Assessment of the sexuality needs of individuals with psychiatric disability

Abstract

Individuals with psychiatric disorders are at risk of experiencing a variety of difficulties related to their sexuality. The objective of the study described here was examination of nursing staff attitudes, assessment of issues related to the sexuality of clients, and assessment of clients' perceptions of their own sexuality needs. The descriptive design included staff survey, client interviews and chart (in-patient record) audits. The setting was a tertiary care provincial psychiatric hospital in Ontario, Canada. One hundred in-patient records were randomly selected for a concurrent chart audit, followed by client interviews. Staff surveys included 68 nurses. Clients were found to be at increased risk for sexual aggression and sexually transmitted diseases. Clients identified learning needs regarding contraception and safe sexual practices. The nurses who completed the staff survey reported high levels of comfort related to clients' sexuality, yet infrequent teaching related to safe sexual practices. Individuals with psychiatric disorders are at increased risk for a number of problems related to sexuality and identify several learning needs. There is also a risk that these needs go unrecognized by nursing staff.

An initial exploration of community mental health nurses’ attitudes to and experience of sexuality‐related issues in their work with people experiencing mental health problems

“…In this survey only one question relating to sexual health promotion was asked: 41% ( n = 50) of respondents did not agree that CMHNs should always carry condoms to give to clients. Sexual health promotion has been identified as a key issue within mental health service provision (Park Dorsay & Forchuk 1994, RCN 1996). The RCN document cites research evidence that people with enduring mental health problems often have poor knowledge about the transmission of sexually transmitted diseases, and are particularly vulnerable in terms of sexual behaviour that may put them at risk.…”

“…The relevance of sexual health care and attention to sexual expression has traditionally not been highly prioritized within mental health care, despite acknowledgement of an holistic integrative approach to assessment and patient care. Indeed, the sexual and relationship needs of people with mental disorders are commonly neglected or receive insufficient attention (Hulson 1992, Bhui & Puffet 1994, Park Dorsay & Forchuk 1994, Rowlands 1995, D'Ardenne & McCann 1997. The Health First report 'Sex in Mind' (Few 1998) highlights the key role of mental health professionals in sexual health promotion and sexual health care but points out that such professionals are rarely trained or supported in ways which ensure that effective or quality care is consistently provided.…”

“…It should not be automatically assumed that mental health service users are more likely to suffer from any one particular sexual or relationship problem, nor that they always request help for relationship difficulties. However, recent studies and reviews suggest a high prevalence of sexual and relationship problems amongst psychiatric patient populations, thus emphasizing the importance of enquiry into such matters in the mental health setting (Swan & Wilson 1979, Park Dorsay & Forchuk 1994, Bhui et al 1995, Kockott & Pfeiffer 1996. Hulson (1992) suggests that relationship problems are common in couples where one or both partner has a mental illness diagnosis.…”

Neuroleptic medication and sexuality: the forgotten aspect of education and care

“…Nurses view sexuality as a taboo subject that lies outside their comfort zone and consequently, cite feelings of embarrassment and discomfort as reasons for their reluctance to engage in this area of practice (Kautz et al . 1990, Park Dorsay & Forchuk 1994). They also report a lack of knowledge and lack of skill, especially in the area of sexual health assessment and have difficulty initiating a conversation around sexual health (Long 1998, Guthrie 1999).…”

The sexual and relationship needs of people who experience psychosis: quantitative findings of a UK study

“…Some support systems were studied along with notions about marriage (Lane et al 1995), family planning (Miller & Finnerty 1996) and vulnerability (Read & Argyle 1999). Further, literature concerning possible professional responses, particularly the identification, assessment and planning of service and therapeutic provision was extrapolated (Park Dorsay & Forchuk 1994, Dilloway & Hildyard 1998. The final picture revealed distinct gaps in psychosexual knowledge in relation to patient needs and this provided the rationale for the present study.…”