【作者】 王琼；

【导师】 蒲川；

【作者基本信息】 重庆医科大学 ， 社会医学与卫生事业管理， 2010， 硕士

【摘要】 精神卫生问题既是全球性的重大公共卫生问题,也是较为突出的社会问题。精神卫生日益受到人们的关注与重视,我国精神卫生事业因缺乏完善的法律制度支持而处于落后状态,《精神卫生法》的立法调研和起草工作,从1985年起已历时24年,但至今未能提上立法议程,成为世界上少数未立此法的国家之一。虽然1980年以来一些相关法律法规涉及相关精神卫生制度,这些条文大多仅涉及部分制度的原则性规定,没有细化与规定具体措施,实施过程中导致了很多问题的出现。精神病人的法律保障问题在地区间发展也不平衡,在大部分地区尚没有独立完整的精神卫生地方法规,社区防控监测体系缺失、专业机构条件落后,精神卫生机构医疗人员普遍不足,致使很多地方现在仍不能保证精神残疾患者基本的医疗条件,患者权益不能得到很好保护,没有良好的社会保障体系,精神残疾患者不能得到及时有效的治疗,有些长期滞留精神病院,有些弃置社会任其发展,精神病人肇事一直是个严重的社会问题,各大报纸、新闻鲜见精神病人肇事所酿成的重大惨案,精神卫生疾病已成为导致一些重大公共事件发生的根源之一,直接破坏了社会的正常秩序和造成生产力的重大损失。随着社会的发展,各种社会矛盾错综复杂,就业、生活、学习压力增大等问题促使心理问题在当今社会越来越凸显,各种心理精神疾患症状的病人日益增多,导致精神分裂、抑郁症、自杀的人越来越多。特别是在重大灾害事故后受灾人群更需要心理救助,但是我国现有法律对灾后心理干预方面没有作出明确的规定,缺乏法律规范和保障。因此,分析我国现行的精神卫生法律制度存在的问题,提出建议完善相关制度,构建适合我国的精神卫生的法律制度,对促进我国精神卫生事业的发展起到推动的作用,也是本文研究的意义所在。对精神卫生法律制度的研究,本文是从一个大框架下对其中的重要制度进行分析,本文共分为四章:第一章主要对精神卫生法律制度的概述,简要介绍了我国从古代到解放后的精神卫生立法的发展历程,可以看出从古代到近现代对精神疾病患者的规定都主要从刑事责任能力出发,而到解放后在民事行政方面也有相关规定。在本章对精神疾病、精神卫生、社区康复模式、精神卫生法律制度等概念进行了解析。第二章首先介绍我国现行精神卫生法律制度的立法现状,然后重点论述了我国精神卫生法律制度中主要存在的问题:强制医疗制度的漏洞及其实施程序混乱,缺乏有效的权利救济渠道;精神卫生资源缺乏,精神卫生医疗机构和工作人员不足;对精神疾病患者的权益保护不够;司法精神病鉴定制度中缺乏统一的标准、机构二元化等问题;心理卫生法律制度缺乏,国民心理健康缺乏保障,对灾后心理干预方面没有作出明确的法律规定。尤其是强制医疗制度和司法精神病鉴定制度存在诸多问题,这两个制度也是本文的重难点。第三章主要介绍国外精神卫生法律制度概况:英国精神卫生法对设立精神卫生委员会和精神卫生法庭及对强制性医疗的监督与控制的法律规定就很好的保护了精神疾病患者的权利,尤其是对强制治疗的监控;美国法律规定的的专家证人制度、鉴定监督制度明确了鉴定专家的责任,有利于鉴定结论的公平公正;日本和澳大利亚建立社区康复制度,建立了新的精神卫生服务模式,更有利于病人的康复和治疗。这些制度都对我国有非常好的借鉴和启示作用。第四章在我国现有的法律制度基础上,借鉴国外优秀的研究成果,然后探析如何构建和完善我国精神卫生法律制度:社区康复制度是精神卫生改革的一个必然方向,除了要加大对社区精神卫生服务的建设,还要确立精神卫生工作中政府的职能及其相应部门的职责,加大精神卫生的健康促进与宣传教育,对精神疾病患者提供社会支持;强制医疗制度中应该规定强制医疗的适用条件、建立强制医疗的司法程序,确定裁决机构和强制医疗执行的合理化内容的完善,以防止强制治疗权的滥用,保护非自愿住院患者的权益;对于司法精神病鉴定制度,我国应完善法律法规,统一鉴定标准、机构,完善监督机构,确立鉴定专家的责任;完善国民心理健康保障机制,建立健全心理卫生法律制度,提高国民心理健康水平。建立灾后精神卫生救援制度,积极开展重大灾害后受灾人群心理应激救援工作,降低灾后精神疾病发生率;我国应建立社会救助制度帮助精神疾病患者,建立社会公益基金,使政府、社会、家庭真正承担起对于精神疾病患者群体的救济职能,保障其治疗费用。更多还原

