Symposium 8 - Telehealth I

Visiting restriction has been set in hospitals as a response to COVID-19. 


We cannot underestimate the significance of the physical presence of a loving relative to a chronically ill patient who is trapped in a hospital bed. It is even worse for patients at the end of life with diminishing consciousness, since hospitalization may simply mean a premature farewell before death. Being able to be present is also important for family of patients who are critically ill in hospital. When the family is not allowed to see the treatment and the progress of a patient, it may delay the coping and acceptance of the family and prolong the decision making. Complicated grief related to lack of preparation for the death and guilt is a concern during the COVID-19 pandemic.


Virtual visiting of family by IT applications (tele-visit) has circumvented the visiting restrictions on physical presence. Stories about tele-visiting in Haven of Hope Hospital would be shared in this session. It is not going to be a narrative of advances in technology. Rather, they are stories about a strife for human connection. Despite being materially virtual, such connection brings forth understanding, support, reconciliation, healing and closure.

Telepsychiatry, the practice of delivering mental health consultations at a distance, has been shown to be cost effective, sustainable, and safe for the provision of mental health services. Telepsychiatry has been used in prison settings overseas and proven to enhance access to specialist psychiatric services and reduce the need for transport of prisoners in custody. In Hong Kong, the Department of Forensic Psychiatry at Castle Peak Hospital provides territory-wide outreach psychiatric services to Siu Lam Psychiatric Centre (SLPC) of the Correctional Services Department (CSD). In the past, the process of transferring remanded and sentenced persons in custody (PICs) from other correctional institutions to SLPC for psychiatric care has been complicated by the significant manpower and security required, infection risks and risk to the public in the event of abscondance. Since July 2020, psychiatric teleconsultations with portable video-conferencing devices have been provided by outreach psychiatrists at SLPC for PICs in other correctional institutions. Our recent qualitative study on PICs referred for psychiatric teleconsultation from 1st Jul 2021 to 31st Dec 2022 has produced promising results supporting the use of telepsychiatry as a sustainable, safe, and less costly alternative to face-to-face consultations for PICs amid the COVID-19 pandemic in Hong Kong. 


Besides the prison setting, telepsychiatry has been used in assessing inpatients nursed in the COVID-19 ward established at Castle Peak Hospital during the pandemic. Virtual hostel tours and Mental Health Review Tribunal meetings via telemedicine for inpatients have also been vital in facilitating their discharge and rehabilitation in the community. Undoubtedly, telemedicine will remain an important modality in the provision of psychiatric services in Hong Kong.