Nakatani Y
Department of Sociopathology, Tokyo Institute of Psychiatry, Japan.
Jpn J Psychiatry Neurol. 1994;48 Suppl:71-6. doi: 10.1111/j.1440-1819.1994.tb03041.x.
The author outlines the legislation and treatment system for mentally disordered criminal offenders in Japan, and reviews the recent studies on the treatment of refractory patients in mental hospitals. Involuntary admission of patients referred by a public prosecutor or by a head of a correctional institution is problematic regarding the judgment criteria for admission and discharge, and imposes a burden on practitioners. The author outlines the main problems of the treatment of criminal offenders in a hospital setting: reaction to the hospital environment, lack of motivation for treatment, therapists' reluctance to treat these patients, absence of support for rehabilitation and uncertainty about future risk. Suggested measures for the solution of these difficulties include the role of the Psychiatric Review Board, the psychiatric evaluation system, and therapeutic skills pertaining to dangerous patients.
作者概述了日本针对精神错乱罪犯的立法和治疗体系，并回顾了近期关于精神病院难治性患者治疗的研究。由检察官或惩教机构负责人转介的患者的非自愿入院，在入院和出院的判断标准方面存在问题，给从业者带来了负担。作者概述了在医院环境中治疗罪犯的主要问题：对医院环境的反应、缺乏治疗动机、治疗师不愿治疗这些患者、缺乏康复支持以及未来风险的不确定性。解决这些困难的建议措施包括精神科审查委员会的作用、精神科评估系统以及与危险患者相关的治疗技能。
