Section 2 Medical Care and Treatment System for Mentally Ill
The medical care and treatment system for the mentally ill covers [1] a person who has committed a designated act (arson, forcible indecency, rape, homicide and robbery, including attempting to commit these offenses, and injury) but who, as the conclusive disposition of a public prosecutor, was not prosecuted for reason of insanity or diminished capacity at the time of the act, and [2] a person who was either found not guilty on the grounds of insanity or received a mitigated sentence on the grounds of diminished capacity at the time of the designated act (excluding those sentenced to imprisonment where the execution of their sentence was not suspended), whose judgment has been finalized.
A hearing for either [1] or [2] determines the necessity of medical treatment and, if found necessary, the expected treatment in accordance with the Act on Medical Care and Treatment for Persons Who Have Serious Cases Under the Condition of Insanity (Act No. 110 of 2003). The hearing is initiated, in principle, upon an application by a public prosecutor, and is to be heard by a panel in a district court consisting of a judge and a mental health expert (psychiatrist). At the hearing, the court may request the director of the probation office to research the living conditions of those persons.
Table 4-10-2-1 shows the trend in the number of persons for whom public prosecutors applied for a hearing and the number of persons whose cases were conclusively disposed at the hearing, and those numbers by type of designated act in 2018.
Table 4-10-2-1 Persons for whom public prosecutors applied for a hearing and whose cases were disposed at district court hearings (by type of designated act)
Those for whom it is decided at the hearing that there is a need for hospitalization are hospitalized in designated inpatient care hospitals (designated by the Minister of Health, Labour and Welfare) where they receive specialized medical care in accordance with the system.
The managers of designated inpatient care hospitals are required to apply for confirmation every six months of the need to continue the hospitalization of subject persons, and for their discharge from the hospital immediately after it is deemed no longer necessary for them to remain hospitalized to receive medical care.
Those who receive a decision by a court on their need for outpatient treatment or permission to be discharged from a hospital must then receive outpatient medical care at a designated outpatient care hospital (designated by the Minister of Health, Labour and Welfare) for three years, in principle, and are placed under mental health supervision by probation offices during the period with the aim of securing continuous medical care.