Conditional discharge in Hong Kong: a qualitative focus-group study

To identify themes among patients on conditional discharge (CD) residing in care homes regarding their understanding of CD and their perspectives on the revised CD guidelines.

Patients on CD aged 18 to 64 years who attended the Tuen Mun Mental Health Centre of Castle Peak Hospital, Hong Kong, were able to read and write Chinese and communicate in Cantonese, and resided in one of two residential care homes for persons with disabilities were identified. Eligible patients were invited to participate in focus-group discussions through purposive sampling. Two focus groups were conducted, each comprising eight participants. Focus-group discussions were guided by 10 semi-structured questions related to (1) participants' understanding of CD and (2) their perspectives on the revised CD guidelines. Participants were encouraged to provide honest and authentic responses and to express their opinions freely in a relaxed, non-judgemental atmosphere; the facilitators remained highly attentive to verbal and non-verbal indicators of social desirability bias. Audio recordings of the discussions were transcribed, coded, and analysed using inductive thematic analysis.

In total, 15 men and one woman (mean age, 57.1 years) completed two focus-group discussions in September 2025. Inductive thematic analysis identified six themes: understanding of the CD mechanism, professional support under CD, impact of CD, recall mechanism, review mechanism through multidisciplinary case conferences, and pamphlet providing information on CD.

Patients on CD residing in long-stay care homes considered that the revised CD guidelines enhanced their understanding and acceptance of the CD mechanism, particularly its supportive elements. Nonetheless, perceptions of CD as punitive and uncertainty regarding recall and review procedures highlight the need for clearer communication and patient engagement. Improvements in explanations through individualised staff guidance, transparent review processes, and bilingual pamphlets may foster trust, autonomy, and compliance among patients under CD.