اخبار سوريا اليوم – وطن نيوز
سوريا اليوم – اخبار سوريا عاجل
W6nnews.com ==== وطن === تاريخ النشر – 2026-07-22 13:40:00
Kenan, the eleven-year-old child, did not know that the hours he spent next to his father after his release from a mental health center would be the last of his life. The child, whom those close to him describe as a quiet memorizer of the Qur’an, used to accompany his father not out of fear of him, but out of fear for him. He was aware, despite his young age, that the man who had rebuilt part of his life in recent years still had a long history of mental illness, and that his stability might not be final. But that relationship, which family members describe as going beyond the paternity bond to a form of daily care, ended on the roof of the family’s home in the town of Atma in the northern countryside of Idlib, where information obtained by Syria 24 from sources close to the family indicates that the father strangled his son hours after he left a mental health center in the city of Sarmada, while traces of bleeding appeared on the child’s neck. The circumstances of the crime and its direct motive are still unknown, while the competent authorities continue their investigations. However, the case, which on its face appears to be a murder within one family, has gone beyond the confines of the criminal file from its first moments, opening a broader discussion about how to deal with psychiatric patients after the end of treatment, the mechanisms for assessing the seriousness of their condition before they leave the hospital, and the role of the family and health institutions in reducing the risk of relapse. Years of recovery…before the collapse during the past five years, Muhammad, according to the accounts of his family members, seemed to have regained a large part of his normal life. He returned to the teaching profession, resumed giving mathematics lessons, built a house, and bought a car, all of which were taken by those close to him as evidence that the disease that had plagued him for many years was under control. Family members say that during that period he only needed to enter a mental health center once, which reinforced the belief among those around him that the stage of severe disorder was behind him. After his separation from his wife, he raised his only son with the support of his parents, and he repeated to those close to him that he lived for Kenan. As for the child, he was almost always with his father. This was not out of fear, but out of responsibility imposed by the circumstances of the disease. He monitored his condition, checked on him, and made sure to stay by his side, until many began to believe that the relationship between them had transcended its traditional form, and the child had become, unannounced, part of his father’s daily care network. However, this stability, which seemed clear to the family and those around him, did not necessarily mean the end of the psychological disorder or the disappearance of the possibility of its return. Complex medical history: According to sources close to the family, the father has suffered several severe episodes of psychological disorder over the past years. The sources say that one of those attacks ended with him assaulting his father, who was taken to the hospital to receive treatment, at a time when that stage coincided with his separation from his wife. She added that another attack occurred about a month before the crime, when, according to her account, he assaulted one of the workers inside his house, after throwing a cement block at him, then trying to slaughter him with a knife. Following that incident, he was admitted to a mental health center in the city of Sarmada, where he spent about a month under treatment. Information obtained by Syria 24 indicates that he left the center only a few hours before the crime occurred. This timeline, in itself, does not mean that there was a medical error or negligence in the discharge decision, but it made this decision a major focus in the investigations and questions raised by the case, especially in light of the absence of any official information about the medical diagnosis, the results of the risk assessment, or the follow-up plan that was supposed to be implemented after the patient left the center. Only a short time separated between the moment of leaving the hospital and the occurrence of the crime, turning the short period of time between the two events into one of the most prominent points that the judicial and medical investigations are expected to address. A medical file surrounded by secrecy… and an investigation looking for answers. In the days that followed the crime, the questions were not limited to what happened inside the family home, but rather extended to what preceded that hours, specifically to the circumstances in which the father left the mental health center in the city of Sarmada. That is why Syria 24 contacted the center’s administration, requesting clarification about the medical procedures that preceded the discharge decision, the nature of the evaluation that the patient underwent, and the mechanism for assessing the level of risk before allowing him to leave the center. She also inquired about the protocols adopted in such cases, and whether they include preparing a post-discharge treatment plan, a schedule for periodic reviews, and instructions provided to the family regarding dealing with any behavioral changes that may occur in the patient. However, the center’s management merely said that the patient’s medical file is subject to the provisions of medical confidentiality, and that