Prevalence and Screening of Mental Illness among Remand Prisoners in Hong Kong

Abstract

OBJECTIVES: This study aimed to validate the Correctional Mental Health Screen (CMHS) in the Hong Kong prison population and determine the prevalence of psychiatric disorders among remand prisoners in Hong Kong and the associated factors of mental illness. METHODS: This cohort study was conducted at the Lai Chi Kok Reception Centre and the Tai Lam Centre for Women in Hong Kong. Remand prisoners aged ≥21 years were recruited between May and August 2014. Sociodemographic and clinical data were collected. Each remand prisoner was assessed using the appropriate CMHS for males or for females, then interviewed by a specialist psychiatrist using the Structured Clinical Interview for DSM-IV for current affective disorder and psychotic disorder for cross-validation. RESULTS: A total of 245 remand prisoners were recruited (150 males and 95 females; mean age, 25.8 years). Of them, 51% (55% males and 44% females) had a lifetime history of psychiatric disorder, whereas 39.6% (46% males and 29.5% females) had a current psychiatric disorder. The most common psychiatric disorder was substance use disorder (>36%), followed by mood disorder (>20%), psychotic disorder (5.3%), and lifetime neurotic disorder (3.7%). Living in a public housing estate (odds ratio [OR] = 1.99), a history of childhood conduct problem (OR = 2.40), and a forensic history (OR = 1.97) were associated with an increased risk of having a psychiatric disorder. The CMHS had good diagnostic efficiency after cross-validation with the Structured Clinical Interview for DSM-IV. CONCLUSION: Psychiatric disorders are prevalent in remand prisoners in Hong Kong. The CMHS is an effective tool to screen remand prisoners for timely treatment of prisoners with mental health needs.