Strengthened Measures for Mental Illness Patients... But Emergency Hospitalization Remains Difficult in Reality

If Patients Hesitate to Go Out, Caregivers Should Consider Emergency Admission
Hundreds of Cases Rejected Annually by Medical Institutions Despite Police Judgments
"Police, Local Governments, and Medical Institutions Must Establish Coordination"

In mid-January, a report was made to a police station in Seoul stating that during a call with the Suicide Prevention Counseling Center, the individual said they were "lighting a charcoal briquette." When the police arrived at the scene, the person was intoxicated, and no evidence of an actual suicide attempt by lighting a charcoal briquette was found. However, since the individual had injuries, the police first treated these and, considering the risk of self-harm, requested emergency hospitalization. The medical institution, however, rejected the request, stating that the criteria for urgency were not met.

Recently, as a series of heinous crimes have occurred, the police have been strengthening measures for emergency hospitalization and other actions concerning individuals with mental illnesses. However, there are differing judgments on whether the criteria are met, and due to a shortage of hospital beds, on-site police officers and guardians still report difficulties in securing emergency hospitalization. There are calls for local governments and medical institutions to consider establishing a proper system to ensure that individuals with mental illnesses receive timely treatment.

Amid ongoing imitative threats involving bladed weapons, riot police officers are patrolling and guarding at Ori Station in Bundang on the afternoon of the 4th. Photo by Heo Younghan younghan@

According to the National Police Agency on the 7th, the police have launched a "special security operation" to strengthen responses to a series of heinous crimes, promoting active emergency hospitalization as a countermeasure. At a recent press briefing, Police Commissioner Yoon Hee-geun stated, "We are actively requesting emergency hospitalization for high-risk individuals with mental illnesses who pose a danger to themselves or others." Hospitalization of individuals with mental illnesses can be voluntary, where the patient consents, or admission with the consent of a guardian (consensual admission), and involuntary admission carried out by the police and medical institutions. The best method is voluntary admission when necessary, but when the patient refuses to go out or receive treatment, guardians face difficult situations. Guardian A said, "My sibling, who suffers from a mental illness, refused to move at home, so I contacted the hospital, but they said they could not take any action if the patient did not come."

If the individual refuses to visit a medical institution and voluntary admission treatment, guardians with no suitable options have no choice but to rely on the police's emergency hospitalization measures. According to the Mental Health Welfare Act, if there is a high risk of self-harm or harm to others and urgency is required, with the consent of a doctor and the police, the individual can be admitted to a psychiatric medical institution within 72 hours. However, police officers dispatched to the scene after a report also find on-site response challenging. When a person with a mental illness does not take prescribed medication or shows prodromal symptoms indicating a risk of self-harm or harm to others, but the criteria are not immediately met, the dilemma deepens. A frontline police officer said, "There is anxiety about incidents that could occur unexpectedly if emergency hospitalization is not carried out due to unmet criteria," adding, "Even if emergency hospitalization is approved, the patient may perceive it as forced confinement."

Even when on-site police officers request emergency hospitalization based on their judgment, cases of rejection by medical institutions occur by the hundreds each year. According to the National Police Agency, the number of emergency hospitalization rejections in the past three years was 385 in 2020, 527 in 2021, and 977 in 2022. From January to July this year, 623 cases were rejected. Some rejections occur due to differences in opinions between police officers and medical staff regarding the risk of self-harm or harm to others and urgency, but there are also cases where suitable medical institutions cannot be found. On-site police officer B said, "Sometimes cases are rejected due to a lack of available beds, and if there are external injuries, hospitals without treatment facilities ask the patient to receive treatment first before admission." Guardian A also said, "There was a case where emergency hospitalization was refused because there was no weekend duty doctor nearby." In fact, the number of closed ward beds in tertiary hospitals decreased from 1,416 in 2017 to 275 as of March this year, and the total number of psychiatric hospital beds dropped from about 67,000 to 53,000 during the same period. The medical community claims that chronic low medical fees are driving the closure of psychiatric wards.

Experts have suggested that an organic system involving the police, local governments, and medical institutions should be established for the hospitalization of individuals with mental illnesses. Professor Kwak Dae-kyung of Dongguk University's Department of Police Administration said, "Since the police are not experts in the medical field, it would be ideal if specialists could make judgments on-site, but realistically this is impossible, so there are limits to on-site measures," adding, "A cooperative system among local governments, medical institutions, and the police should be established to enable assessment and action regarding the patient's situation in urgent situations." Professor Lee Hae-guk of the Catholic University Department of Psychiatry said, "Because hospitalization is discussed without proper treatment facilities, emergency hospitalization is perceived as inhumane," adding, "There should be at least two hospital rooms available for at least two weeks in regional emergency medical centers or tertiary hospitals, and the government should support this. Patients should not be denied admission due to the absence of protective beds or duty doctors."

This content was produced with the assistance of AI translation services.