台灣司法精神護理的現況需求、挑戰、未來展望與國際接軌：聚焦在重症精神疾病

Current Needs, Challenges, Future Prospects, and International Integration of Forensic Mental Health Nursing in Taiwan: Focus on Persons with Severe Mental Illness

隨著台灣重症精神疾病(severe mental illness, SMI)病人涉及刑事案件或其他法律問題觸法的案件受到高度重視，司法精神護理(forensic mental health nursing, FMHN)的需求愈加迫切。司法精神護理在照護精神疾病觸法者中扮演關鍵角色。儘管如此，台灣的司法精神護理仍處於起步階段，尚未建立聚焦於重症精神疾病病人的照護模式、護理標準及實務規範。本文探討台灣司法精神醫療的發展歷程，到司法精神病房的專業化及制度化，以及司法精神護理現況及發展需求；分析聚焦重症精神疾病的台灣司法精神護理面臨的多重挑戰；更深入分析司法精神護理師所需的專業技能，包含精神疾病觸法者多元需求的整合評估能力，與司法精神醫療環境與治療照護模式的獨特性。本文更深入剖析台灣司法精神護理專業面臨最核心的困境，以及倡議可行策略之推動：發展台灣本土化的系統性研究，以及將本土實務經驗進行知識轉譯；建構並落實標準作業流程(standard operating procedures, SOP)，涵蓋關鍵臨床實務，如自殺防治、暴力防治與再犯風險之評估；以及強化包含安全管理人員在內的跨專業團隊合作機制。最後，提出台灣司法精神護理未來展望以及國際接軌的方向，以確保精神疾病觸法者在治療和處置過程中獲得專業的照護，並促進其復元與賦歸社會。

As the involvement of persons with severe mental illness (SMI) in criminal cases and other legal issues gains increasing attention in Taiwan, the demand for forensic mental health nursing (FMHN) has become more pressing. FMHN plays a critical role in the care of offenders with mental disorders. However, FMHN in Taiwan remains underdeveloped, with no established care models, nursing standards, or clinical guidelines specifically designed for persons with SMI. This article explores the historical development of forensic mental health services in Taiwan, the gradual professionalization of forensic psychiatric wards, and the current state and future needs of FMHN. It further analyzes the multifaceted challenges faced by FMHN in addressing the needs of individuals with SMI and delves into the essential competencies required of forensic mental health nurses, including the ability to conduct integrated assessments of complex needs and the capacity to navigate the unique characteristics of forensic mental health environments and treatment models. This article also provides a comprehensive analysis of the core challenges faced by the forensic mental health nursing profession in Taiwan, and advocates for the promotion of feasible strategies: the development of localized, systematic research in Taiwan, and the translation of Taiwan’s clinical experience into knowledge, the establishment and implementation of standard operating procedures (SOPs), encompassing key clinical practices such as suicide prevention, violence management, and risk assessment for recidivism, as well as strengthening interdisciplinary collaboration mechanisms, including the involvement of security personnel. Finally, the article outlines the future prospects for FMHN in Taiwan, with a focus on aligning with international standards to ensure that offenders with mental disorders receive professional care throughout their treatment and judicial process, facilitating their recovery and reintegration into society.