Sexual behaviours on acute inpatient psychiatric units

Abstract

The purpose of the study was to assess the types and frequency of sexual behaviours displayed by patients during the first 2 weeks of admission to acute psychiatric units and what relationship these have to other challenging patient behaviours. The method used was a survey of sexual behaviours, conflict and containment events carried out by 522 patients during the first 2 weeks of admission in 84 wards in 31 hospitals in the South East of England. Incidents of sexual behaviour were common, with 13% of patients responsible for at least one incident. Although exposure was the most frequent of these behaviours, non-consensual sexual touching, was instigated by 1 in 20 patients. There were no differences in the numbers of sexual events between single sex and mixed gender wards. Few associations were found with the demographic features of perpetrators, although all those engaging in public masturbation were male, and male patients were more likely to sexually touch another without their consent. Single sex wards do not seem to necessarily offer significant protection to potentially vulnerable victims. Perpetrators do not seem to be predictable in advance, nor was there any common set or pattern of disruptive behavioural events indicating that a sexual incident was about to occur.

Nursing diagnoses related to psychiatric adult inpatient care

“…Although a study indicated that 13% of patients were involved in at least one incident of sexual behaviour (consensual or nonconsensual sexual touching, exposure, public masturbation) during the first two weeks of admission (Bowers, Ross, Cutting, & Stewart, ), no nursing diagnoses were found in the domain “ Sexuality .” Gonzalez‐Torres et al. () demonstrated that psychiatric inpatients have sexual experiences similar to those in the general population, but with an enhanced risk potential due to lower rates of condom use even in higher risk situations with partners who are HIV‐positive or intravenous drug users.…”

‘Hiding in plain sight’: Exploring the complexity of sexual safety within an acute mental health setting

“…The adherence to policy and protocols is clearly important and should not be undermined at all. However, it has also been highlighted elsewhere in the literature that structural changes within organizational systems, for example the inception of single-sex wards, may not on their own automatically lead to safer patient environments (Bowers et al 2014). This is an important observation and clearly highlights that safeguarding encompasses a number of facets beyond measures which are quantifiable or structural in nature.…”

“…However, it has also been highlighted elsewhere in the literature that structural changes within organizational systems, for example the inception of single-sex wards, may not on their own automatically lead to safer patient environments (Bowers et al 2014). However, it has also been highlighted elsewhere in the literature that structural changes within organizational systems, for example the inception of single-sex wards, may not on their own automatically lead to safer patient environments (Bowers et al 2014).…”

Sexual violence and mental health services: a call to action

“…It is also unclear how many of the sexual incidents were related to being unwell, confused and disinhibited. Bowers et al (2014) found that most incidents occurred in communal areas and that there were no differences in rates of sexual incidents between same sex and single sex wards.…”

“…However, despite these limitations in the methodology, the CQC report findings do mirror a prospective study of sexual incidents that occurred during in the first 2 weeks of admission. Bowers et al (2014) undertook an analysis of prospective data collected in the first 2 weeks of admission related to incidents that had resulted in conflict and containment incidents arising from inappropriate sexual behaviours. The study included a study cohort of 522 who have consent for their data to be included.…”