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從觀龍樓事件到英國的第 136 款

2016/7/18 — 17:02

觀龍樓火警 (無綫新聞截圖)

觀龍樓火警 (無綫新聞截圖)

西區觀龍樓獨居精神病患者對鄰居縱火,做成4死,社會表現關注。患者有多次傷人紀錄,因聽收音機聲浪過高滋擾鄰居,常遭投訴,男事主與其爭吵,雙方積怨近三年。可以想像,社區精神健康協作計劃和警察都沒有能力處理這類紛爭,導致最終慘劇發生。事件引出一個問題,精神病者的社區照顧和警察的角色。

在香港,如果居民感到受精神病患者滋擾,可致電區內的社區精神健康協作計劃隊。社區精神健康協作計劃(Community Mental Health Intervention Project)簡稱CoMHIP為2006 – 07年度施政報告內的一項建議。服務目標為提供介入服務協助社區內懷疑有精神健康問題的人士及其家屬。這些協作計劃隊由各非政府組織申請社署資助而成立。它們沒有實權,但它們會派出社工上門,若社工認為事件嚴重,他們可聯絡駐精神科醫院的社區精神科小組(CPT)跟進。社區精神科小組由精神科醫生和護士組成。精神科醫生可根據《精神健康條例》將有需要患者送院,期間會尋求警方協助。

在香港,強制送院的權力並非在醫生,而是法院。法官有權,根據精神科醫生的建議,將患者送院,不得超過七天。就算醫生根據1A入紙申請,法官未必照單全收。

廣告

香港的警察在《精神健康條例》中沒有特定角色,因而警察在接獲觀龍樓的類似投訴,通常不會做嘢。

CPT的資源極之有限,每次出動勞師動眾,每隊約5人,擾攘大半天。香港市民對這類社區滋擾實在投訴無門,聽天由命。

廣告

英國的 Section 136

英國的國會剛剛在16日討論了這一問題。在英國,警察直接得多,他們可以將被懷疑有危害性的精神病患者送到安全地方,為期不超過3天。但問題是,他們的權力只限於在公眾地方發生的事。2011-12年,英國警察根據136條,拘留了23,500人。國會議員表示,曾經有好心的警察以136條帶走了一個有明顯自殺傾向的患者,但警局坐堂幫不肯落案。好心的警察只好將他帶到其親戚的家裡,結果那人在翌日自殺。有3成的第136條個案是在其家門外執行的。警察想方設計引透對方踏出家門,再行拘捕。英國正考慮是否刪去“在公眾地方”的要求。在愛爾蘭,警察沒有這一限制。

後記

英國的國會辯論反映香港的處境。正反雙方的觀點環繞著,一,這不是警察的工作,警察不會判斷精神病;二,警察已有其他的權力處理相類問題。

但正如爭取修例的英國議員所言,本來可以在兩個鐘頭解決的,由於要傳召精神科醫生到場,結果花了5小時。香港如是,在資源是有限的情況下,社會應該三思。

附錄
 Mental Health Act (UK)
136  Mentally disordered persons found in public places.

(1)If a constable finds in a place to which the public have access a person who appears to him to be suffering from mental disorder and to be in immediate need of care or control, the constable may, if he thinks it necessary to do so in the interests of that person or for the protection of other persons, remove that person to a place of safety within the meaning of section 135 above.

(2)A person removed to a place of safety under this section may be detained there for a period not exceeding 72 hours for the purpose of enabling him to be examined by a registered medical practitioner and to be interviewed by an [F1approved mental health professional] and of making any necessary arrangements for his treatment or care.

[F2(3)A constable, an approved mental health professional or a person authorised by either of them for the purposes of this subsection may, before the end of the period of 72 hours mentioned in subsection (2) above, take a person detained in a place of safety under that subsection to one or more other places of safety.

(4)A person taken to a place of a safety under subsection (3) above may be detained there for a purpose mentioned in subsection (2) above for a period ending no later than the end of the period of 72 hours mentioned in that subsection.]

