Preventing people with signs of mental illness from committing crimes

Haunting incidents

More than 10 months have passed but Mr. Nguyen Xuan Hieu (born in 1956), residing in Vinh Tan Ward, Vinh City, is still in shock after being repeatedly attacked by his neighbor with a hammer. With a physical disability of up to 60%, after more than 20 days in the hospital, Mr. Hieu was able to return home but with a large dent on his head.

The perpetrator of the incident was Nguyen Dac Nhat (born in 1988), his longtime neighbor. Having a history of mental illness, when he heard Mr. Hieu's motorbike start, Nhat felt frustrated and uncomfortable, and caused the incident. Because he is mentally ill and has limited ability to perceive and control his behavior, Nguyen Dac Nhat was sentenced to 5 years in prison.

Although he has to carry the disability for life, now what Mr. Hieu worries about most is the day the defendant returns from serving his sentence: “My family has no grudge against Nhat, on the contrary, we sometimes give him rice and vegetables to eat. At the time of the incident, my family knew that Nhat was financially poor, so we did not ask for compensation. However, now the family is afraid that after Nhat returns from prison, there will be grudges against the family.”

It has been nearly 2 years since the heartbreaking murder, but the people of Nghia Thai commune (Tan Ky) still cannot forget the cries for help of the victims in the murder of their neighbor that left 1 person dead and 3 injured. The perpetrator is Luong Van Thao (born in 1983), residing in Nghia Thai commune, Tan Ky district. Thao has a mental illness record since 2019. However, during his life, Thao did not take medication, causing emotional and behavioral disorders leading to the heartbreaking incident above.

The above are just 2 of many cases caused by people with mental disorders.

According to the management records at the Provincial Mental Hospital in 2023, the hospital must provide and back up records related to 57 patients under management for the police to work with. In the first 6 months of 2024, this number was 21 patients.

Currently, according to the World Health Organization's classification of diseases, there are more than 300 disease codes for mental and behavioral disorders. Some common mental illnesses are schizophrenia, depression, anxiety, behavioral disorders in adolescents, dementia, alcoholism, etc. However, the number of patients managed and treated in the community in Nghe An is mainly implemented in 2 disease codes: schizophrenia and epilepsy.

Accordingly, in the province, the number of schizophrenic patients being treated in the community is currently up to more than 7,000 people, the number of epileptic patients is more than 3,000 people, mainly concentrated in localities such as Yen Thanh, Dien Chau, Quynh Luu, Thanh Chuong... Most of these patients will be examined, diagnosed, prescribed at the provincial level, then handed over to local medical centers and health stations for monitoring, management and drug dispensing.

Difficulty in management

In order to create conditions for support and rehabilitation for people with mental illness to achieve good results, Nghe An province has had many projects and policies to support funding for drug purchases for patients treated in the community. Specifically, in 2024, the amount of money supported by the province for the community mental health care program is 1.3 billion VND. Accordingly, when returning to the community, mentally ill people will be managed at grassroots health stations, and will be given medicine twice a month; families will be supported with instructions on how to use medicine for patients. Although the regimes and policies for subjects with mental illness have been guaranteed, many objective reasons have led to the potential risk of increased crime in the community.

The main reason is that people's awareness is still limited, combined with relatives' lack of skills and treatment methods, so some families neglect to manage the sick, making the disease easy to relapse and progress more and more seriously. Not only that, some households in remote areas believe that this is a demon possessing a person, so instead of taking medicine, they let the sick perform exorcism rituals. In addition, there are some cases of spontaneous mental illness, with a medical record, but due to the fear of being discriminated against, they do not go out to get medicine, causing the disease to worsen.

Doctor Tran Ngoc Linh - Head of the Line Command Department, Nghe An Provincial Mental Hospital said: For patients with schizophrenia who are managed in the community, if they take medication regularly, the patient will be 80 - 85% stable. However, for many diseases, not taking medication can easily lead to a relapse, causing negative emotions such as screaming, smashing... even harming people around. As in the case in Tan Ky district, the subject was a person with a mental illness book but was not in the category of illness code that was given medication. In addition, the family did not take the patient for timely treatment, leading to the heartbreaking incident above.

In Lang Thanh commune, Yen Thanh district, more than 30 mental patients are being managed in the community. Most of the screening and management work is done by local authorities through paperwork, while most of the work of preventing dangers from patients is left to the family and security and order forces at the grassroots level.

According to Major Dang Thanh Hoa - Head of Lang Thanh Commune Police: In reality, the management of subjects with mental symptoms in the locality is still loose, there is no close coordination between local authorities, functional departments and agencies with families of people with mental symptoms. Therefore, there are no preventive measures before people with mental symptoms carry out the actions.illegal behaviorlaw. Furthermore, for severely mentally ill patients, treatment at medical facilities depends on the family's willingness, but with high treatment costs and difficulties in moving for mentally ill patients, most of these mentally ill patients still live freely at home.

Discussing this issue, Dr. Lawyer Nguyen Trong Hai - Director of Trong Hai and Associates Law Firm LLC said: “Currently, there is no legal document stipulating that individuals and agencies must be responsible for taking people with mental illness to medical facilities for examination and treatment when the patient has not committed a crime. This compulsory treatment only applies within the scope of criminal proceedings, that is, when there are consequences of illegal acts. If in the case of a family not cooperating to prevent the risk of that person developing the disease, it is very easy to cause a heartbreaking incident. This is also a potential danger to society.”

To overcome the above shortcomings as well as to effectively manage, treat and help mentally ill people, contributing to the prevention of crimes and violations of the law caused by mentally ill people, it is necessary to have the cooperation and contribution of the whole community and society. In addition, localities and functional agencies need to support families and people with mental symptoms in monitoring and timely treating the disease to prevent the emergence of illegal acts and avoid possible unfortunate consequences.