any access to it or disclosure of its details requires permission from the Public Prosecution, in compliance with the legal rules regulating the protection of health data. The administration did not answer questions related to the general procedures followed before discharging patients or the mechanisms for assessing risk, which left a number of basic points unanswered. Among these questions: Was the discharge decision based on a comprehensive clinical evaluation? Was a clear follow-up plan developed for the patient after his discharge? Did the family receive instructions regarding adherence to treatment, review dates, and signs that require seeing a doctor or re-admitting the patient to the hospital? Between mental illness and criminal responsibility, the investigation in the case is not limited to determining how the crime occurred, but also extends to a more complex legal question related to the extent of the father’s eligibility for criminal accountability at the time of its commission. A lawyer working in one of the directorates of the Ministry of Justice, who preferred to remain anonymous for job considerations, believes that the first thing the judicial authorities will examine is the psychological state of the accused at the moment the crime occurs, because that determines the nature of his legal responsibility. He says that proving that the accused was suffering, at the time of committing the act, from a mental illness or psychotic disorder that caused him to lose consciousness or will, makes the case subject to the provisions of Article (211) of the Syrian Penal Code, which stipulates that the person who is unconscious due to mental illness is exempt from criminal liability, while subjecting him to the therapeutic precautionary measures decided by the judiciary, instead of traditional criminal penalties. He explains that Article (240) of the Penal Code stipulates that a permissible excuse exempts the perpetrator from punishment. However, cases of mental illness are not based, from a legal standpoint, on the concept of a permissible excuse, but rather on the absence of criminal liability due to the lack or lack of criminal capacity, which is determined exclusively by judicial psychological expertise. He stresses that the diagnosis of the disease alone is not sufficient to exempt the accused from responsibility, but rather the decisive factor is whether the disease made him lose, at the time of committing the crime, the ability to perceive or choose. Reviewing the discharge decision. According to the lawyer, the investigation does not stop at the limits of the father’s responsibility, but may extend to reviewing all the procedures that preceded his release from the mental health center. He says that the judicial authorities will examine the medical basis on which the discharge decision was based, and the extent of the treating team’s commitment to professional principles and medical protocols for assessing risk, stabilizing the condition, and preparing a treatment plan and follow-up after discharge. If investigations prove the existence of a professional violation, this may open the door to disciplinary accountability before the Ministry of Health or the Medical Syndicate, where the competent authorities are responsible for investigating the performance of the treating physician and the management of the center, and imposing appropriate penalties if a violation is proven to have occurred, which may range from warning and temporary ban from practicing the profession to removing the doctor from the list of doctors in cases where serious violations are proven, in accordance with the applicable laws and regulations. However, if investigations conclude that there is a direct causal relationship between gross professional negligence and the occurrence of death, criminal liability may also be raised based on Article (550) of the Syrian Penal Code, which punishes causing death as a result of negligence, lack of caution, or failure to observe laws and regulations, with a penalty that may reach imprisonment from six months to three years, if all elements of responsibility are proven before the judiciary. The lawyer stresses that this path remains conditional on the results of investigations and medical expertise, as the mere occurrence of the crime after the patient leaves the center is not sufficient, legally, to prove the existence of a medical error or criminal liability against the doctor or the treatment institution. He also indicates that the investigation may include reviewing the administrative circumstances surrounding the discharge decision, to ensure the integrity of the procedures followed, and whether all decisions were made in accordance with medical and legal principles, without this meaning assuming the existence of a violation or collusion before the evidence appears. What does psychiatry say? Away from the legal controversy, psychological supporter Abdel Nasser Al-Youssef believes that judging any incident related to a psychological disorder must be based on a specialized medical evaluation, and not on circulating impressions, explaining that severe psychological disorders, including cases that may lead to psychotic or schizophrenic symptoms, require direct intervention from a psychiatrist who determines the need for drug treatment or hospitalization. Al-Yousef explained that admission of a patient to a psychiatric hospital means that his condition required specialized care, which requires the medical team to prepare an integrated treatment plan that includes drug treatment, continuous psychological evaluation, and