《精神健康條例》 (香港)

條: 31 接受觀察病人的羈留 L.N. 29 of 1999 01/02/1999

(1) 凡基於下述理由,可向區域法院法官或裁判官申請將某名病人羈留以作觀察的命令─

(a) 該病人患有精神紊亂,而其精神紊亂的性質或程度,足以構成理由將他羈留在精神病院內至少一段有限的期間,以接受觀察(或接受觀察後再接受治療);及

(b) 為該病人本身的健康或安全,或是為保護他人著想,應該將該病人如此羈留。

(1A) 凡申請命令將某名病人羈留以作觀察,須基於一名註冊醫生以訂明表格提供的書面意見,

而該醫生在作出意見前7天內須曾經檢查該病人,而其意見須包括下述各項─

(a) 一項表示該醫生認為第(1)款所載條件已獲符合的陳述;

(b) 訂明詳情,列舉與第(1)(a)款所載條件有關的意見所基於的理由;及

(c) 一項列舉與第(1)(b)款所載條件有關的意見所基於的原因的陳述。

(1B) 在接獲根據第(1)款所提出的申請後,區域法院法官或裁判官可以訂明表格作出命令,授權將病人移往精神病院,以作羈留和觀察,由作出命令之日起計(並包括該日在內)為期不超過7天。

(2) 上述每項命令均具有效力,授權申請人及每名公職人員在每宗個案中按情況所需的協助下,使用合理所需的武力,將該病人移往精神病院,又不論因任何原因,如將該病人立即移往精神病院並不切實可行,則將該病人羈留在安全地方,為期不超過48小時。

(3) 凡在區域法院法官或裁判官裁定是否要根據第(1B)款作出命令之前,病人請求見該區域法院法官或裁判官,則─

(a) 該區域法院法官或裁判官在接見該病人前,不得作出該命令;及

(b) 為施行第(1A)款而曾提供意見的註冊醫生所簽發以證明該病人是否曾作上述請求的證明書,即成其所載事項的足夠證據。

(4) 院長可將屬根據本條或第32條作出的命令的標的之人羈留在精神病院內,以接受觀察、調查和治療。

社區精神健康協作計劃

張建宗答立法會問:

『社會福利署於二○○九至一○年度,獲撥款5,900多萬元,為精神病康復者及懷疑有精神健康問題人士和他們的家屬/照顧者提供以下四項社區精神健康支援服務:

(a) 社區精神健康協作計劃(下稱「協作計劃」);
(b) 社區精神健康照顧服務;
(c) 社區精神健康連網;及
(d) 精神病康復者訓練及活動中心

協作計劃的服務對象為懷疑有精神健康的人士,其餘三項服務則為精神病康復者及家人/照顧者而設。

服務隊伍/單位數目方面,協作計劃及社區精神健康照顧服務各設有十一隊服務隊伍,為全港各區提供服務。社區精神健康連網則設有二十五個連網點,分布全港。而五個精神病康復者訓練及活動中心的服務範圍亦覆蓋全港。

社署在二○○九年於天水圍區重整上述四項及其他相關的社區精神健康支援服務,設立了首間精神健康綜合社區中心,為區內精神病康復者及懷疑有精神健康問題的人士提供一站式的社區支援服務。在二○一○至一一年,社署會透過集結現有的社區精神健康支援服務資源,加上每年額外撥款約7,000萬元,重整社區精神健康支援服務,把精神健康綜合社區中心的服務模式推展至全港十八區。』

英國國會辯論(片斷)

Detention under Mental Health Act

14 July 2016

Volume 613

House of Commons

​At the inquest, the coroner had no hesitation in agreeing with Professor Keith Rix, who was called to give expert evidence, that Mr Middleton fell into a category of mentally disordered persons for whom there is no appropriate provision under the Act.

I am reliably informed that in the Republic of Ireland, the Garda Siochana have a clear operational advantage in that, under section 12 of Ireland’s Mental Health Act, 2001, where there is

“a serious likelihood of the person causing immediate and serious harm to himself or herself or to other persons”,

a garda can

“enter…any dwelling or other premises or any place if he or she has reasonable grounds for believing that the person is to be found there.”

10 years between 1997-98 and 2007-08, admissions to hospital as a place of safety increased from 2,237 to 7,035. T

It was calculated that 17,417 people were detained under section 136 in 2005-06. By 2011-12, the overall number of incidences of its use was recorded as 23,500.

London-based social services authority’s audited figures indicated that some 30% of section 136 arrests were recorded as having been made at or, just outside, the detainee’s home.

One argument against the amendment that I am suggesting is that the police already have sufficient powers. It is quite clear, from my own observation, that that is basically incorrect. The second argument is that it would extend the right of the police to enter people’s private properties.

“in a place to which the public have access”.

It is important that we work together. I give my hon. Friend a commitment that if we cannot get this right using the measures that we are working on, an amendment to section 136 might be exactly what we need.

I do not want the police to be seen, yet again, to be picking up something that another Department needs to address. That is what has happened over the years

發表意見