内拒不认领尸体的,由作出收治决定的公安机关拍照后依法予以处理。

        第十五条 市安康医院按照本办法第五条规定收治病人的治疗费用,以及按照本办法第十条规定中止收治的人员在其他医疗机构治疗期间所产生的精神疾病治疗费用,按照下列规定执行:

  1. 参加城镇职工基本医疗保险和城镇居民医疗保险的,按照城镇职工基本医疗保险和城镇居民医疗保险的有关规定执行;
  2. 未参加城镇职工基本医疗保险的单位职工,由其所在单位负担;
  3. 参加新型农村合作医疗保险的,按照新型农村合作医疗保险的有关规定执行。

        被收治人员的医疗费用无前款所列负担渠道或者有前款所列负担渠道之一但不足的部分,由其本人或者监护人负担;确实无力负担的,由作出收治决定的公安机关或者有关医疗机构报同级财政部门按相关政策予以解决。

        第十六条 精神障碍患者在不能辨认或者控制自己行为时,有违反治安管理行为,不住院治疗会继续危害公共安全或者他人人身安全、扰乱公共秩序的,以及按照本办法第六条规定不能作出收治决定的精神障碍患者,公安机关应当建议其到相应的医疗机构住院治疗。

        第十七条 被收治人员出院后,公安机关派出机构以及其所在地的精神卫生机构、社区医疗服务机构应当与其家庭建立合作关系,共同做好后续治疗康复工作。

        第十八条 各级公安机关应当会同乡、镇人民政府或者街道办事处,对辖区内严重危害社会安全的精神障碍患者进行登记,建立共同管理机制,防止严重危害社会安全行为的发生。

        第十九条 公安机关及市安康医院的工作人员滥用职权、玩忽职守、徇私舞弊的,由其所在单位或上级主管部门给予行政处分;构成犯罪的,依法追究刑事责任。

        第二十条 本办法自2011年8月30日起施行。市人民政府1997年1月9日发布的《西安市强制收治严重危害社会安全精神病人办法》(市政发〔1997〕7号)同时废止。

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