Authors (including presenting author) :
Siu B, So WL, Yuen KK, Chan A, Chan C, Lai E, Leung HW
Affiliation :
Department of Forensic Psychiatry, Castle Peak Hospital
Introduction :
The Forensic Psychiatric (FP) Department of Castle Peak Hospital is the only Department in Hong Kong that provides full-range territory-wide forensic psychiatric services for patients with criminal involvement. The FP Department has been striving to enhance clinical risk assessment by the multi-disciplinary application of internationally validated assessment tool, namely the Short-Term Assessment of Risk and Treatability (START) by Webster et al. (2004). START is a structured clinical guide evaluating improvements related to therapeutic interventions across seven risk domains: risk to others; self-harm; suicide; self-neglect; substance abuse; unauthorized leave; and victimization by others. Each of the seven risk domains is measured by strength scores and vulnerability scores.
All in-patients of the FP Department have their seven risk domains assessed by START within two months of admission and subsequently in three-month intervals. After passing through the acute phase of mental illness, FP in-patients receive individualized rehabilitation programmes provided by the Community Reintegration Unit (CRU) and the Offending Behaviour Unit (OBU) of the Department. CRU is a pre-discharge unit for forensic in-patients aiming at promoting their successful reintegration into the community by tailor-made programmes such as anger management, symptom management, medication management, stress management, emotional regulation, problem-solving, social skills, domestic skills and community living skills. OBU targets at offending behaviours of forensic in-patients such as violence, sexual offending, substance abuse, and impulse control.
Objectives :
To explore whether the rehabilitation programmes provided by the FP Department could significantly reduce the risks of FP in-patients as measured by START. The demographic characteristics of the in-patients and their readmission rate would also be explored.
Methodology :
This is a retrospective review of the demographic data and START ratings of the in-patients who were hospitalized in FP Department for more than 3 months and were discharged to the community during the period 1st April 2015 to 31st March 2019.
Result & Outcome :
A total of 79 patients were assessed, of which 61 (77.2%) were males. Fifty-four (68.4%) patients had been suffering from schizophrenia. Fifty-five (69.6%) patients were discharged to hostels. START scores upon admission (strength score: 5.67; vulnerability score: 17.43) and before discharge (strength score: 6.87; vulnerability score: 11.18) indicated significant reduction of risks of in-patients (p value: < 0.05). The readmission rate was 13.9%.
