'Gaps' in the management of people with mental illness

(Baonghean) - The number of mentally ill individuals committing crimes has been increasing recently, especially serious crimes. How to prevent and deter criminal behavior and better manage this group within the community remains a challenge.

The distressing issue of mentally ill people committing crimes.

The residents of Hamlet 11, Nghi Xa Commune (Nghi Loc District) still cannot forget the death of Mr. Hoang Van Chau, who was stabbed multiple times in his own home on May 20, 2016. The perpetrator was none other than Hoang Van Nhat (born in 1990), his son. Mr. Chau's death shocked and worried everyone because Nhat suffered from mental illness. The family had taken Nhat to the Nghe An Psychiatric Hospital for treatment for some time, but when the treatment was nearing its end, they requested to take him home for fear of being added to the local mental health registry. Unexpectedly, one dark night, Nhat used a knife to kill his own father.

In Hamlet 1, Nghi Cong Nam Commune, Nghi Loc District, the family of Ms. Tran Thi Yen (born in 1963, residing in Hamlet 1, Nghi Cong Nam Commune) has two members suffering from mental illness: Ms. Yen and her eldest daughter. Currently, both mother and daughter are receiving outpatient treatment at home. While Ms. Yen is more lucid and able to do some chores around the house, her daughter, Pham Thi Hoa, is unable to work. Despite taking her medication regularly, her temperament remains extremely erratic. One evening in May 2016, during a psychotic episode, she attacked her sleeping brother with a knife. Fortunately, her brother only suffered a hand injury.

Severely mentally ill patients are treated at the Provincial Social Welfare Center.

At a meeting of the Provincial People's Council in early July 2016, Colonel Nguyen Huu Cau, Director of the Provincial Police, stated that the issue of individuals lacking civil capacity is causing many tragic cases and is becoming increasingly complex. In the first six months of 2016 alone, there were 12 murder cases, including those involving mentally ill individuals who killed family members.

According to Colonel Nguyen Huu Cau, investigating these cases is extremely difficult due to legal obstacles. Prior to 2013, if a murder suspect was mentally ill or suspected of being mentally ill, the provincial police and People's Procuracy would process the paperwork within 5 days and send the case to the provincial psychiatric hospital for assessment, treatment, and diagnosis. However, the central government now stipulates that the case must be sent to Hanoi, and it takes up to 6 months for assessment. This lengthy process creates difficulties for the police in managing these suspects.

On the other hand, if some relatives and family members continue to distance themselves or discriminate against the defendants after they return from treatment, their condition may relapse and pose a potential danger to the community. According to regulations, even if they commit serious crimes, those with severe mental illness will not be held responsible for their actions. Therefore, when a case occurs, the investigating agency must request a psychiatric evaluation. If the conclusion is that the subject's illness does not warrant criminal responsibility, the Procuratorate will issue a decision not to prosecute, along with a mandatory treatment order. The investigating agency will then arrange for their treatment until they are stable, before handing them over to their family and local authorities.

Shortcomings in management

Currently, over 95% of mentally ill individuals are being managed, monitored, and treated at home. However, entrusting this responsibility to families is extremely difficult and poses many risks to the community. Mr. Vo Van Tue (Hamlet 2, Nghi Xa Commune, Nghi Loc District) has suffered from mental illness for nearly 20 years. Because he is being cared for by relatives, Mr. Tue is not eligible to be admitted to the Provincial Social Welfare Center. However, due to the unpredictable nature of his condition, his family has had to confine him to the old house left behind by his parents. Ms. Dang Thi Phuong (Mr. Tue's sister-in-law) said: "The family really wants to take him to a center, but we don't have the means. Every time he has an episode, he destroys things, wanders around, and causes accidents for himself. It's only out of desperation that the family has to confine him..."

Ms. Nguyen Thi Viet (on the left - Nhat's mother) recounts the events of her son's criminal act.

Mr. Nguyen Dang Duong, Deputy Director of the Department of Labor, War Invalids and Social Affairs, said: "Managing this group is very difficult because most families are in difficult circumstances, and their ability to care for and treat them is very limited, so the illness worsens. When this person has an episode, the family has no way to prevent or stop it. And the family often has to chain or shackle them."

Currently, there is no legal document specifying who or which agency is responsible for bringing mentally ill individuals to treatment facilities before they commit a crime. Compulsory treatment is only applied during the investigation phase, as decided by the competent authority, meaning only after the consequences of a criminal offense have occurred. Many other mentally ill individuals receive no supervision, with only their families providing care and treatment. The issues of preventing horrific crimes committed by mentally ill individuals, holding them accountable when they commit crimes, and compensating victims for damages are not easy to answer.

Fearing that Mr. Tue might harm himself or others, his family has kept him confined to the house for many years.

Dr. Phan Kim Thin, Director of the Nghe An Psychiatric Hospital, stated: There are nearly 500 types of mental illness, of which 15% are chronic and difficult to cure, while the remaining 85% are treatable if detected and treated early. According to the plan, Nghe An receives 960 million VND annually from the central government, in addition to provincial funding, to provide free medication for patients. However, this year, the hospital has not yet received funding and is currently relying on outpatient treatment funds. These funds will run out by the end of September, after which the hospital will have to become self-sufficient.

Pham Bang