Authors (including presenting author) :
Tang YDY(1), Lai ESK(2), Lam EHY(1), Siu BWM(1)
Affiliation :
(1)Department of Forensic Psychiatry, Castle Peak Hospital
(2)Occupational Therapy Department, Castle Peak Hospital
Introduction :
Conditional Discharge (CD) is a legal provision under section 42B of the Mental Health Ordinance (Cap 136) (MHO) in Hong Kong. The primary objective of CD was to safeguard the health and safety of patients and others by mandating individuals with mental disorders who meets certain criteria to follow treatment after discharge. In a recent report by the Review Committee on Mental Health under the Health Bureau, four limitations of CD were identified: (1) voluntarily admitted patients were not under scope of CD; (2) patients with risk of suicide or self-neglect were not under scope of CD; (3) patients who relapsed but have not breached any CD conditions could not be recalled; and (4) there is no limit in the duration and review period of CD status.
Objectives :
To collect stakeholders’ perspectives and propose recommendations to improve current CD regime
Methodology :
Focus group methodology was adopted to collect perspectives of relevant stakeholders. Comprehensive purposive sampling was employed to recruit potential participants. All participants had provided verbal consent (written consent for psychiatric patients) and agreed the discussion to be recorded in written format.
The focus groups were led by two facilitators and one observer. Each group consisted of 8 to 10 participants with similar background and was conducted via video-conferencing due to the COVID-19 pandemic. The discussions were guided according to a semi-structured bilingual questionnaire designed to review on limitations of current CD mechanism. Descriptive statistics and thematic analysis were conducted to identify distinctive categories based on the results of the questionnaire.
Result & Outcome :
Five focus groups were conducted from April to June 2022. A total of 43 participants were recruited including psychiatrists, nurses and allied health professionals, representatives from Non-Government Organisations, patients with CD experience and care-givers. The results highlighted the following recommendations: to consider (1) including voluntarily admitted patients under scope of CD, especially for “patients with severe mental illness with risk to self and others” and “patients with high violence risk”; (2) maintaining patients with risk of suicide or self-neglect outside scope of CD; (3) suggesting not to recall a relapsed patient who had not breached any CD conditions, in view of availability of other practical ways for providing care to the patient; and (4) establishing a regular review of CD status by psychiatric Multi-Disciplinary Case Conference.
