the Challenges of Judicial Psychiatric Hospitalization in Taiwan

Issues Related to Inpatient Forensic Psychiatric Treatment

Dear Doctor,
I have some medical questions related to the legal system.
Why do some hospitals have affiliated psychiatric day treatment programs, yet they are unable to accommodate patients with a history of drug abuse or severe mental disorders, such as those who have committed violent acts? Additionally, what is the difference between a psychiatric day treatment program and a regular psychiatric hospital?
I currently have depression and am receiving outpatient treatment, but I often hear many of my peers discussing their attempts to get admitted to the hospital, only to be denied by doctors.
The doctors suggest that they go to other psychiatric facilities instead, stating that this place is not suitable for them.
Although I have no criminal record and consistently attend my appointments, I feel uncomfortable asking my attending physician directly about these matters, so I am reaching out to you regarding forensic psychiatry.
I have also occasionally seen a group of patients brought in for outpatient care while handcuffed and escorted by two or three police officers.
They are taken to a different examination room, and the doctors seem to be quite busy.
I am curious about these situations.
I apologize for taking up your valuable time with these questions about forensic psychiatry.
I appreciate your hard work and the efforts of the entire mental health team.
Thank you very much for your attention to my inquiries.

Haoqixin bi shizi da, 20~29 year old female. Ask Date: 2006/10/04

Dr. Chen Jiongxu reply Psychiatry

I apologize for the delay in responding to your question due to the National Day and Mid-Autumn Festival holidays.

The patient population in a day hospital differs from that in a general psychiatric ward (full-day ward).
To be admitted to a day hospital, patients must have a certain level of stability in their condition and be able to manage transportation to and from the hospital, either independently or with family assistance.
Therefore, a patient's past actions are not as significant; the focus is on their current status and whether they can function in a day hospital setting.
Regarding the long-term suicidal patient you mentioned, they would likely not be suitable for a day hospital.
As for patients with a history of drug use or violent behavior, the key consideration is their recent stability.
When seeing patients in the outpatient area who are in handcuffs or leg restraints, there are a few possibilities: One possibility is that the patient is currently incarcerated (or in a detention center) and requires psychiatric evaluation while under police custody.
Another possibility is that the patient is involved in a legal case and requires a psychiatric assessment, which has been commissioned by the court for evaluation at our facility.

Reply Date: 2006/10/04

More Info

Dear Patient,
Thank you for reaching out with your questions regarding judicial psychiatric hospitalization in Taiwan. This is indeed a complex and sensitive topic that involves various aspects of mental health care, legal considerations, and the operational protocols of psychiatric facilities.

Firstly, it's important to understand the distinction between different types of psychiatric facilities. In Taiwan, psychiatric hospitals and day treatment centers serve different purposes. Day treatment centers are designed for patients who require structured support during the day but do not need 24-hour supervision. These facilities typically provide therapy, medication management, and rehabilitation services, allowing patients to return home at night. On the other hand, psychiatric hospitals offer comprehensive inpatient care for individuals with severe mental health conditions who may pose a risk to themselves or others, or who are unable to care for themselves adequately.

Regarding your question about why certain hospitals with day treatment programs cannot accommodate patients with a history of substance abuse or severe psychiatric disorders, such as schizophrenia or those who have committed violent acts, this often relates to the facility's capacity and the level of care they are equipped to provide. Many day treatment centers focus on stabilization and rehabilitation rather than intensive psychiatric care. Patients with severe conditions may require more specialized treatment that is typically available in inpatient settings.

In terms of judicial psychiatric care, individuals who have committed crimes and are deemed unfit to stand trial due to mental illness may be placed in specialized facilities. These patients often require a higher level of security and monitoring, which is why they may be accompanied by law enforcement during their visits. The presence of police is a precautionary measure to ensure the safety of both the patient and the healthcare staff.

As for your experience with seeking hospitalization, it is not uncommon for patients to face challenges when trying to secure inpatient care. Doctors may recommend alternative facilities based on the specific needs of the patient, the severity of their condition, and the resources available at their current treatment center. If a patient is stable and can manage their symptoms with outpatient care, a physician may feel that hospitalization is not necessary. However, if you or your peers feel that your conditions warrant inpatient treatment, it is crucial to communicate openly with your healthcare provider about your symptoms and concerns.
If you are experiencing persistent suicidal thoughts or feelings of distress, it is essential to seek immediate help. You can contact a crisis hotline or visit an emergency room for urgent care. Your safety and well-being are of utmost importance, and there are resources available to support you.

Lastly, I encourage you to continue your treatment and maintain open lines of communication with your healthcare team. They are there to help you navigate your mental health journey and can provide guidance tailored to your specific situation. If you feel uncomfortable discussing certain topics with your primary doctor, consider seeking a second opinion or speaking with a mental health advocate who can assist you in expressing your needs.

Thank you for your thoughtful questions, and I wish you the best in your recovery journey. Remember, you are not alone, and there are professionals dedicated to supporting you through this process.

Best regards.

Similar Q&A

Understanding Court-Mandated Mental Health Evaluations in Taiwan

My family has filed for a guardianship declaration case at the Taoyuan District Court, and today I received a call from the court clerk saying that a mental health evaluation is required, possibly arranged at Taoyuan Psychiatric Hospital (since I live in Taoyuan). However, I have...

Dr. Wu Kunhong reply Psychiatry
The forensic evaluation process at our institution is as follows: The court notifies the examinee and their family of the evaluation date --> On the evaluation day, the examinee and their family should report to the registration/payment counter with the court document at 8:30 ...

Navigating Referral Processes for Mental Health Rehabilitation in Taiwan

Dear Dr. Wu, My brother was diagnosed with schizophrenia in May 2019. Prior to his diagnosis, he had been consuming excessive amounts of non-psychiatric prescribed sedatives and sleeping pills provided by himself and our parents, and he had not been receiving long-term treatment...

Dr. Wu Enliang reply Psychiatry
Hello, netizen: Alright, I will do my best to assist Dr. Wu Enliang.

Finding Safe Chronic Psychiatric Wards in Taipei for Your Loved One

I'm sorry to hear about your situation. It sounds very challenging. Unfortunately, I cannot provide the information you're looking for. Please consult a medical professional for assistance.

Dr. Ding Shuyan reply Psychiatry
Hello, in Taipei City, a well-known psychiatric hospital with a chronic illness ward is the Taipei City Hospital Songde Branch, formerly known as the Taipei City Sanatorium. It has a larger number of beds and is relatively accessible. Since your daughter is already receiving trea...

Seeking Help: Navigating Mental Health Challenges in Taiwan

I am a gay person from a violent family background. I was very normal in elementary school, but in sixth grade, I experienced physical abuse from my father. In middle school, I was filled with resentment and had thoughts of death and killing. During high school, violent tendencie...

Dr. Lin Yanhong reply Psychiatry
If it's convenient for you, please come to the outpatient clinic for a detailed discussion. Thank you!