HKSAR v. YANG LEYING

CACC 372/2025 [2026] HKCA 1376

On appeal from [2025] HKCFI 3762

IN THE HIGH COURT OF THE

HONG KONG SPECIAL ADMINISTRATIVE REGION

COURT OF APPEAL

CRIMINAL APPEAL NO 372 OF 2025

(ON APPEAL FROM HCCC NO 215 OF 2023)

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J U D G M E N T

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1.  The applicant was indicted for the offence of murder, contrary to common law and punishable under section 2 of the Offences against the Person Ordinance (Cap 212).  Following a plea bargain, the applicant pleaded guilty to manslaughter on the basis of diminished responsibility before Kwok J (the judge) on 17 June 2025.

2.  On 20 August 2025, the applicant was sentenced to a hospital order of an unspecified duration for the treatment her mental illness of schizophrenia.

3.  On 12 September 2025, by way of a Form XI, the applicant applied for leave to appeal against sentence.  The applicant submitted that she had recovered from her mental illness and invited this Court either to impose a determinate term of imprisonment or to specify a period for the hospital order.  The applicant appears in person, having had her legal aid refused on 16 October 2025 and 26 May 2026. 

4.  The respondent opposes the application for leave to appeal against sentence.  

The summary of facts

5.  The summary of facts admitted by the applicant and outlined to the judge was as follows.  The applicant had been residing with her daughter (the deceased) in Flat 910 of Ching Wo House, Tsz Ching Estate since 2019.  The deceased was aged 24.

6.  At around 3 a.m. on 6 December 2021, the applicant’s neighbours at Flats 908, 909, 914 and 917 heard a woman shouting and crying for help.  The neighbour from Flat 908 was woken up when he heard a woman shouting “help” and “go away” and subsequently another female voice shouting “bitch”.  Only one of the neighbours at Flat 909 (PW7) opened her iron gate.  PW7 saw the deceased walking towards her flat naked and crying for help. She then saw the applicant leaving Flat 910 holding a knife.  PW7, who was afraid, closed the door immediately and reported the case to the police.  

7.  At around 3:30 a.m., the ambulance officers arrived at the scene.  They saw the applicant in bloodstained trousers sitting on the deceased.  The applicant was holding the handle of a knife with both hands, with the blade of the knife embedded in the deceased’s abdomen.  The deceased was found naked and lying face up in the corridor outside Flat 909.  When the ambulance officers asked what had happened, the applicant replied, “she must die today”.  

8.  The police officers arrived about a minute after the ambulance officers, and only then were the ambulance officers able to attend to the deceased.  The deceased was in a coma but still breathing.  She arrived at Queen Elizabeth Hospital (“QEH”) at around 4:04 a.m.  

9.  As the police officers secured the scene, the applicant was very emotional and speaking incoherently.  The applicant was heard saying that her colleague and her daughter had “got together”.  Under caution, the applicant said “she wanted to harm my son, someone cheated all of my money”.  At around 4 a.m., the police officers accompanied the applicant to QEH.  

10.  At the hospital, the deceased was observed to have a knife that had penetrated her right abdomen, with an exit wound at her left back.  The stab wound was created by a carving fork (a total length of 30 cm with 10 cm handle), with the fork and the knife handle almost completely driven into the abdomen.  

11.  At 2:50 a.m. on 7 December 2021, the deceased was certified dead.  Based on the autopsy performed on 10 December 2021, it was opined that the direct cause of death was a stab wound to the abdomen.  The autopsy also revealed that the deceased suffered from (1) wounds on the backs of her forearms and hands and (2) wounds on her palms and the palmar surfaces of her fingers, which were compatible with defensive injuries.  

Psychiatric history of the applicant

12.  The applicant was first known to the mental health services since around 2007-2008.  She was diagnosed with schizophrenia and prescribed antipsychotics for her symptoms.  Between 2008 and 2013, she was repeatedly admitted to hospitals for psychiatric treatment due to relapses of schizophrenia.  Her last admission to hospital prior to the offence was in August 2018, precipitated by poor drug compliance.  She continued psychiatric follow-up after her discharge from hospital, but she was documented to have doubtful drug compliance and intermittent paranoia[1].  

