Profiling mentally ill offenders in Hong Kong: A 10-year retrospective review study.

INTRODUCTION: This study aimed to analyze the estimated prevalence of mental disorders among offenders and compare the estimated crime rate between mentally ill patients and the total population in Hong Kong. METHODS: Service data of offenders referred to psychiatrists at the Siu Lam Psychiatric Centre from January 2011 to December 2020 were analyzed. Demographic data of gender, age on admission, educational level, principal psychiatric diagnosis, index offense, and assessment outcome were collected. RESULTS: Data of 7535 offenders (74.8% males) aged 14 to 97 (mean: 41.3 ± 13.7) years were analyzed. More than 60% (66.2%) had a diagnosable mental disorder. The most prevalent principal psychiatric diagnosis was schizophrenia and related disorder (22.8%), followed by mental and behavioral disorders due to psychoactive substance use (18.6%), and mood disorders (8.8%). The commonest index offenses were theft and related offenses (20.5%), followed by acts intended to cause injury (19.7%), and illicit drug offenses (11.6%). The estimated prevalence of mental illness among prison population was 7.1% (male: 8.2%, female: 5.0%). The estimated crime rate for mentally ill patients was found to be 43.3 to 263.2 per 100 000 population. DISCUSSION: The estimated prevalence of mental disorders among offenders and the estimated crime rate for mentally ill patients are relatively low in Hong Kong. The result was an important effort to document the changing characteristics of mentally ill offenders and provide an estimation of the prevalence and crime rate for mentally ill patients in Hong Kong.

Measuring the profiles of the security needs of forensic psychiatric inpatients: Validation of the See, Think, Act Scale.

INTRODUCTION: This study aimed to develop and validate a Chinese version of the See, Think, Act Scale (C-STA). The relational security of the Department of Forensic Psychiatry of Castle Peak Hospital, which provides territory-wide forensic psychiatric services in Hong Kong, was measured. METHODS: The See, Think, Act Scale was first translated into Chinese, then back-translated into English for comparison, and finally, subject to modification until alignment was achieved. Its content validity and face validity were explored through expert panel evaluation and focus group discussion, respectively. Eighty-nine Chinese mental health professionals were recruited from six service units to measure the relational security of the Department of Forensic Psychiatry using the C-STA. RESULTS: The Cronbach's alpha coefficient for internal consistency was high, with all components exceeding 0.90. The intraclass correlation coefficients for the test-retest reliability of all components ranged from 0.50 to 0.72. Participants had the lowest score on the "patient focus" component (M = 2.56, standard deviation [SD] = 0.32). A significant sex difference in total relational security scores was found (P < 0.001). DISCUSSION: The C-STA is a valid and reliable instrument to measure the relational security of forensic psychiatric services. "Patient focus" might be the target component of relational security for which the Department of Forensic Psychiatry needs to have interventions. The significant sex difference in total relational security scores needs further exploration.