社會安全網政策的棘手問題──以兩位護送就醫後接受強制住院治療的個案為例

The Wicked Problems of the Social Safety Net Policy: Examples of Two Cases Escorted for Involuntary Psychiatric Hospitalization After Community Reintegration

精神衛生法歷經2007年與2022年重大修正後，強制住院與強制社區治療案量逐年減少。強化社會安全網計畫第二期於2021～2025年實施過程，各地區積極布建精神衛生資源，是否在強制住院漸被視為最後手段的當代，這些社區資源足能承接個案，仍待探索。社會安全網政策試圖處理棘手問題（wicked problems），易受本位主義和犬儒主義影響政策運作效能，相較驗證性分析，經驗資料或可提供政策調整過程需要的反證（falsification）。本文參考近年審查會強制住院與強制社區治療審查案量變化，並以兩位不同性質之強制住院個案為例，探討當前精神照護服務資源在社區連結的困境。從實作經驗中可得知，各網絡間運作仍有時程與流程銜接的限制，社會安全網政策未來仍需更多經驗資料確認實作流程的可行性與存續性。

Following significant amendments to the Mental Health Act in 2007 and 2022, the number of cases involving mandatory hospitalization and community treatment has gradually decreased. During the implementation of the second phase of the Social Safety Net Plan (2021-2025), mental health resources have been actively developed across various regions. However, in an era where mandatory hospitalization is increasingly regarded as a last resort, whether these community resources are sufficient to support individuals in need remains an open question. The social safety net policy aims to address wicked problems, yet its effectiveness is often influenced by parochialism and cynicism. Compared to confirmatory analyses, empirical data may provide falsification evidence necessary for policy adjustments. This study examines recent trends in the review of mandatory hospitalization and community treatment cases, using two cases of mandatory hospitalization with differing characteristics to explore the challenges of integrating mental health services within communities. Practical experience suggests that operational limitations persist in coordinating timelines and processes across service networks. Moving forward, the social safety net policy requires further empirical data to verify the feasibility and viability of its implementation.