Striking proper balance between privacy and safety

HONG KONG has seen another mental patientstab his neighbours to death. Nevertheless,the scheme to help discharged mentalpatients to assimilate into the community deservessupport in principle, though the government shouldallocate more resources so that it can provide themwith better support.It is unrealistic to try to have every dischargedmental patient looked after by a community psychiatricnurse (CPN), but the government must set areasonable CPN CPN--patient ratio. It may have taken intoconsideration the employment of resources when itdecided to launch the scheme. However, economyshould not be its primary consideration, or it will pushpotentially dangerous mental patients to thecommunity. It is irresponsible to do so.

The suspect in the Kwai Shing East Estate tragedyhas rejected CPNs' regular home visits. HospitalAuthority chief executive Shane Solomon maintainsthat discharged mental patients, who are not criminals,have the right not to be visited at home. We could notagree with him. Mental illnesses can rarely be totallycured, and they must be kept under control withmedications. Former mental patients' personal freedommust be respected. However, they may be potentiallydangerous and home visitors can best observewhether their condition has worsened. Therefore, forthe sake of their neighbours' safety, it should not be upto them to decide whether to allow home visits. Tenyears ago, the suspect, a schizophrenic, stabbed hiswife. He was jailed for thirty thirty--two months. Evidently, itwas an indication of his worsened condition that hesuddenly rejected home visits.

It is clear from some cases that discharged mentalpatients may signal danger when they reject homevisits by CPNs or social workers.

A discharged mental patient's rejection of homevisits should not be dismissed as nothing serious. Thegovernment should put in place a mechanism forensuring that discharged mental patients are regularlyvisited at home so that problems can be prevented atthe outset. Violence Violence--prone discharged mental patientcannot control themselves if their condition worsens.Therefore, in dealing with them, it is necessary to strikea proper balance between respecting their rights andkeeping others safe. Strictly speaking, it is a measureto protect discharged mental patients to require themto be visited at home.

The suspect in the Kwai Shing East Estatetragedy is mentally ill. He was jailed for stabbinganother. After he had been released, the authoritiesbounteously allowed him to live in public rental housing(PRH). There are PRH tenants like him, and the SocialWelfare Department has information on them. In ourview, the government should consider having theSocial Welfare Department inform the HousingDepartment of such cases provided that it does notviolate the Personal Data (Privacy) Ordinance to do so.With such information, the Housing Department cantell estate officers to be more careful.

If there are too many fire walls betweengovernment departments, lack of basic informationmay make it hard to alert people to problems. TheKwai Shing East Estate tragedy once again showsthat, if government departments just mind their ownbusiness, it is citizens that will be harmed. We hopethey will better coordinate their efforts. Thegovernment should devote more resources to the careof discharged mental patients and set up such anotification mechanism so as to help them toassimilate into the community and to keep theirrelatives and neighbours safe.

明報社評2010.05.11

勿只顧私隱罔顧安全 設通報機制減少慘劇

本港又發生精神病人斬殺街坊鄰里事件，儘管如此，政府推行社區精神科計劃的原則，仍然值得支持，但必須多撥資源增加支援配套服務，協助精神病康復者融入社會。

要求每一名在社區康復者都有社康護士跟進，不切實際，但是當局須制訂合理的社康護士與病人比率。政府推行社區精神科計劃，不排除有資源運用的考慮；不過， 「節省資源」不應該是首要考慮，否則是政府把有潛在危險的精神病人推向社會，乃不負責任的做法。

今次葵盛東邨慘劇，疑兇曾經拒絕社康護士的定期家訪，醫管局行政總裁蘇利民認為精神病康復者並非犯人，有不接受家訪的權利。對於這個說法，我們不敢苟同。精神病難以根治，患者只能靠藥物等控制病情。因此， 精神病康復者的個人自由固然值得尊重，不過，若康復者有潛在危險，而家訪最能觀察其病况有否惡化，為了周遭鄰居安全，是否接受家訪，就不能由康復者說了算。10 年前，疑兇因為精神分裂，斬傷妻子前科，被法庭判囚32 個月，他「突然」拒絕家訪，現在看來是病情轉變的表徵。

從過去一些個案顯示，拒絕精神科社康護士或社工家訪，其實是康復者釋出的危險信號。

所以，若有精神病康復者拒絕家訪，不宜等閒視之，當局必須有機制確保康復者接受定期家訪，以收防微杜漸之效。事實上， 康復者的暴力傾向惡化至行動，他們也不能自制，所以，對有暴力前科和傾向精神病康復者的處理，必須在尊重其權利和其他市民的安危之間，取得適當平衡。嚴格而言，例如強制家訪也是保護康復者的步驟。

另外，類似葵盛東邨慘劇疑兇的人，有精神病，也有斬人、坐牢前科，出獄後獲恩恤安排入住公屋，他們的情况社會福利署應該知之，我們認為政府應該研究在符合私隱條例的前提下，社署宜把有關康復者的基本情况知會房屋署，再轉告管理公司人員多加留意。

部門之間太多「防火牆」，基本情况互不知會，容易出現信息不靈通以至無法及早預警的問題；今次葵盛東邨斬殺慘劇，再一次說明部門各自為政，受害的是市民大衆。我們希望部門之間加強協調、在適當增加資源和建立通報機制之後，一方面協助精神病康復者融入社會，另方面可以增加與康復者共處的親友、街坊、鄰居的安全系數。

Glossary

em employment ploymentuse.

economy

the use of the time, money etc available in away that avoids waste.

violence violence--prone

who is prone to violence (likely to use violence).