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Chapter Law Content

Title: Mental Health Act CH
Category: Ministry of Health and Welfare(衛生福利部)
Chapter 5 Tasks of Psychiatric Medical Care
Article 35
The psychiatric care for patients shall adopt the following measures considering the severity of their illness and danger of harm:
1. Outpatient service;
2. Emergency service;
3. Full day admission;
4. Hospital day care;
5. Community psychiatric rehabilitation;
6. Home care;
7. Other methods of care.
The methods and recognition standards of home care mentioned in the preceding Paragraph shall be promulgated by the central competent authority.
Article 36
As patients are treated or hospitalized, psychiatric institutions shall explain to patients and or their protectors matters related to the illness conditions, treatment policies, aspects of prognosis, reasons for hospitalization, rights entitled to by the patients and their protectors, and so on.
Article 37
In order to protect the safety of patients, psychiatric institutions may restrict the patients’ geographical range of activities after informing the patients.
For medical purposes or the prevention of emergency violent incidents, suicide or self-injury events, psychiatric institutions may restrain patients’ bodies or limit their freedom of activities to specific protection facilities, and they shall assess the patients regularly without above measures exceeding the necessary duration of time.
For the prevention of emergency violent incidents, suicide or self-injury events, mental health care institutions other than psychiatric institutions may restrain patients’ bodies and immediately escort them to get access to medical care.
The physical restraint and limitation of activity freedom mentioned in the preceding two Paragraphs shall not be implemented through criminal restraint instruments and other unjustified means.
Article 38
When patients are in stable conditions or recover and continuous hospitalization is no longer needed, psychiatric institutions shall notify the patients or their protectors for going through discharge formalities, and shall not detain the patients without reasons.
Before the discharge of patients, psychiatric institutions shall assist patients and their protectors in formulating concrete feasible plans for rehabilitation, referral, placement, and follow-up.
The municipality and county (city) competent authorities shall establish a 24-hour mechanism for emergency psychiatric management in their jurisdictions to assist in medical care matters of escorting patients to get access to medical care and emergency placement.
Article 39
The central competent authority shall award mental health related institutions and associations for their engagement in services of patients’ community care, support, rehabilitation, and so on.
Regulations governing the qualifications and conditions, service contents, operational methods, management, and awards to the service institutions, associations mentioned in the preceding Paragraph, shall be promulgated by the central competent authority in collaboration with the central competent authorities of social affairs, labor, and education.
Article 40
The municipality and county (city) competent authorities may, by themselves or by entrusting relevant professional institutions and associations, assess patients’ needs of care and on the basis of need refer the patients to appropriate institutions or associations for services; the severe patients reported in accordance with provisions of Paragraph 3, Article 29, shall be provided with services of community care, support, rehabilitation, and so on.
Article 41
Regarding severe patients harming others or themselves or having the danger of harm, who have been diagnosed by specialist physicians such that it is necessary for them to be hospitalized full day, their protectors shall assist the severe patients to go to psychiatric institutions for going through hospitalization formalities.
When the severe patients mentioned in the preceding Paragraph refuse to accept full day hospitalization, the municipality and county (city) competent authorities may designate psychiatric institutions to enforce emergency placement and assign them to more than two specialist physicians designated by the municipality or county (city) competent authorities for mandatory examination. However, in offshore islands, the mandatory examination may be conducted by one specialist physician.
When there is still necessity of full day hospitalization according to the result of the mandatory examination mentioned in the preceding Paragraph, and when asked for their opinions the severe patients still refuse to accept hospitalization or are unable to express their decisions, the designated psychiatric institutions shall immediately fill out the mandatory hospitalization basic information and reporting sheets, attach documents of the opinions of the severe patients and their protectors and other relevant diagnosis certificates, and file application to the Review Committee for its permission of mandatory hospitalization; the decision of whether mandatory hospitalization is approved shall be served to the severe patients and their protectors.
The emergency placement in Paragraph 2 and application for permission of mandatory hospitalization in the preceding Paragraph shall be performed by the designated psychiatric institutions entrusted by the municipality and county (city) competent authorities; regulations governing the procedures, necessary documents, other matters to be complied with for emergency placement and the application of mandatory hospitalization shall be promulgated by the central competent authority.
Article 42
The duration of emergency placement shall not exceed five days and the attention shall be paid to the protection of rights and interests of severe patients and the engagement in necessary treatment; mandatory examination shall be completed in two days counted from the date of emergency placement. The emergency placement shall be terminated when shown by the examination there is no necessity of mandatory hospitalization or when the permission of mandatory hospitalization is not obtained in the aforementioned five-day duration.
The duration of mandatory hospitalization may not exceed sixty days; however, it may be extended, if the examinations by two or more specialist physicians designated by the municipality or county (city) competent authorities find the extension necessary and the case is reported to and granted permission by the Review Committee. The duration of extension is limited to sixty days each time. During the period of mandatory hospitalization, if the conditions of the severe patients improve and the continuity of mandatory hospitalization is no longer necessary, the designated psychiatric institutions shall immediately go through the discharge formalities for them and notify immediately the municipality or county (city) competent authorities. On the expiration date of the mandatory hospitalization or as the Review Committee finding it unnecessary to continue mandatory hospitalization, the same rule applies.
The severe patients subject to emergency placement or mandatory hospitalization or their protectors may petition the court for the ruling of ceasing the emergency placement or mandatory hospitalization. Those severe patients or their protectors who refuse to accept the rulings may appeal within 10 days counted from the date the ruling is served. No further appeal may be filed against the appeal court’s ruling. During the period of petitioning and appealing, the emergency placement or mandatory hospitalization of the severe patients may continue.