【Abstract】 The mental hygiene question is not only the global significant public health question, is also the more prominent social question. The mental hygiene receives people’s attention day by day and takes seriously, our country mental hygiene enterprise because of lacks the consummation the legal regime support to be at backwardness condition, "Mental hygiene Law" the legislative investigation and study and the draft work, have lasted for 24 years from 1985, but has not been able to raise until now legislates the agenda, became in the world minority not to set up one of this law countries. Although since 1980 some related laws and regulations have involved the related mental hygiene system, these articles mostly only involve the partial system’s sense of principle to stipulate that does not have the refinement and the stipulation specific measures, implements in the process to cause many question appearances. Mental patient’s legal safeguard question is not balanced in the country development, still did not have the independence complete mental hygiene local code and regulation in the most districts, the community prevention and control monitor system flaw, the specialized organization condition to be backward,Mental hygiene organization medical officers universal insufficient, cause many places still could not guarantee that now the energetic disabled patient’s basic medical service condition, the patient rights and interests cannot obtain very well protect, do not have the good social security system, the energetic disabled patient cannot obtain the prompt effective treatment, some long-term detention mental hospital, somewhat abandons the society, no matter what its development, The mental patient cause troubles has been the serious social question, each big newspaper, the news rarely seen mental patient cause trouble the significant massacre which breeds, like the mental patient in the regional campuses, the kindergarten initiates are many violence, mental hygiene disease has become causes one which of roots some significant public events occur, destroyed society’s normal order directly and creates the productive forces the heavy loss. Along with society’s development, each kind of society contradictory intriguing, questions and so on employment, life, study pressure build-up urge the psychological question more and more to highlight now in the society, each kind of psychological mental disorder symptom’s patient increases day by day, causes the schizophrenia, the depression, the suicide person to be getting more and more. Specially after significant disaster accident hits by disaster the crowd to need the psychological rescue, but our country existing law after the disaster the psychological intervention aspect has not made the explicit stipulation, lacks the legal norm and the safeguard. Therefore, analyzes our country present mental hygiene legal regime existence the question, proposed that the suggestion consummates the related system, the construction suits our country’s mental hygiene legal regime, to promotes our country mental hygiene enterprise’s development impetus function, is also the significance which this article studies is.To the mental hygiene legal regime’s research, this article is carries on the analysis from a big frame to important system, this article altogether divides into four chapters:The first chapter mainly to the mental hygiene legal regime’s outline, briefly introduced our country from the ancient times after the liberation mental hygiene legislation’s development process, might see from the ancient times mainly embarks to near modern age to the mental illness patient’s stipulation from the criminal capacity, but after liberation also had the related stipulation in the civil administrative aspect. In this chapter to concepts and so on mental illness, mental hygiene, community recovery pattern, mental hygiene legal regime has carried on the analysis.The second chapter First introduced that our country present mental hygiene legal regime’s legislative present situation, then elaborated in with emphasis our country mental hygiene legal regime the main existence question: The compulsion medical service system’s crack and the implementing procudure are chaotic, lack the effective right relief channel; The mental hygiene resources lack, the mental hygiene Medical establishment and the staff are insufficient; Is insufficient to the mental illness patient’s rights and interests protection; Judicial neurosis appraises in the system to lack questions and so on unification standard, organization dualization; The mental hygiene legal regime lacks, the national psychologically healthy lacks the safeguard, after the disaster the psychological intervention aspect has not made the explicit legal rule. Especially the compulsion medical service system and judicial neurosis appraise the system to have many problems, these two systems are also this article heavy difficulties.The third chapter Main introduction overseas mental hygiene legal regime survey: The British mental hygiene law to set up the mental hygiene committee and the mental hygiene court and to the compulsory medical surveillance and the control legal rule very good protection mental illness patient’s right, particularly forced the treatment the monitoring; US legal rule the expert witness system, the appraisal control system was clear has appraised expert’s responsibility, was advantageous fairly in the appraisal conclusion fair; Japanese and the Australian establishment community recovery system, has established the new mental hygiene service pattern, is more advantageous to patient’s recovery and the treatment. These systems have good model to our country with the enlightenment function.The fourth chapter in our country existing legal regime foundation, profits from the overseas outstanding research results, how then searches analyzes to construct and consummate our country mental hygiene legal regime: The community recovery system is a mental hygiene reform inevitable direction, except must enlarge to the community mental hygiene service construction, but must establish in the mental hygiene work government’s function and the corresponding department’s responsibility, enlarges the mental hygiene the health promotion and the public education, provides the society to the mental illness patient to support; In the compulsion medical service system should stipulate that the compulsion medical service the suitable condition, the establishment compulsion medical service’s judicial process, determined the ruling organization and the compulsion medical service execution’s rationalization content’s consummation, prevents the compulsion treatment power abusiveness, protects the non-voluntary in hospital patient’s rights and interests; Appraises the system regarding the judicial neurosis, our country should consummate the laws and regulations, the unification appraisal standard, the organization, consummates the cognizant agency, the establishment appraises expert’s responsibility; The perfect national psychologically healthy safeguard mechanism, establishes the perfect mental hygiene legal regime, raises the national psychologically healthy level. After establishing the disaster, the mental hygiene rescue system, launches the significant disaster, after positively hits by disaster the crowd psychology stress rescue work, after reducing the disaster, mental illness formation rate; Our country should establish the social relief system help mental illness patient, establishes the social benefit fund, causes the government, the society, the family to undertake truly regarding the mental illness patient community’s relief function, safeguards its treatment expense.更多还原