Presentation Information
[SY-10-01]Human rights and ethical practices in Japanese forensic psychiatric wards
*Koji Takeda (National Center of Neurology and Psychiatry (Japan))
Keywords:
forensic psychiatry,violence,ethics
In Japan, individuals with mental illness who have committed serious violence in a state of lack of or diminished responsibility are subject to specialized forensic mental health services under the Medical Treatment and Supervision Act (MTSA). Treatment orders under the MTSA are divided into inpatient and outpatient categories. Approximately 90% of patients begin with an inpatient treatment order. After completing the inpatient phase, approximately 80% are transferred to an outpatient treatment order. The average duration of an inpatient treatment order is approximately 3 years. In principle, the outpatient treatment order also lasts 3 years. Consequently, the MTSA imposes substantial human rights constraints by mandating long-term patient treatment. There are 35 forensic psychiatric wards nationwide with 856 beds. Ethical considerations in forensic psychiatric wards include seeking ethics committee approval from external experts for practices such as physical restraint, forced treatment, clozapine use, and modified electroconvulsive therapy. This presentation reports on the current status, issues, and future human rights and ethics prospects in Japanese forensic psychiatric mental health services, particularly under MTSA treatment orders.