Admission to the maximum security Siu Lam Psychiatric Centre is rare for those who are neither prisoner nor warden. For those who willingly step through its steel gateway, the windswept cluster of grey buildings reveals scenes which swing from the mundane to the surreal, through shades of pathos. Unlike the Correctional Services Department's Pik Uk or Stanley maximum security jails, Siu Lam stands well away from heavily-populated areas. Isolated at the end of a steep and winding drive which branches off the Castle Peak Road, it gazes from its hilltop at the far-off development boom of the Ma Wan channel. The enclosure, guarded by five surveillance towers where sentries shoulder Remington shotguns, is surveyed only from a ridge running alongside the Tai Lam Chung Reservoir. Its sole neighbour is the Siu Lam Hospital, which offers long-term care of the mentally-ill under the auspices of the Hospital Authority. Senior superintendent Henry Wong Wai-lam has run Siu Lam for about two years. A trained psychiatric nurse who worked in two mental hospitals in England before serving in Hong Kong's jails, Wong operates from an office dated by the decades-old furniture of his predecessors. A faded, 1970s-era framed photograph of Queen Elizabeth II stares impassively from the wall above his chair. He plans to remove it in July. Unlike other Hong Kong prisons, Siu Lam houses both men and women. The women's section is by far the smaller. Daytime quarters are a medium-sized room where inmates in army-green quilted jackets gather around a large table assembling pieces of felt and cotton wool to create stuffed toys. Those on remand, clothed in blue uniforms, stare blankly at their hands. One or two read newspapers in silence. 'They're not prisoners so they don't work,' offers a CSD administrator. In a small en suite, a middle-aged woman pedals an ancient and well-used Singer sewing machine. It is one of three tired old machines in the room, but the only one in use. Beside her stand boxes crammed with pink flannel pyjamas and demure yellow uniforms for female prisoners, their pastel colours striking a discordant note against the spartan room. Across a small exercise yard, a handful of men linger in the sick bay. Single beds with metal frames, their battered paint-work showing the strain of years of service, stand in two rows. Elderly men and a few younger ones, diagnosed with fevers, huddle in chairs circling a television set mounted high on the yellow cement wall. One man stares into space from his wheelchair; he could go free through the gates if he only had a home. 'When the elderly home staff came along and interviewed him, they said: Sorry, we have no places,' Mr Wong says. 'He needs very intensive care. He has to be fed, looked after, we have to give him a massage every day to prevent his neck stiffening up. The officer in charge here is a registered nurse.' Between the buildings and blackened bars, chrysanthemums raise their brilliant yellow, gold and purple heads above immaculately-clipped hedges. Each line of colour is restrained by a tiny, white-washed picket fence. When Siu Lam Psychiatric centre opened in November 1972, the facility perched on a hillside near Tuen Mun attracted neither fanfare nor public attention. Far from the sight of most Hong Kong residents, it has expanded to contain ever-increasing numbers of convicted criminals deemed too unstable or violent for an ordinary jail. Its first 25 years have seen it acquire the status of a modern-day Bedlam in the eyes of some. At times, the psychiatric hospital and maximum security prison has been allowed to remain in the shadows, collecting the creatures of Hong Kong's id. At others it has been cast into sharp relief by allegations of nurses dispensing unprescribed injections, the mysterious strangulation of a young woman tied to a bed and a peculiar spate of suicides. The Correctional Services Department runs Siu Lam Psychiatric Centre with the help of a forensic psychiatric team, based at nearby Castle Peak Hospital. The security and medical professions hold different views about whether the 266 residents of Siu Lam are largely inmates with mental problems, or patients being detained by the Crown. From its opening day, when Americans still cheered President Nixon and Sir Murray MacLehose governed Hong Kong, the jail has always been reasonably full. Today it hovers at capacity, with convicted criminals whose crimes have spun from delusion and disease, inmates of other prisons who have exhibited violence or mental imbalance and prisoners on remand, including those for whom the courts have ordered psychiatric