In July 2021, an autistic resident with aphasia and severe emotional dysregulation at the private Defang Rehabilitation Institute in Miaoli County was physically abused by care personnel during an episode of emotional instability. His hands and feet were bound with restraints and he was confined to his room, resulting in heat exhaustion and metabolic failure that led to his death. This incident shocked society and underscored the lack of government policies and support resources for persons on the autism spectrum. Due to insufficient community-based support, families often have no choice but to place autistic persons in full-time care institutions. The imbalance between the supply and demand of care services has allowed facilities with poor service quality to remain in the system, contributing to such tragedies.
In 2019, an autistic child with emotional and behavioral disorders who had been placed in a children’s home was repeatedly asked to leave school by both the school and parents due to a “lack of necessary resources,” forcing him to transfer between schools multiple times. In the same year, a resident with a Class I psychiatric disability in Kaohsiung suffocated to death after care personnel taped his mouth shut to stop him from making noises during the night. These incidents were investigated by the Control Yuan, which later released investigation reports revealing structural problems in society. The findings indicated that autistic individuals with cognitive impairments and severe emotional and behavioral issues are often forced to reside in full-time care facilities due to insufficient community-based support resources, and that government support for persons with disabilities and their family members remains inadequate.
The National Human Rights Commission (NHRC) found that the individuals involved in these cases were classified as persons with Class I systemic disabilities. According to statistics published by the Ministry of Health and Welfare, as of the first quarter of 2024, there are 371,702 persons with Class I neurological, mental, or intellectual disabilities, accounting for 30.59% of all persons with disabilities—the largest group under the new disability classification system. When cognitive functioning, emotional regulation, and communication abilities are limited, individuals may be unable to express their needs clearly and may resort to self-harm or aggressive behavior as a means of expression.
Under the Convention on the Rights of Persons with Disabilities (CRPD), persons with disabilities, including those with severe emotional, behavioral, and intellectual disabilities, have the right to live independently and be included in the community on an equal basis with others. However, as shown in the Defang Rehabilitation Institute case and other similar incidents, individuals with severe emotional and behavioral disorders, due to limitations in cognition, communication, and emotional capacity, are compelled to reside in care facilities in the absence of adequate community-based support systems. Yet these facilities may expose them to potential maltreatment by care personnel, sometimes resulting in death.
To examine how the government may address the lack of a support system for persons with severe emotional, behavioral, and intellectual disabilities in accordance with the CRPD, the NHRC established a task force, conducted a literature review, and held two advisory meetings to collect perspectives from stakeholders. Based on these findings, the NHRC prepared this special report to identify core issues and propose concrete recommendations.