Study On Forensic Psychiatric Expertise Cases Before And After The Implementation Of "China Mental Health Law"

BackgroundIt was on May 1,2013, in the process of 30-year legislation, that Mental Health law of the People’s Republic of China was officially carried out. "The Mental health law" aimed to solve the medical care and security problems of modern people with mental disorders and mental stress by means of state intervention, increasing investment in early society. Mental health law is mainly to protect the legitimate rights and interests of the vast number of mental patients and ensure that the troublemaking patients with severe mental disorders will not do harm to themselves, to the society and to any other people due to neglect of duty. With the development of Psychiatry, changes in mental disease diagnosis, classification system, diagnosis appraisal, responsibility assessment criteria have taken place and forensic psychiatric expertise has presented many new changes. Therefore, to explore the characteristics of forensic psychiatric expertise cases in the new era from the perspective of Mental Health Law have been of actual importance both theoretically and practically.ObjectivesBefore and after the one-year analysis of the Mental Health Law status and characteristics of forensic psychiatric assessment cases to investigate the impact of the implementation of the Mental Health Law of forensic psychiatric expertise, and seek to improve the identification of quality measures.MethodsFrom May,1,2012 to April 30,2014, the Judicial Department of the Eighth Hospital of Zheng zhou city have made 406 cases evaluations in total, among which cases assessed from May 1,2012 to April 30,2013 as Group A (183 cases) and from May 1,2013 to April 30,2014 as Group B (223 cases) using self-made questionnaires to do the following:to make comprehensive evaluations of two groups, to analyze the current situation and characteristics of the two-groups cases, to authenticate the medical conclusions, types of cases and the relevant jurisprudence conclusions, to analyze correlations between cases of prominent violence & traffic accidents and types of diseases & responsibility assessment, to perform regression analysis of correlative factors influencing jurisprudence:prominent violence & traffic accidents. For all data, the following methods are adopted:SPSS 16.0 software for data entry and processing, statistics scanning, chi-square test, Pearson’s r, multiple stepwise regression method, etc. all two-tailed tested, significance level a=0.05.Results1. Distribution characteristics of two-group cases of forensic psychiatric expertise in our hospital:Nature of the case:With a view to nature of cases, traffic accidents in Group B more obviously increased than those in Group A, but the violence cases had decreased clearly in Group B.(P<0.05). Identification of diagnosis:In Group B case ratios, diagnosed as mental disorders and mental retardation as a result of traumatic brain injury increased more than those in Group A, nevertheless the proportion cases of schizophrenia, without psychosis decreased compared with those in Group A. The two groups have statistical difference in P< 0.05.2. Criminal (Violence) cases’distribution characteristics of two groups:Identification of diagnosis:The two groups are in the forefront of medical diagnosis is schizophrenia, without psychotic, affective disorders, the two groups showed no difference (P> 0.05). Responsibility capability assessment:It was rated as fully, partly responsible for the ability of the proportion of cases than in group A was significantly increased, and no liability was assessed as the ability to significantly reduce the proportion of cases (P<0.05) than in group A. By Logistic regression analysis, elements affecting responsibility assessment are previous psychiatric history, substance abuse history, choice of guilty places, the motive for the crime, mental state before the incident and actions afterwards.3. The two-set-Civil-cases (traffic-accident-case) distribution features:Disability rating:It was assessed as grade Ⅰ-Ⅲ disability cases accounted for more than 50% the proportion of the two groups showed no difference (P> 0.05). By regression analysis the discovery revealed that the brain damage location and coma time were the influencing factors of intelligent damage. Intelligent injury and brain injury site, the nature of the injury, coma, EEG, neurological symptoms, mini-mental state examination (MMSE) was significantly correlated.ConclusionsAfter the implementation of the Mental Health Law1. The forensic psychiatric expertise cases increase more visibly than the previous year with the clear increase of traffic accident case proportions and palpable decrease of violence case proportions.2. The case proportions of criminal cases (alleged violent cases) evaluated as complete or partial responsibility have obviously increased, yet the case proportions assessed as irresponsibility have reduced much.3. Factors of intelligent brain damage of civil-cases (traffic accidents) are brain injury site and coma time. Brain injury site, the nature of the injury, coma time, EEG, neurological symptoms, mini-mental state examination (MMSE) are significantly correlated forensic psychiatric expertise as an objective valid reference.