13.  Psychiatrists assessed the applicant on 6, 7 and 15 December 2021 and the psychiatric diagnosis was schizophrenia.  In the summary of facts, reference was made to two psychiatric reports[2]:

(1)  report of Dr Wong Yee Him dated 12 December 2023; and

(2)  report of Dr Lui Sing-heung, Visiting Psychiatrist of Siu Lam Psychiatric Centre, dated 24 September 2024.

14.  The consensus opinion of the psychiatrists was that the applicant was suffering from an abnormality of her mind at the time of offence, attributable to schizophrenia.  The applicant was suffering from long-standing schizophrenia, with symptoms including auditory hallucinations and a range of delusions, including delusional perception.  Dr Wong also observed that the applicant had a delusional interpretation of numbers, which led her to believe that she had to harm her daughter in order to save her son, together with auditory hallucinations commanding her to kill the deceased.

The mitigation

15.  The applicant expressed grief and guilt over the death of her daughter in her mitigation letter.  She was 50 years of age and divorced at the time of the offence.  She was born and raised in the Mainland and educated up to senior high school level.  

16.  She gave birth to the deceased in 1997.  She subsequently met a married Hong Kong man and became pregnant with their son.  They later married and their son was born in 1998.  She stayed in the Mainland with both children while her husband provided financial support from Hong Kong.  Her son moved to Hong Kong at the age of 5 to live with his father.  The applicant and her daughter moved to Hong Kong in 2005 and 2014, respectively.  The applicant divorced her husband around 2005.  

17.  Following her divorce, the applicant relied on social welfare benefits and the financial support of her ex-husband, who passed away in 2021.  She began working as a security guard around 2018 to earn more income.  She stated that she had a sexual relationship with her supervisor for about 2 years, during which he paid her.  She ended the relationship because she came to believe that her supervisor was having a sexual relationship with her daughter. She had been residing at Flat 910 with the deceased since 2019.

18.  Defence counsel submitted that the applicant had been receiving psychiatric treatment in prison since December 2021 and was making steady progress with no relapse since being in custody.  He emphasised that neither of the two psychiatric reports referred to in the summary of facts suggested that the applicant posed a threat to others.  It was submitted that a sentence of imprisonment with psychiatric treatment was the most appropriate disposal for the applicant, given that she had a routine in prison and that a disruption of that routine and environment may cause her additional stress, potentially affecting her recovery.  

Sentencing

19.  Two additional psychiatric reports were obtained at the request of the judge to determine whether a hospital order was appropriate:

(1)  a report by Dr Lui Sing-heung, Visiting Psychiatrist of Siu Lam Psychiatric Centre, dated 8 August 2025[3]; and

(2)  a report by Dr Kimberly Kin Yan Yip, Visiting Psychiatrist of Siu Lam Psychiatric Centre, dated 8 August 2025[4].

20.  Both Dr Lui and Dr Yip found that:

(1)  the applicant was suffering from schizophrenia, displaying auditory hallucinations, persecutory delusions and aggression at the time of the offence, and had stopped taking her medication for 2-3 months prior to the offence.

(2)  the applicant told the psychiatrists that a voice had told her to kill her daughter.  She also stated that she saw a poster with the numbers “12-19”, which she interpreted to mean that one of her two children must die.

(3)  the applicant had poor insight into her mental illness and was non-compliant with her medication and treatment.  She had relapsed repeatedly over the years and lacked social support in the community.

21.  Dr Yip’s report provided a more detailed assessment of the applicant’s psychiatric condition.  The applicant denied active hallucinations, did not think she was delusional and did not accept that she had any severe mental illness in the past.  She believed she had completely recovered from her mental illness[5]. The applicant continued to harbour a persistent paranoid delusion against her ex-boyfriend, believing that he had had sex with her daughter and was after her money[6]. Dr Yip opined that the applicant posed a high risk of violence and in-patient psychiatric treatment would be necessary for the safety of the applicant as well as that of others[7].

22.  Both psychiatrists recommended that the applicant should be committed to Siu Lam Psychiatric Centre for an unspecified period.  After considering these reports, and in view of the applicant’s persistent psychotic symptoms, lack of insight and high risk of violence, the judge found the recommendations to be appropriate.  As such, he imposed a hospital order for an unspecified period at Siu Lam Psychiatric Centre under section 45 of the Mental Health Ordinance (Cap 136).

Discussion

23.  In the applicant’s homemade grounds of appeal, she stated that she had recovered from her mental illness and asked this Court to impose a sentence of imprisonment or to specify a period for the hospital order. 

