Consumers living with psychosis: Perspectives on sexuality

Abstract

Mental health clinicians work within a recovery framework that is rights based and emphasizes positive and respectful approaches to working with mental health consumers. Mental health nurses’ practice is also predicated on holism and inclusiveness, yet consumers’ sexuality is sometimes neglected and rights in this area overlooked. Also overlooked is sexuality as an area for investigation, particularly from a consumer perspective, even though it constitutes part of consumers’ broader remit of sexual health. This paper reports findings from a case study where consumers were asked about their ability to negotiate and sustain sexual expression while residing in a long‐stay mental health rehabilitation facility. There were three main findings. First, the physical space of the facility, inclusive of consumers’ bedrooms, was policed by mental health clinicians with ongoing intrusions into consumers’ privacy, which inhibited their sexual expression. The creation of barriers to sexual expression is counter to polices that promote recovery. Second, consumers reported significant medication‐related weight gain which negatively affected their self‐image and sexual sense of self. Third, the consumers spoke about their sexuality in ordinary, everyday language devoid of any hallmark of psychosis. This highlights the importance of relating to consumers about their sexuality and sexual needs from a humane rather than technical framework. Further, it foregrounds the relational aspect of the mental health nurses’ role rather than the technical aspect. Yet sexuality is a topic that is often neglected, indicating that an upskilling of the mental health nursing workforce is required, to strengthen communication and relationship skills.

Service User and Carer Views and Expectations of Mental Health Nurses: A Systematic Review

“…The authors of 13 studies reported on service users’ expectations of the types of interventions delivered by mental health nurses [ 19 , 21 , 25 , 32 , 33 , 50 , 51 , 52 , 54 , 56 , 62 , 63 , 95 ]. Providing psychosocial support and fostering hope were identified as core interventions across multiple studies [ 50 , 51 , 52 ].…”

“…Across 13 studies, services users reported notable negative views of mental health nurses, which included skills deficits, negative attitudes, and poor therapeutic engagement [ 20 , 23 , 25 , 32 , 42 , 43 , 44 , 45 , 48 , 55 , 59 , 61 , 62 ]. For example, in a study involving 119 inpatient service users from a single Mental Health service in England, the authors reported that MHNs seemingly lacked the necessary skills [but did not provide examples] to address their needs [ 62 ].…”

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).…”

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

“…The expression of sexuality can be impacted by various considerations, including psychological, social, cultural, legal and religious influences ( 3 ). Sexuality and sexual functioning are aspects of an individual's sexual health and are essential components of the individual's holistic health ( 4 ), with most people feeling the desire to have an intimate relationship and to engage in sexual activity, including those with mental illness ( 5 ). The World Health Organization ( 2 ) defines sexual health as:…”