美國精神疾病犯罪者司法處遇之介紹與借鏡──美國精神衛生法庭之探究

Introducing Judicial Treatment on Criminals with Mental Disorders in the United States - What Lessons Can We Learn from American Mental Health Courts?

因應當前我國司法實務對於處理精神疾病患者觸犯刑事法令之案件時所面臨之挑戰，本文希望透過美國法系的視角，探討美國晚近對於精神疾病患者觸法時的司法判例與審判標準、實務政策以及美國精神衛生法庭之運作，是否有值得我國參採之處。綜觀美國法制與實務之經驗，本文提出數點建議如下：刑事司法系統秉持特別預防的治療而非應報的思維、轉向處遇的治療成效比監禁措施更能得到預防再犯的效果、發展結構式犯罪風險量表以提供不同層級之治療服務、針對每位參加精神衛生法庭的精神疾病犯罪者制訂個別化治療計畫、成立司法精神病院以收容嚴重精神疾病障礙患者、個案即使離開機構性治療，仍須及時銜接治療和康復服務。

In response to the current challenges faced by Taiwan's judicial practice in dealing with criminals with mental disorders, this article aims to explore the recent judicial precedents, trial standards and practical policies for the treatment of offenders with mental illness in the United States. Specifically, this article pays more attention to introduce the procedures, the operations, and the content of treatment of the Mental Health Courts in the states of New York and Utah, respectively. Based on the review of literature derived from experiences of the U.S. legal system and judicial practice, several policy implications have been proposed to Taiwan's judicial authorities as follows: the criminal justice system should uphold specific preventive treatment rather than retribution philosophy for those offenders with mental illness; the alternative to the treatment can be more effective than imprisonment to prevent recidivism; the structured crime risk scales should be developed to provide different levels of treatment services for those mental offenders; the individualized treatment plan should be established for each criminal offender with mental illness while upon the mental health courts; the judicial psychiatric hospitals should be built to accommodate patients with severe mental illness; and the treatment and rehabilitation services must be seamlessly provided in time after those leaving psychiatric institutions.