Violence by released mental patients increases

Gaping holes in the medical law are becoming increasingly apparent with a recent uptick in mental disorder-related crimes.

Last Sunday, a 41-year-old man suffering from schizophrenia murdered a police officer in Yeongyang County, North Gyeongsang, and it was later discovered that he had not received any additional treatment for his disorder after being discharged from a psychiatric hospital at the end of May.

The number of violent crimes committed by people suffering from mental disorders increased to 847 cases last year from 540 in 2012. This month alone, in addition to the Yeongyang murder, a 35-year-old man strangled his 69-year-old mother to death last Friday in northern Seoul and a 48-year-old man threatened a doctor in a psychiatric ward with a hammer in Gangneung, Gangwon, on the same day. All three were suffering from schizophrenia.

Analysts are now questioning a revision to the Mental Health and Welfare Law in May 2017 that made it more difficult for people suffering from mental disorders to be admitted to psychiatric hospitals - and widened the criteria for allowing their discharge. More crucially, the change in the law gives more control to people with disorders, effectively forbidding hospitals from admitting patients against their will.

The problem, of course, is that the patients may lack the clarity to make sound judgments about their own mental health and their need for supervision. In the Yeongyang murder case, the alleged murderer, whose name has not been disclosed, had been admitted and discharged from a mental hospital in nearby Cheongsong County ten times over the course of six years.

Despite having served an 18-month jail sentence for manslaughter in 2011 after fatally assaulting a street sweeper, the man was judged by the hospital to be able enough to make decisions about his own condition over and over again. A spokesman for the hospital said that the patient insisted on being discharged in May despite pleas from his mother to stay longer and him regularly refusing to take medication.

Last Sunday, the Yeongyang police station received an emergency call from the man’s mother, who said her son was at their house uncontrollable. Police inspector Kim Seon-hyun went to the house with a co-worker and was stabbed in the neck with a knife by the man.

“If people with schizophrenia are not treated on time or are socially isolated for an extended period of time,” said Lee Myung-soo, a spokesman for the Korean Society for Schizophrenia Research, “they are likely to have persecutory delusions and exhibit dangerous behavior.”

The revised law stipulates that local health clinics and mental health facilities must be informed when a patient is discharged from a mental hospital so that follow-up care can be provided. But this again requires consent from the patient, which the suspect in the Yeongyang police murder did not agree to.

According to the Ministry of Health and Welfare, the number of patients admitted to hospitals nationwide for mental disorders has decreased to 66,523 this April from 69,162 in December 2016 before the change to the law. The percentage of forced admittances - cases in which patients are judged to be unable to decide on their own - in the same period decreased from 61.6 percent to 37.1 percent.

Last year’s decision to revise the mental health law, which has been in effect since 1995, was largely an attempt to protect the human rights of patients suffering from mental disorders and was heavily influenced by the UN Convention on the Rights of Persons with Disabilities.

Analysts say alternatives to hospital care, particularly post-discharge oversight, remains inadequate largely due to a lack of personnel or facilities. Fifteen administrative districts do not have mental health care centers, while many more lack auxiliary facilities and services like rehabilitation centers.

BY SHIM KYU-SEOK [shim.kyuseok@joongang.co.kr]