During the periods of petitioning and appealing mentioned in the preceding Paragraph, if the court decides that there is necessity of protecting the severe patients’ rights and interests it may rule for a certain preliminary emergency management. No appeal may be taken against the ruling of emergency management.
Public interests associations for the promotion of patients’ rights recognized by the central competent authority may conduct case monitoring and review of mandatory treatment and emergency placement; if they find events of impropriety, applying the provisions of Paragraph 3 mutatis mutandis they shall immediately notify the individual competent authorities with jurisdiction to take improvement measures, and based on the consideration of the best interests of severe patients they may petition the court for the ruling of ceasing the emergency placement or mandatory hospitalization.
The petitions in Paragraph 3 and the applications in Paragraph 3 of the preceding Article may be filed by means of electronic transmissions, fax facsimile, or other scientific and technological equipment.
Article 43
Specialist physicians with one of the following Subparagraphs’ conditions may not conduct the examinations as prescribed in Paragraph 2 of Article 41 and Paragraphs 1 and 2 of the preceding Article:
1. they themselves are patients;
2. they are protectors or interested persons of the patient.
Article 44
When necessary, the central, municipality, and county (city) competent authorities may scrutinize the practices of mandatory hospitalization performed by the designated psychiatric institutions, or order them to provide reports of relevant practices. The designated psychiatric institutions may not refuse.
The central, municipality, and county (city) competent authorities may entrust relevant institutions or associations to conduct the review of reports and scrutiny of the practices mentioned in the preceding Paragraph.
Article 45
When severe patients do not comply with medical orders and as a result their illness conditions becomes unstable or there is danger of regression of their daily functions, and have been diagnosed by specialist physicians to be in the necessity of receiving community treatment, their protectors shall assist the severe patients to receive community treatment.
When the severe patients of the preceding Paragraph refuse to accept community treatment and the specialist physicians designated by the municipality or county (city) competent authorities diagnose that community treatment still is necessary, and the severe patients refuse to accept community treatment or are unable to express their decisions, the designated psychiatric institutions shall immediately fill out the mandatory community treatment basic information and reporting sheets, attach documents of the opinions of the severe patients and their protectors and other relevant diagnosis certificates, and file application in advance to the Review Committee for its permission of mandatory community treatment; the decision of whether mandatory community treatment is approved shall be served to the severe patients and their protectors.
The duration of mandatory community treatment shall not exceed six months; however, it may be extended, if the examinations by one specialist physician designated by the municipality or county (city) competent authorities find the extension necessary and the case is reported to and granted permission by the Review Committee. The duration of extension is limited to one year each time. During the period of mandatory community treatment, if the conditions of the severe patients improve and the continuity of mandatory community treatment is no longer necessary, the institutions and associations performing mandatory community treatment shall immediately cease mandatory community treatment and notify immediately the municipality or county (city) competent authorities. On the expiration date of the mandatory community treatment or as the Review Committee finding it unnecessary to continue mandatory community treatment, the same rule applies.
Public interests associations for the promotion of patients’ rights recognized by the central competent authority may conduct case monitoring and review of mandatory community treatment; if they find events of impropriety, applying the provisions of Paragraph 3 mutatis mutandis they shall immediately notify the individual competent authorities with jurisdiction to take improvement measures.
The applications in Paragraph 2 may be filed by means of electronic transmissions, fax facsimile, or other scientific and technological equipment.
Article 46
Items of mandatory community treatment are listed below, some of which may be combined in implementation:
1. Pharmaceutical therapy;
2. Testing of pharmaceutical concentrations in blood or urine;
3. Screening for alcohol or other addictive substances;
4. Other measures that can prevent deterioration of illness conditions or can promote patients’ life-adapting functions.
Mandatory community treatment may be performed without informing the severe patients; and, if necessary, the police agencies or fire-fighting agencies may be contacted and asked for assistance in the execution.
Regulations governing the diagnosis conditions of severe patients, methods, application procedures, necessary documents, qualifications and conditions of the performing institutions and associations, management, and other matters to be complied with for the mandatory community treatment as mentioned in Paragraph 1, shall be promulgated by the central competent authority.
Article 47
For the needs to treating mental illness, after designing a protocol which is then proposed to, collaboratively reviewed and approved by relevant medical science and technology workers, legal experts, and social workers, teaching hospitals may perform the specific treatment modalities list below:
1. Psychiatric surgical operations;
2. Other special treatments modalities promulgated by the central competent authority.
Article 48
When in the period of performing the special treatment modalities mentioned in the preceding Article, the teaching hospitals shall submit treatment reports to the central competent authority; if the central competent authority finds any danger to safety, the teaching hospitals shall immediately terminate the said treatments.
Article 49
Under patients’ emergency conditions and with one specialist physician’s recognition of necessity and after obtaining consent pursuant to Article 50, psychiatric institutions may perform the following treatment modalities:
1. Electroconvulsive therapy;
2. Other special treatments modalities promulgated by the central competent authority.
Article 50
Psychiatric institutions performing the treatment modalities mentioned in Article 47 and the preceding Article shall exercise the medical duty of care in good faith and only after explanation and obtaining consent in writing pursuant to the following provisions may they perform the treatment modalities:
1. If the patents are adults, consent shall be made by them. However, in the case of severe patients, consent may be made only by their protectors.
2. If the patients are minors under seven years of age, consent shall be made by their proxy designated by law.
3. If the patients are minors above seven years of age, consent shall be made by them and the proxy designated by law. However, in the case of severe patients, consent may be made only by their protectors.