New legislation for offenders with mental disorders in Japan

Nakatani, Yoji; Kojimoto, Miwa; Saburo, Matsubara; Takayanagi, Isao

doi:10.1016/j.ijlp.2009.10.005

Cited by 41 publications

(33 citation statements)

References 3 publications

(4 reference statements)

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“…Up until 2005, mentally disabled persons who had committed a serious offence were treated under the framework of general psychiatry in Japan [13]. This was a unique situation, particularly when compared with European nations; for example, the German Penal Code, revised in 1933, specifies that those who are found incompetent to stand trial or declared not criminally responsible, as well as those who are considered to have diminished responsibility and who may be expected to commit further serious crimes, are placed involuntarily in forensic hospitals.…”

Section: Discussionmentioning

confidence: 99%

“…According to official statistics published in 2008 [22], a total of 3,937 offenders with mental disorders were detained in hospital as of 31 December 2008 in England and Wales, the population of which was approximately half that of Japan. In Germany, which has a population roughly two-thirds of Japan’s, 6,287 inmates were reported to be receiving treatment in forensic hospitals in 2008 [13]. Even though it is increasing, the small number of offenders under inpatient treatment order in Japan is believed to be partly attributable to the stringent conditions for commencement of the MTSA system, which is aimed at only those who are referred to the system by the public prosecutor and who meet the three criteria described in the Background.…”

Section: Discussionmentioning

confidence: 99%

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Development of forensic mental health services in Japan: working towards the reintegration of offenders with mental disorders

Fujii

Fukuda

Ando

et al. 2014

Int J Ment Health Syst

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BackgroundUntil the recent enactment of the Medical Treatment and Supervision Act (MTSA) in 2005, neither legislations nor facilities for mentally disordered offenders were available in Japan. The aim of the country’s forensic mental health services, based on this new law, is to improve the social reintegration of mentally disordered offenders. In order to provide optimal psychiatric care to these individuals, specialised court proceedings, treatment facilities, and concrete guidelines have been established. The aim of this study was to review the current status of the new system and to clarify future challenges for improving services.MethodsThe authors collected official statistics regarding the new system published separately by the Ministry of Health, Labour and Welfare, the Ministry of Justice, and the Supreme Court of Japan. We aggregated the data and examined the system’s current implementation status, nationwide.ResultsThere were 2,750 requests for enrolment in the MTSA system between its initiation in 2005 and 31 December 2012. Of those requests, 2,724 cases had been concluded in court. In 63.1% of the cases, an inpatient treatment order had been made; 82.4% of those inpatients were diagnosed with schizophrenia. By the end of March 2012, two patients completing treatment under the MTSA had re-committed a serious offense. While overall designated inpatient and outpatient treatment facilities have reached national targets in terms of resources and beds available, a regional gap in MTSA designated facilities remains and the number of patients under inpatient treatment order is on the increase.ConclusionsOverall, the MTSA system has been running smoothly without encountering any serious problems. However, several concerns have emerged, such as the accumulation of patients under inpatient treatment order and insufficient regional resources. To more successfully promote the reintegration of mentally disordered offenders, improvements in outpatient treatment and welfare services are crucial. In order to install effective measures to help improve the system, a nationwide database of patients being treated under order of the MTSA should be properly built and maintained.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Development of forensic mental health services in Japan: working towards the reintegration of offenders with mental disorders

Fujii

Fukuda

Ando

et al. 2014

Int J Ment Health Syst

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“…In Japan, clinical psychiatry evolved without a formal forensic mental health system [2], leaving psychiatrists to develop their own evaluations and assessments of forensic psychiatric needs, as a natural part of everyday clinical practice. So, to varying degrees, forensic psychiatry is commonly practiced in Japan, but outside of the national formal framework.…”

Section: Discussionmentioning

confidence: 99%

“…For many years, Japan had no specific legal provisions for offenders with mental disorders [2]. In 2005, Japan enforced a new law entitled the "Act on Medical Care and Treatment for Persons Who Have Caused Serious Cases under the Condition of Insanity", shortened to the Medical Treatment and Supervision (MTS) Act.…”

Section: Introductionmentioning

confidence: 99%

No change of attitude toward forensic psychiatry: 5 years after the Medical Treatment and Supervision Act in Japan

Shiina¹,

Okita²,

Fujisaki³

et al. 2013

OJPsych

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“…Until the recent enactment of the Medical Treatment and Supervision Act (MTSA) in 15 July 2005 (1), neither legislation nor facilities for offenders with mental disorders were available in Japan (see the following site for recent information of the MTSA by the Ministry of Health, Labour, and Welfare, Japan: ). The aims of the MTSA are to improve symptoms of clinical offenders, who are defined as patients committing criminal acts because of their mental health status, to prevent them from re-offending and to promote their rehabilitation into local communities by providing them with adequate support systems for continuous and appropriate medical care.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Problematic Behaviors among Forensic Outpatients under the Medical Treatment and Supervision Act in Japan

et al. 2016

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The Medical Treatment and Supervision Act (MTSA) was enacted in 2005 in Japan to promote the reintegration of clinical offenders with mental disorders into society. Under the MTSA, individuals who committed serious crimes in a state of insanity or diminished responsibility are diverted from the criminal justice system to the mental health system. Based on court decisions about MTSA-based treatment, clinical offenders have an obligation to engage in rehabilitation within their local community under the guidance of mental health professionals. However, patients under MTSA-based clinical treatments have faced various problems in the course of treatment, because of psychiatric as well as other static or dynamic factors, and sometimes have committed problematic behaviors, such as violence and medical non-compliance. Hence, this study aimed to clarify factors related to patients’ inclusion in MTSA-based outpatient treatment and additionally, their commitment of problematic behaviors, based on confidential data acquired during a four-year government survey period (National Center of Neurology and Psychiatry) from MTSA enactment (July 15, 2005) to December 31, 2009. In total, we recruited 441 clinical offenders receiving MTSA-based outpatient treatment from 158 nationwide facilities. To evaluate related factors, we collected demographic, psychiatric, forensic, clinical treatment, and social service information. Statistical analyses demonstrated that predominant profiles of patients included male gender, younger age, low school history, psychiatric diagnoses (F1, F2, and F3), and no correctional or outpatient history before MTSA-based treatment. F1 or substance use diagnosis, in particular, was increasingly correlated with other factors, such as male gender, older age, and correctional history before MTSA treatment. Among the 441 patients, 189 (43%) committed problematic behaviors in the course of the MTSA-based outpatient treatment. Risk factors for patients’ commitment of problematic behaviors comprised F1 diagnosis and inpatient history before MTSA-based treatment inclusion. In summary, reduction of overall problematic behaviors under the MTSA outpatient likely makes progress by focal attention to patients with psychiatric disorders caused by substance use and/or a past inpatient history for more severe psychiatric symptoms. This work is of ongoing and future importance in the domain of forensic community treatment, to connect risk-enhancing factors with risk management.

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New legislation for offenders with mental disorders in Japan

Cited by 41 publications

References 3 publications

Development of forensic mental health services in Japan: working towards the reintegration of offenders with mental disorders

Development of forensic mental health services in Japan: working towards the reintegration of offenders with mental disorders

No change of attitude toward forensic psychiatry: 5 years after the Medical Treatment and Supervision Act in Japan

Risk Factors for Problematic Behaviors among Forensic Outpatients under the Medical Treatment and Supervision Act in Japan

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