Survey of High Expressed Emotions Experienced By Community Mental Health Service Users in Hong Kong During the COVID-19 Pandemic

BACKGROUND: High expressed emotion (EE) experienced by people with mental illness is a known risk factor of relapse. With drastically increased time spent at home and limited health and social service provision during the COVID-19 pandemic, patients’ experience of high EE warranted attention. AIMS AND METHODS: The study aimed to investigate the experience of high EE among people with mental illness during the COVID-19 pandemic. We surveyed the service users of 2 community mental health centers, including participants with psychotic and nonpsychotic disorders. RESULTS: Valid responses from 303 participants indicated an overall high EE prevalence of 71.62%, much higher than previous findings, which range between 30% and 40%. People with other psychotic and nonpsychotic disorders showed a higher probability of experiencing high EE than people with schizophrenia. Participants reported a higher probability of experiencing high EE as a result of caregiving by other family relatives and friends than by parents. CONCLUSION: Findings suggest a significantly elevated high EE prevalence among people suffering from mental illness in the community during the COVID-19 pandemic. It is worth further evaluating the long-term effects of high EE beyond the pandemic.