男性精神疾病犯罪者於醫療機構執行監護之效益

The Effectiveness of Custodial Protection on Male Offenders with Mental Illnesses

目的：了解我國男性精神疾病犯罪者於精神醫療機構執行監護之效益以及結束監護後再犯罪率。方法：經由病歷回顧，收集於精神醫療機構執行監護之男性精神疾病犯罪者個人變項、精神疾病史、犯罪史、監護期間接受的治療及監護結束前精神病症狀。委請地方檢察署提供監護個案結束監護3年內是否犯罪起訴，進行再犯因子分析。結果：76.7%男性精神疾病犯罪者監護結束前精神病症狀改善，23.3%男性精神疾病犯罪者監護結束前已無明顯精神病症狀，50.0%男性精神疾病犯罪者結束監護處分3年內發生犯罪行為且偵查起訴。精神疾病診斷複雜程度、成癮物質使用及監護結束時精神病症狀與結束監護3年內是否犯罪無統計上差異。執行監護期間有違規行為之男性精神疾病犯罪者，結束監護後犯罪率較高。結論：精神醫療機構以治療精神疾病為主要目標，男性精神疾病犯罪者經積極治療，可使精神疾病症狀穩定，但無證據顯示監護處分可矯治犯罪行為或降低未來犯罪可能性。男性精神疾病犯罪者在執行監護期間發生違規行為，將進一步研究是否可做再犯預測參考。為確保精神疾病犯罪者精神疾病症狀穩定，建議結束監護處分後建立醫療追蹤機制。

Objectives. To understand the effectiveness of custodial protection system in a psychiatric facility on recidivism rates of the male offenders with mental illnesses who have completed their custodial protection period.
Methods. The study subjects were male offenders with mental illnesses in the psychiatric hospital for custodial protection in eastern Taiwan. The male offenders with mental illnesses were tracked for commission of crimes for three years after completing their custodial protection period. We collected the following data: personal information, psychiatric diagnoses, criminal history, treatment received during the custodial protection period, mental condition before they finished their custodial protection program, rule violations and any re-offences within three years after the completion.
Results. Almost all subjects showed improvement in psychiatric symptoms before they finished their custodial protection program. Fifty percent of the subjects were prosecuted for re-offences within three years of completion. The male offenders with mental illnesses who violated the rules while hospitalized were most likely to commit crimes after completion of the program.
Conclusion. Psychiatric facilities can treat mental illnesses and stabilize symptoms, but there is no evidence to support the hypothesis that they can correct criminal behaviors. To ensure stability of psychiatric symptoms, psychiatric institutions may establish the follow-up programs on the patients have completed custodial protection periods.