“When patients are admitted to hospital voluntarily, but with possible conditions imposed on them when getting discharged, this could bring more concern to patients who originally hoped to enter hospital voluntarily,” Yuen told a radio show on Friday.
She said some patients went to hospital voluntarily if they felt severely depressed or were concerned about suicide.
“With these extra measures, we are worried that people would step back and the original goal of helping would be lost,” she said.
She said some patients were concerned about being conditionally discharged if they had a history of violent behaviour, even if they were admitted to hospital for other reasons.
Daisy Cheung Tin-muk, an assistant professor of law at the University of Hong Kong (HKU), backed Yuen’s view.
She told the Post people could be deterred from seeking help if they could be given a conditional discharge in future.
“We are worried that it would be a worse outcome for some hidden mental health patients in the community,” she added.
She also questioned the need to include patients who voluntarily asked for help and who were considered to be more compliant.
“Expanding the regime to cover this group of more compliant patients leaves a big question mark – where is the efficacy of this move,” she asked.
Professor Eric Chen Yu-hai of HKU’s department of psychiatry told the same radio show the government should ensure sufficient capacity to follow up on the expected rise of patients with conditional discharge orders.
Undersecretary for Health Dr Libby Lee has said the expansion would be applied with discretion. Photo: Edmond So
Chen, also a member of the advisory committee, said he hoped the Hospital Authority would conduct a study to find out how many more patients would fall under the conditional discharge scheme and what resources would be needed to follow up.
“If we need to operate the mechanism well, we need resources, people and time, and good communication with patients and their family members,” Chen said.
He hoped the authority would complete the study in one to two months.
The government on Thursday also proposed that patients’ conditional discharge status would be reviewed by the authority’s multidisciplinary case conference mechanism every two years.
Yuen said it would be an improvement on the present practice, where there was no automatic review of cases.
But Cheung highlighted a review done by hospital staff would not be an independent one.
“Members in the case conference are usually part of patients’ care team. They usually have formed their opinion on patients’ condition, and there is also a bias,” she explained.
Cheung said the Mental Health Review Tribunal, which also handled patients’ applications to end a conditional discharge order, involved third-party professionals in reviewing cases.
Patients and carers could also make submissions and hire legal representatives to present their arguments.
“It’s like having a fresh pair of eyes, and being relatively unbiased, to look at the cases,” she said.
Undersecretary for Health Dr Libby Lee Ha-yun said the expansion would be applied with discretion.
“This mechanism is only applicable to psychiatric patients with violent tendencies,” she explained.
“We do not include other mental health patients such as those with a risk of suicide.”
She highlighted that not all psychiatric patients with violent tendencies admitted to hospital involuntarily at present were given conditional discharge orders.
Healthcare staff conduct assessments to see if patients require such arrangements before they are discharged.
Lee said authorities would need to establish how many patients would be included in the conditional discharge scheme and the number of medical staff needed.