After Korea revised the law to curb involuntary hospitalizations of people with a mental health condition, the nation’s unintentional psychiatric admission rate quickly dropped to 30 percent levels from 60 percent, the government said. These changes were made in just one year since the Mental Health Act was amended in May last year.
The Ministry of Health and Welfare said Thursday that involuntary hospitalization rate had been steadily decreasing since the legal revision, with a slight decline in the total number of the inpatients with mental disorders.
The ministry said 37.1 percent of the inpatients had to be committed to a mental institution forcefully by guardians, mayors or district office heads as of April 23. The figure is down by 24.5 percentage points compared to the involuntary hospitalization rate of 61.6 percent as of Dec. 31, 2016, before the law revision.
However, 37.1 percent is still regarded high, compared to those of advanced nations such as Italy’s 12 percent, the U.K.’s 13 percent, and Germany’s 17 percent.
Among all the involuntary cases, those by administrative force spiked from 94 in December 2016 to 2,560 in April.
The total number of inpatients at mental institutions fell by 2,639, or 3.8 percent, to 66,523 in April.
“The new Mental Health Welfare Act has created an important opportunity to treat the mentally ill as the subject of the treatment and medical service. Changes have been made to protect the patient’s human rights and procedural rights during hospitalization and discharge,” said Je Cheol-ung, a professor at Hanyang University School of Law. He also serves as a member of the National Human Rights Commission’s disability discrimination remedy committee.
Under the amended law, beginning May 30 last year, doctors can order involuntary commitment for a patient for up to only 14 days with the legal guardian’s consent. Three months of hospitalization is allowed only after getting a confirming second opinion from a specialist. Out of the total additional diagnoses for involuntary admissions, 32.7 percent was made by state-run mental institutions.
The law also established a new type of hospitalization for mentally ill patients with the concurrent consent of the guardian. Mental patients are voluntarily admitted and discharged basically. However, if they want to be released without the consent of the guardian, a specialist can limit the discharge for 72 hours and turn it into an involuntary admission.
Hospitalization adequacy evaluations for involuntary admissions will start on May 30. Five national psychiatric hospitals will establish 12 assessment committees and 58 subcommittees, region by region. The committees will review the adequacy of admissions of new involuntary inpatients within one month after the hospitalization.
The health and welfare ministry projected that there would be about 40,000 assessments per year and hired 49 staffs at five state-run psychiatric hospitals.
The ministry also appointed 276 people, including mental health specialists, lawyers, families of the mentally ill, and operators of mental health promotion facilities, as members of the assessment committees at the five hospitals.
The ministry is conducting the "Halfway House" pilot project from October 2017 to June 2018, a short-term training residence service that helps the discharged mentally ill patients to settle down and become self-reliant in the local community. By developing a model to fit Korean society, the ministry plans to run it as part of community care project from 2019 and gradually expand the program until 2022.
“To support the mentally unhealthy returning to the community, we will expand community services such as Halfway House and achieve qualitative growth,” said Cha Jeon-kyeong, director of the mental health policy division at the health and welfare ministry. “We will actively cooperate with the medical community to continuously collect their opinions and keep communicating with them to supplement or improve the policy.”
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