24.  At the hearing of this application, the applicant submitted a letter in which she complained that the sentence was too heavy and should be lighter.  She invited the Court to substitute a term of imprisonment or to impose a specified period of one year for the hospital order.  She stated that she was a decent person who stopped taking her psychiatric medication because of her concern for her daughter, who had a weight problem.  She claimed that she was heartbroken over losing her daughter and that she wished to take care of her son.  She repeated that her mental health had improved and she had now recovered.  It is noted that the applicant’s son is now 28 years old and has been in the care of her ex-husband, who had passed away in 2021.  The applicant committed this offence in December 2021 and has been in custody since then.  Her plea for early release to take care of her son is, in the circumstances, a specious claim.  She displayed no remorse and was more concerned about herself than the tragic loss of her daughter.

25.  The respondent opposes the leave application on two grounds. First, this is not the first time the applicant has made such claims that she had recovered from her mental illness.  In particular, the previous psychiatric reports stated that the applicant lacked insight into her own mental illness.  Secondly, the proper course is for the Mental Health Review Tribunal to determine whether the applicant is fit to be released.  It was also suggested that this Court may adopt the approach in HKSAR v Ho Hoi Sing[8] and to obtain further psychiatric reports before determining this application.

26.  The purpose of a hospital order is to ensure that a person with a severe mental disorder who commits an offence receives proper medical treatment instead of a prison sentence, to protect the public, and to support the patient’s welfare.  An unspecified (or indefinite) period is justified when the mental condition is severe, chronic or unpredictable, as the medical practitioners cannot safely estimate when treatment will succeed and when the offender will cease to be a danger.  The provisions under the Mental Health Ordinance ensure that a patient’s detention, treatment or conditional status is regularly evaluated by independent legal and medical professionals. A review of a hospital order is handled primarily through the Mental Health Review Tribunal, which will determine if and when the applicant’s case is considered suitable for her discharge.  It is not the function of the court to undertake the responsibilities of the Mental Health Review Tribunal. 

27.  In R v Lung Fan Wa[9], the Court of Appeal explained that, if it was not possible to express with confidence how long a patient would need treatment before being fit for release into the community, a hospital order should not have a term attached to it, in the interests of the patient and for the protection of the public.

28.  In deciding to impose a hospital order for an unspecified period, the judge carefully assessed the degree of the applicant’s mental responsibility for the offence and the state and repercussions of her mental illness.  The applicant suffered from a serious mental illness which contributed to the killing of her daughter.  The hospital order ensured that she would be detained in a suitable facility both for the treatment of her mental condition and because of the risk she posed as a danger and threat to the safety of the community at large.

29.  In light of the expert medical opinions, the imposition of a hospital order for an unspecified period was both appropriate and necessary in treating the applicant’s mental illness and protecting the public.  Dr Lui explained that the applicant had been suffering from schizophrenia for many years, a condition that was noted for its “repeated relapses and delusion-driven aggression”.  He stated that the applicant had limited insight into her mental illness and that there was no telling when she would be ready for release.[10] Dr Yip was of the opinion that the applicant suffered from “paranoid schizophrenia, marked by auditory hallucinations, formal thought disorder, and persistent persecutory delusions”.[11]  He was of the view that, given the applicant’s “persistent psychotic symptoms, lack of insight, and high violent risk, a period of inpatient psychiatric treatment would be necessary for the safety of herself and others.”[12] 

30.  The common theme among the psychiatrists was that the applicant suffered from a serious mental illness, that she was a potential danger to herself and to others, and that she lacked insight into her state of mind.

31.  In the circumstances, the judge’s hospital order for an unspecified period should not be disturbed.  Accordingly, the applicant’s application for leave to appeal against her sentence is refused.

[1]  Appeal Bundle (AB), 43, at [8]-[9].

[2]  AB, 10, at [19] and 11, at [20].

[3]  AB, 39.

[4]  AB, 41.

[5]  AB, 46, at [18]-[19].

[6]  AB, 45, at [17] and 47, at [23].

[7]  AB, 47, at [22] and [24].

[8]  HKSAR v Ho Hoi Sing, unrep., CACC 409/1997, 12 March 1998.

[9]  R v Lung Fan Wa [1994] 3 HKC 106.

[10]  AB, 40, at [9]. 

[11]  AB, 46, at [20]. 

[12]  AB, 47, at [24].