本文以精神障礙患者之犯罪為關注重心，從刑罰理論為起點，架構其與監護處分的橋樑。進而以司法實務之觀點，探討如何判斷行為人於行為時之辨識能力與控制能力，以及司法精神鑑定在司法實務上之意義。無論係採取二階層或三階層犯罪理論，均有不法及罪責之區分，向來刑事司法實務著重於蒐集證明行為人行為不法之「不法性證據」，至於證明罪責層次之「罪責事由證據」，則往往非調查重點或淪為次要調查事項。為落實特別預防理論下保安處分之處遇理念，本文從現行偵查與執行實務經驗出發，就罪責事由證據之調查、司法精神鑑定、監護處分必要性及其所面臨之困境，並提出相應之解方──包含立法與制度論、理想之實務建議──作為本文結論。

This article is concerned about offenders with mental illness addiction. At the beginning, we bridged the theory of punishment with rehabilitative measures. Then, we explore how to judge the person who has the recognizing ability and control ability or not in his behavioral time, and the meaning of the judicial forensic psychiatry assessment in the perspective of judicial practice. No matter we take the second order theory of criminal (Zweistufentheorie) or the third order theory of criminal (Dreistufentheorie), those all contain the difference of rechtswidrigkeit and responsibility. Criminal justice practice always focuses on collecting evidences to prove the person whose rechtswidrigkeit in the behavioral time. As for the evidence of proving the guilt, it’s not always the point under investigation, or becomes the minor. In order to realize the mental disorders under the special prevention theory, this article is based on the criminal investigation practice and enforcement to put forward dilemmas and solutions about the evidences of criminal responsibility, judicial forensic psychiatry assessment, and the necessity of disposition of custody which includes legislation, institutionalism and the practical advices of ideals to sum up this article.