Friday, July 26, 2013

The MTS act and suicide (1)

Yesterday, Ms. Eiko Asano reported about the number of suicidal cases on the Medical Treatment and Supervision Act.

Nara no Koe: Thirty six suicidal cases for 8 years on the MTS act (in Japanese)

The Medical Treatment and Supervision Act (the MTS act) is a new legislation of forensic mental health enforced in 2005 in Japan. Its official name is “The Act on Medical Care and Treatment for Persons Who Have Caused Serious Cases under the Condition of Insanity”. The purpose of this law is to rehabilitate the offender with mental disorders. Based on this scheme, offenders with mental disorders who committed a serious case under the dominant influence of mental disorders are to be treated by designated hospitals.

According this article, a total of 36 patients under the MHS act have committed suicide during 8 years. This number is reliable because it is based on a presentation by government officials. It is also consistent with information I heard in the past.

Some people claim that the MTS act is inappropriate referring to the number of suicidal cases. They criticize the program to make the patient reflective to his own crime performed at a designated hospital. I wonder that they imagine that the therapist force the patient to be full of remorse for the crime. Nonsense idea!

Indeed, reflection program is one of the techniques in forensic mental health. However, the purpose of it is not to harm the patients. Confrontation to the crime is a necessary stage for the offenders to overcome his behavior. Meanwhile, the patients learn how to deal with his mental symptom not to let it deteriorate through the program. Traditionally, mental health practitioners have avoided talking about the crime of the patient. Therefore, patients could not consult anyone about his offense with honesty. The rich structure and staffs on the MTS act have realized it for the first time.

We also have to deal with the number of the suicide cases quite carefully. Most people who criticize the MTS act seem not to allow any suicidal cases. Of course suicide is the worst scenario for anyone concerned. However, suicidal accident is inevitable in mental health practice. I have some suicidal cases each of which is extremely miserable. Nevertheless, I must not abandon mental health practice, for a lot of patients are waiting for me calling for help.

Then, is it true that the suicide rate on the MTS act is high?

(To be continued)

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