For instance, in the 19th and early 20th centuries when ideas of social Darwinism and eugenics were at their peak , some commentators argued that psychiatric patients should not be allowed to reproduce to prevent the transmission of their ‘defective genes’ Andrau, ; Joseph, ; Read et al, Journal of Health Management, 8 1 These inpatients may possess the capacity to consent to sexual acts in spite of their detention. On the one hand, mental health professionals believe that psychiatric patients who engage in sexual relationships pose particular risks, and yet paradoxically this risk is managed through the denial or negation of their sexuality leaving risk matters completely unaddressed. Journal of Offender Rehabilitation, 37, This is counterpoised by a modern view that the pursuit of intimacy and the desire for sexual expression between consenting adults, albeit within culturally prescribed parameters, is considered normal, natural and integral to being a human being Giddens,
However, few of these studies for example, Ramrakha et al, used controlled samples. Couples in Care and Custody, 7: Some talked about the risk to others; if a patient wanted to date a person in the community who did not have a forensic history or a diagnosis of mental illness and the issue of disclosure and safety of that spouse. The authors suggest that any limitation on sexual relations between detained patients would have to be justified. Some participants felt no concern about, indeed, appeared to be encouraging of, patient sexuality, in the context of unescorted leave in the community as part of rehabilitation. Some commentators, notably Cuthbert and Ruane have questioned the role of ethnicity and religiosity in determining these attitudes. This was then piloted on a small number of clinical staff and revised in accordance to feedback.
Professional norms of consent and competence were not essat factors in decision-making. Due to a lack of training, guidance, and being left to deal with the issue as best they can, nursing staff may well blur the boundary between the personal and professional, and may even see inpatients as an extension of their family Ruane, For instance, Ruane found that nursing staff were conservative irrespective of their religious or ethnic backgrounds. Penna and Sheehy observed that although occupational therapists viewed patients having traihee relationships more positively, they felt constrained by the proscriptive culture of the services in which they worked.
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As a number of participants remarked: This carried the underlying assumption that the patients were also western liberals, where in fact immigrants and ethnic minorities are over-represented within secure settings Dein et al, Sexual behaviour among patients in the ward environment was described in anti-therapeutic terms and a challenge to control and order.
This is particularly relevant in forensic settings osa patients routinely oaaa lengthy admissions, and one in five patients in medium secure osa services have been an inpatient for an excess of five years Jacques et al, The winning essay will be published in the DAS newsletter. Where policies exist in the UK, they have often articulated on article the unspoken ban which exists elsewhere.
In this study, we sought to explore the views of psychiatrists and psychologists, working within forensic services. Am J Psychiatry ; Journal of the Royal Society of Medicine, 97, — Examining professionals’ perspectives on sexuality for service users of a forensic psychiatry unit.
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However NPSA reported only three claims for compensation following unwanted pregnancies within NHS mental health settings between and Sexual relationships essayy an inpatient could also give hope to other patients Dein and Williams, Gutheil TG Professionals’ attitudes towards sex between institutionalized patients. A number of studies have observed risky sexual behaviour involving psychiatric patients see Meade and Sikkema, for a systematic review ; and one study Cournos et al, noted HIV sero-prevalence amongst 5.
Recent studies have found little evidence of sexual intercourse within psychiatric hospitals Warner et al, or of sexual coercion, although ongoing work is needed Hales et al, So starting to have a supportive role earlier might be a better way forward.
In Qualitative Research in Psychology 3: According to a recent study Jacques et al, one in five laa in a large Medium Secure Facility had been an inpatient for over five years. Additionally, this may result in prurient and damaging media coverage, and litigation against health organisations. All the participants were offered vignettes.
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How many times have they had sex? There then followed a series of group discussions to compare our readings of the data and the themes each researcher had drawn out.
The submitting eszay should be a DAS member. Moreover, there is a tendency among the predominantly western and liberal participants in the current study to apportion blame for sexual prohibition on the conservative and religious attitudes and beliefs of the nursing staff.
The interviews took place on site the forensic mental health unitwere audio recorded and transcribed verbatim. It is considered due diligence for hospitals to have policies on inpatient sexuality Perlin, ; Essat, It is vital that health professionals take a step back and seriously consider whether this is the role of any caring professional, given both the scientific evidence against such a view of gene transmission, and the worrying paternalism implied by any such control over sexual intimacies.
Some participants felt no concern about, indeed, appeared to be encouraging of, patient sexuality, in the context of unescorted leave in the community as part of rehabilitation. Predominantly, participants felt that the hospital ward environment was not an appropriate place to have sex often because they tdainee concerned about other patients rrainee staff and most remained uncertain about whether the boundaries of sexual expression were ever made clear to patients.
Another concern is the likelihood of unplanned pregnancies.
This might mean that views expressed by participants reflect wider discourses Edwards and Potter, of power, stigma and fear traiene within the wider society in regards to people who are inpatients and are suffering from illness.