Defining outcome measures of hospitalization for assessment in the Japanese forensic mental health scheme: a Delphi study.

Akihiro Shiina,Masaomi Iyo,Yoshito Igarashi

doi:10.1186/1752-4458-9-7

Abstract

BackgroundA new legislation concerning forensic mental health was established by the Japanese Government in 2005, the “Act on Medical Care and Treatment for the Persons Who Had Caused Serious Cases under the Condition of Insanity,” or the Medical Treatment and Supervision (MTS) Act. Since it was passed, however, there has been broad controversy over Hospitalization for Assessment (HfA), the first stage of the MTS scheme.MethodsFollowing a comprehensive literature search to assemble a list of candidates, we conducted a Delphi study to establish standard outcome measures for HfA.ResultsFive Delphi rounds were conducted by 19 panelists including medical practitioners and lawyers. A total of 139 items were accepted as outcome measures for HfA based on panel agreement.ConclusionThe Delphi study established a list of HfA outcome measures for the MTS act, which will contribute to the optimization of the new forensic mental health system in Japan.Electronic supplementary materialThe online version of this article (doi:10.1186/1752-4458-9-7) contains supplementary material, which is available to authorized users.

Highlights

A new legislation concerning forensic mental health was established by the Japanese Government in 2005, the “Act on Medical Care and Treatment for the Persons Who Had Caused Serious Cases under the Condition of Insanity,” or the Medical Treatment and Supervision (MTS) Act
Such offenders were subject to Official Involuntary Hospitalization (OIH) under the Mental Health and Welfare Law, a system completely detached from the criminal justice system [5]
We encouraged the panelists to propose new items to be included as candidate Hospitalization for Assessment (HfA) outcome measures on subsequent Delphi rounds

Summary

Introduction

A new legislation concerning forensic mental health was established by the Japanese Government in 2005, the “Act on Medical Care and Treatment for the Persons Who Had Caused Serious Cases under the Condition of Insanity,” or the Medical Treatment and Supervision (MTS) Act. There is a global trend toward deinstitutionalizing patients with mental disorders, necessitating forensic mental health systems to develop [2]. Many countries have established legislation for offenders with mental disorders that link together different disciplines [3]. Japan had no specific legislation for patients with mental disorders who had violated criminal laws [4]. Such offenders were subject to Official Involuntary Hospitalization (OIH) under the Mental Health and Welfare Law, a system completely detached from the criminal justice system [5]. The OIH scheme was harshly criticized by lawyers for lack of proper legal procedures protecting patient rights, while psychiatrists

Methods

Results

Conclusion