Kim Agnus M, Sohn Jee Hoon
Department of Health Policy and Management, Seoul National University College of Medicine, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Public Healthcare Center, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Psychiatry, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Psychiatry Res. 2023 Mar;321:115089. doi: 10.1016/j.psychres.2023.115089. Epub 2023 Jan 31.
This study examined changes in the crime rates of people with schizophrenia in Korea in comparison with the general population after the Mental Health Act revision for deinstitutionalization in 2017. The crime rates of people with schizophrenia and the general population were calculated from 2012 to 2021 using the Korean National Police Agency crime statistics. The effects of the law revision in 2017 on the crime rates were assessed using the interrupted time series and difference-in-difference analyses. The crime rates of people with schizophrenia tended to be lower than the general population except for murder and arson, which were 5.3 and 11.4 times, respectively, that of the general population. While no significant effect of the revision was found in the interrupted times series analysis, the difference-in-differences analysis indicated that the total crime rates and the rates of violence and public order crime increased among people with schizophrenia compared with the general population. The revision of the Mental Health Act for deinstitutionalization did not lead to an increase in the murder rate of people with schizophrenia as is commonly thought. However, the increases in overall crime and violence rates of people with schizophrenia suggest that the deinstitutionalized patients may not have been successfully relocated into the community. The increase in crime after the revision should be interpreted as a call for well-resourced community care rather than the reason for re-transfer of patients to hospitals.
本研究调查了2017年韩国《精神卫生法》修订以推进非机构化后，精神分裂症患者的犯罪率与普通人群相比的变化情况。利用韩国国家警察厅的犯罪统计数据，计算了2012年至2021年期间精神分裂症患者和普通人群的犯罪率。采用中断时间序列分析和差分分析评估了2017年法律修订对犯罪率的影响。除谋杀和纵火罪外，精神分裂症患者的犯罪率往往低于普通人群，谋杀和纵火罪的犯罪率分别是普通人群的5.3倍和11.4倍。虽然在中断时间序列分析中未发现修订有显著影响，但差分分析表明，与普通人群相比，精神分裂症患者的总犯罪率以及暴力犯罪率和公共秩序犯罪率有所上升。《精神卫生法》关于非机构化的修订并未像人们普遍认为的那样导致精神分裂症患者谋杀率上升。然而，精神分裂症患者总体犯罪率和暴力犯罪率的上升表明，非机构化患者可能并未成功融入社区。修订后犯罪率的上升应被理解为对资源充足的社区护理的呼吁，而不是将患者转回医院的理由。
