Supporting the intimate relationship needs of service users with psychosis: what are the barriers and facilitators?

Abstract

Background: Mental health services aim to provide holistic care, but the intimacy needs of clients are neglected. Currently there is limited understanding of the challenges mental health professionals (MHPs) face when considering supporting the relationship needs of people with psychosis. Aim: This study investigated the views of community-based MHPs from a range of disciplines regarding the barriers and facilitators to supporting clients with their romantic relationship needs. Method: Semi-structured interviews were conducted with 20 professionals and analysed from a realist perspective using thematic analysis. Results: Barriers identified were: (1) "They will never be able to form close attachments." (2) "Modern social care teaches us reduce risk, reduce risk, reduce risk." (3) "You're only relying on what you've picked up over the years". Facilitators were: (1) "If they could find a partner they would progress a lot more". (2) "It's all to do with the relationship you've got between you and your client". (3) "It's having the resources". Conclusions: Results highlight areas for service improvement and will help inform the development of future interventions.

Romantic relationships, sexuality, and psychotic disorders: A systematic review of recent findings.

“…Our results highlight a need for greater communication and assistance in the areas of intimacy and sexuality for people with psychotic disorders. Indeed, many individuals with a psychotic disorder feel that they lack the experience and the resources to engage in romantic relationships (Redmond et al, 2010; White, Haddock, & Varese, 2019). Although efforts to understand and address these issues have increased in recent years, corresponding services (e.g., intimate skill-building and couples therapy programs) are still virtually nonexistent.…”

Loneliness in psychosis: A practical review and critique for clinicians.

“…Negative attitudes about loneliness and mental illness from mental health professionals can also be a barrier to supporting the relationship needs of people with psychosis (e.g., having an expectation that people with psychosis will never be able to form close attachments, or that supporting relationships will be too time-consuming; White, Haddock, & Varese, 2019). On the other hand, evidence also suggests that affirming attitudes and behaviors can help to reduce stigma and promote recovery in people with psychotic disorders (Nieweglowski, Qin, Paniagua, & Corrigan, 2019).…”

‘It’s Not Really a Part of Standard Practice’: Institutional Silencing of Sexuality Within Australian Mental Health Settings

“…Miller & Byers, 2012; Quinn & Happell, 2012). A dearth of appropriate sexuality-related professional education is commonly observed across mental health disciplines and reported to contribute to clinicians’ pervasive discomfort with and avoidance of sexuality within their everyday practice (Miller & Byers, 2012; Quinn & Happell, 2012; White et al, 2019). This is often interpreted as producing a skill deficit in clinicians, which drives further research focussing on clinicians’ competence and confidence in raising and addressing sexuality in the therapeutic encounter.…”

“…For example, evidence of inadequate relevant training and other organizationallevel supports for clinicians suggests that their avoidance of raising and addressing sexuality-related needs may be located in the broader workplace or institution rather than an individual deficit. This is indicated by some recent studies identifying that addressing sexuality-related needs is not well embedded in practice at the organizational level and recommending that mental health clinicians must be better enabled to address these, for example, via clear guidelines and relevant proformas (Hughes et al, 2018;White et al, 2019;Zatloff et al, 2020). Higgins et al (2008Higgins et al ( , 2009 specifically demonstrated how Irish mental health nurses' practice was shaped by wider sociocultural and professional discourses that constructed sexuality as primarily reproductive (i.e.…”