reports. Siu Lam also has a secure unit, added in a $60 million extension in 1991. Here, the Government houses convicted criminals who have made themselves vulnerable by acting as witnesses for the Crown or as informants for the police and Independent Commission Against Corruption. The disgraced former director of public prosecutions, Warwick Reid, is one of the many who have served time in this completely segregated wing of 30 cells. Mr Wong is pondering the problem lying before two of his elderly inmates. The Mental Health Review Board, which examines prisoners' status every two years, wants them to go. He wants to release them. The prisoners disagree. The men - including Prisoner Number One Tse Cho-lau, now 92 years old - have no family to take them in. The thought of venturing from his prison-sanctuary into a city which cast him out 15 years before man walked on the moon is a terrifying one for Tse. In 1953, Tse was a 46-year-old clerk with the Hong Kong Electric Company. He lived with his wife and grown-up son and daughter in a subdivided first-floor apartment in Spring Garden Lane. But while he worked to send his son to technical school and feed the family, Tse was fighting his own demons. He began to beat pots and pans nonsensically, to carry his radio into the street and, one November night, arrived home from work convinced his wife had poisoned his rice. After protesting violently and reluctantly allowing himself to be calmed, Tse arose in the middle of the night, seized a chopper from the kitchen and began striking his wife. As the family awoke and began scrambling, screaming, through windows into nearby flats, Tse turned on a neighbouring cubicle and hacked his landlord to death. At the culmination of a high-profile court case in which psychiatrists testified Tse had lost control of himself in a fit of epilepsy, he was found guilty of murder but insane and sentenced to an unspecified period. Tse was sent first to Victoria Prison, then to Stanley and finally to Siu Lam, where he has continued his 43 years of imprisonment, watching hundreds come and go around him. 'He became violent because he is epileptic, but he is quite okay under the medication,' Mr Wong says. 'The board says he can go, but he prefers to stay here. 'When the board recommends to release them, one of the conditions is that they have to be admitted to an elderly home. After release, they need to be looked after by somebody, especially with no family support. 'Even though the Government wants to pay for the costs, the private sector will come along and interview the inmate and after a few days they will say: sorry, we have no vacancies.' In the first of Siu Lam's seven male psychiatric wards, prisoners in brown quilted jackets sit on a bench lining two walls of a single, long room. They have been sentenced for serious offences - arson, wounding, murder - and are making cotton wool balls. They pluck small wads of fluff and roll them into regulation-sized mounds. Mr Wong gestures to an elderly man and his mottled face is illuminated as he rises to unsteady feet. 'Ninety-seven,' he bellows proudly. 'I am 97. I am lucky because I am very strong for an old man.' This is Tse, who has begun to add five years to his age, having heard the figure repeated countless times and assumed its notoriety for himself. A man in his early 20s suddenly bounds to his feet behind him. 'Hello! Hello!' he shouts. 'Hello! ' Eyes unfocused and dull, his voice shakes with disembodied emotion as he declares his demand for an immediate release. Guards swiftly escort us to the door. As we emerge into the mid-winter sunlight of another exercise yard, an angry voice rises from a tiny window in the building behind. 'I am all right. Nothing wrong with me.' Mr Wong strolls to the middle of the yard and gazes into a large aviary. 'He killed his brother,' he says. 'His own brother.' The aviary is the centrepiece of the yard. It is filled with a variety of birds, some perched quietly on a roost, others squawking and flapping their wings in a vain attempt to be airborne. Nearby, in the occupational therapy rooms, prisoners cut bales of flannel cloth to make towels for a Hospital Authority contract, weave rattan strips around wooden frames to build stools and shape pieces of clay into pottery jugs for sale at the CSD's annual autumn fair. 'They are quite slow because they are under the influence of medication. Most of them have to be maintained on a certain dosage of medication,' Mr Wong says. A psychiatrist who has dealt with Siu Lam cases identifies the drug group as phenophiazine, which has yielded the widely-used Largactil and Stelazine. 