Case Report: The Sexual Experiences of Forensic Mental Health Patients

Abstract

The recovery-based approach to forensic mental health rehabilitation is to support the patient to achieve a fulfilling life—a principle which should include achieving a fulfilling sexual life. This paper presents four vignettes from forensic mental health patients. The four cases demonstrate the omission, avoidance and then judgement by forensic mental health clinicians around the intimate and sensitive, yet important domain of the patient's sexual life. The cases illustrate that gap in the clinical domain and demonstrate the requirement for forensic mental health clinicians to have a greater awareness, acknowledgment, and assessment of their patient's sexuality and sexual health needs. Incorporating sexual health into standard clinical assessments will contribute to improved patient management in addition to supporting the principles of holistic forensic mental health recovery and rehabilitation.

The sexuality and sexual experiences of forensic mental health patients: An integrative review of the literature

“…Nine papers focused exclusively on forensic inpatients, one on forensic outpatients ( 35 ) and two on a combination of in and outpatients ( 32 , 36 ).…”

“…Limited information was identified regarding the physical and sexual development of forensic patients even though initial forensic patient hospitalization often coincided with the critical period of development of adult sexuality and personal relationships ( 37 ). Brand et al ( 36 ) acknowledge the bi-directional impact between mental health and sexual health and the particular importance given the young ages at which mental health problems tend to emerge and develop.…”

A Qualitative Study on Sexuality and Sexual Experiences in Community Forensic Mental Health Patients in Queensland, Australia

“…This is the third phase of a larger research program that investigated forensic mental health participants' sexuality and sexual health needs, the background and protocol of which is published elsewhere ( 21 , 25 ). This qualitative phase was focused on providing participants an opportunity to talk openingly with researchers whom they were now familiar with, and for the researchers to better understand the participants current sexual experiences, future expectations in terms of sexuality, their barriers to achieving their ideal sex life, and the perceived need for involvement by their mental health team.…”

“…The first Australian large-scale national data study on the sexual health of Australians [ Australian Study of Health and Relationships 2 ( 20 )] provided robust information around sexual health, experiences, knowledge and education in the general Australian population. However, sexuality is unique in the created tension—it is both mundane and exciting ( 21 ). On the one hand, it is a part of everday normal life experiences.…”

The Sexual Development, Sexual Health, Sexual Experiences, and Sexual Knowledge of Forensic Mental Health Patients: A Research Design and Methodology Protocol

“…Further compounding and widening the sexology-mental health-clinician gap, Quinn et al (11), Evans (12), and Brand et al (13) emphasis the lack of, and barriers to positive sexual experiences for patients with mental illness and show that patients' are reluctant to self-report sexual dysfunction to clinicians. This reluctance is contrary to the anecdotal evidence presented by Baggaley (14) which suggests that sexual dysfunction has a considerable impact on quality of life (15) and adherence to antipsychotic medications (16).…”