monitoring the development of symptoms before making the decision to discharge. He added that the decision to discharge the patient is not taken except after repeated clinical evaluation that determines the stability of the condition, noting that the psychiatrist provides the patient upon discharge with a drug treatment plan, a schedule for reviews, in addition to an educational program for caregivers on how to follow up on the condition, monitor any deterioration, and communicate immediately with the doctor when new symptoms appear. He pointed out that the family bears part of the responsibility if it does not adhere to the treatment plan and medical follow-up, explaining that commitment to taking medications, attending periodic visits, and keeping the patient under observation according to a security and safety plan, are essential elements for reducing the risk of relapse or violent behavior. He pointed out that some severe psychological cases, including some cases of bipolar disorder accompanied by severe symptoms, may require the patient to be readmitted to the hospital if the treatment plan does not achieve the desired results, or if it turns out that the severity of the symptoms still poses a danger to the patient or those around him. He added that the responsibility for follow-up is not limited to the medical team, but rather is based on a partnership between the medical team and caregivers, and the extent of both parties’ commitment to the treatment plan, stressing that any failure to implement medical instructions may increase the chances of the condition deteriorating. Al-Yousef called for enhancing community awareness of mental health, and recognizing psychological disorders as diseases that require specialized treatment, stressing the importance of visiting the nearest mental health center when noticing clear changes in behavior or thinking. He also recommended facilitating citizens’ access to mental health services through hot numbers and clear referral services, increasing the number of specialized cadres in mental health centers in governorates and rural areas, integrating mental health services within primary health care centers, in addition to training workers in the field of mental health and psychosocial support to evaluate cases, manage the case, and deal with patients according to professional protocols, and train health sector workers on the principles of psychological first aid. What do international standards say? The World Health Organization does not set a fixed period of time for a patient to stay in the hospital, nor does it link the decision to discharge to the number of days he spent under treatment, but rather stresses that the decision must be based on a comprehensive clinical assessment, taking into account the stability of the condition, the degree of risk, and the possibility of continuing treatment outside the hospital. The organization recommends that the discharge of patients suffering from severe psychological disorders be preceded by the preparation of a clear follow-up plan, which includes review dates, drug treatment, and a mechanism for communicating with the medical team when any new symptoms appear, with the family being involved in this plan as an essential partner in care. The International Principles of Mental Health also confirm that returning to society does not mean the end of the responsibility of the therapeutic institution, but rather its transition to another stage based on continuous care and the ability to intervene quickly when needed. The absence of data…and the difficulty of comparison. Despite the attention given to crimes related to mental illness, there are no official Syrian statistics documenting the number of these incidents or the nature of the diseases from which their perpetrators suffer, which makes assessing the extent of the phenomenon extremely difficult. At the international level, scientific reports indicate that murders committed by people suffering from severe psychological disorders remain relatively rare, and that a large percentage of them are related to interruption of treatment or the absence of medical follow-up, rather than to the psychological diagnosis itself. Researchers say that the absence of accurate databases prevents drawing general conclusions from individual cases, and makes each case need an independent evaluation based on its own circumstances, far from generalization. After Kenan… Questions that go beyond a criminal case Kenan’s life ended within hours, but the questions left by the crime may remain open for months, and perhaps years. Between the forensic report, the psychological evaluation, the results of the investigation, and what the court will conclude, the path of justice will not only be limited to determining criminal responsibility, but may also answer a question that has been present since the first hours of the crime: Could this tragedy have been avoided if more effective mechanisms had been available to follow up on mentally ill patients who may pose a danger to themselves or their surroundings? The case also raises broader questions about the government’s ability to develop a mental health system that provides a safe environment for patients, and at the same time protects their families and society, through clear protocols for evaluation, follow-up and intervention when necessary, and benefiting from the experiences and practices adopted in countries that have developed advanced systems for managing high-risk psychological cases, in a way that achieves a balance between the rights of patients and the requirements of public safety.