'Between them, they diminished probably by half the outpatient wards in (psychiatric hospitals in) Britain,' he says. 'It got rid of their delusions. The effectiveness was tremendous . . . It was to psychiatry what penicillin was to general medicine. One of the side effects is that it slows you down, although that's not a bad thing for those running amok. (Patients) are usually a bit slow and stilted in their movements.' In other occupational therapy rooms, prisoners wash and iron Siu Lam's laundry amid clouds of steam. One of the few places they do not work is the kitchen. The knives and boiling oil, Mr Wong explains. Throughout the building, the sweeping strains of saxophinist Kenny G float incongruously from room to room through a series of loudspeakers. On the ground floor, through several barred gates, Unit 16 houses the acutely disturbed. 'They are newly-admitted here. Maybe they have tried to commit suicide at other institutions, so they are here for observation. Or they are violent and bang their heads against the walls,' Mr Wong says. Unit 16 contains 20 one-man cells, four of which are padded and hooked up to closed-circuit television monitors watched by a guard at the entrance to the wing. The floor is bare grey concrete, patchy and stained with years of use. The walls are pastel yellow, broken by door frames of an alarming pink. Each cell contains a metal bunk, a concrete sink and concrete toilet moulded into the wall. 'The average is two weeks in here. I think the longest was here for a month,' Mr Wong says. The air-conditioned padded cells are for those whose rage or psychosis drives them to violence. Here there are no beds, no sinks, no toilets. The grey linoleum walls and floor yield slightly and spring back at a touch; the unblinking eye of a camera watches from the high ceiling. A drainage hole is a stark reminder of the practicalities of this room - it can be hosed out on the departure of each unwilling guest. 'We must have doctors' orders before we can move someone here,' Mr Wong says. '[Their use] depends on the situation. Sometimes we have used four of them at one time.' Siu Lam's reputation has taken a battering in the latter part of its first quarter-century. In 1991, weeks after the opening of the new wing, an inquest jury returned a verdict of 'lack of care' in the death of 31-year-old To Sam, strangled by a ligature after staff put a safety vest on her and tied her to a bed. In 1994, four CSD officers were acquitted of assault and attempting to pervert the course of justice after a 20-year-old prisoner died in the sick bay. The court found the sole witness had weak vision in one eye and was reported to suffer delusions. During the same year, four suicides and seven attempts were counted at Siu Lam, believed to be the highest for a single CSD facility. Three of the deaths were within six weeks. Last year, a report by CSD psychiatric nurses compared the jail unfavourably with Britain's Broadmoor forensic psychiatric hospital and slammed the nursing workforce of 48 as inadequate. The CSD insists that 35 staff are taking nursing qualifications, but could take three years before they enter the gates to take on duties at Siu Lam. Fifty-five prisoners remain in Siu Lam serving an unspecified period. Doctors say they include those arrested on relatively minor offences, such as loitering, and sentenced to an unspecified period because they were deemed mentally unfit to plead. One former Siu Lam psychiatrist tells of nurses injecting patients with medication when they felt it was required, and later asking doctors to sign prescriptions to validate their actions. 'There's another part, the vulnerable prisoner unit,' said psychiatric chief Dr Yuen Cheung-hang. 'This refers to those who have a transexual or homosexual problem. 'Correctional Services tends to concentrate these people in Siu Lam. Homosexuality is not regarded as a mental illness any more, but they are afraid these people will be scapegoats when they are in prison. There are about 20 admissions a year; they never complain.' As well as the mentally ill, Siu Lam has housed some of Hong Kong's most feared criminals. Loan shark Wong Kwai-fun - linked to a campaign of intimidation launched by his younger brother, Wong Kwai-nam, against dignitaries including Chief Secretary Anson Chan Fang On-sang - is serving his time in Siu Lam. Mr Wong is satisfied with the infamous loan-shark's presence in his prison. 'He's right near my office - right beneath me.' The senior superintendent stops and stamps his foot with a hard, bright grin. 'I have to make sure he is under me all the time.'