Sexual safety in mental health

Disclosures of sexual violence

Rachel Luby 2019 RCNI MHN award winner has prepared guidance on how to support women using impatient services who have been sexually assaulted. See: Disclosures of sexual violence

Nurses within The Nottingham Centre for Transgender Healthcare (NCTH) team have specialist skills in psychotherapy, prescribing, sexual health, substance misuse and neurodevelopmental disorders.  Currently NCTH employs 3 Clinical Nurse Specialists (CNS) (Band 7) and a Nurse Consultant who are highly trained and specialised clinicians within transgender health.  They have developed standard and advanced competencies for nurses. The competencies cover all aspects of the Lead Clinician role including the ability to assess and diagnose clinical aspects of gender incongruence, to distinguish co-existing mental health problems from gender dysphoria, and to assess capacity for treatments.  The team is piloting a training for CNS to undertake the role of a ‘Lead Clinician’ under the NHS England service specifications for a ‘Gender Dysphoria Clinic’.  Educational and Clinical supervision is being provided from NCTH’s experienced clinicians and educators and supplemented (where required) with the CNS successfully undertaking the Royal College of Physicians and University of London’s Gender Identity Healthcare Practice PGDip. For more information please contact Sally.Robbins-cherry@nottshc.nhs.uk 

You may be interested in the following articles

If you are a member you can access them via the RCN Library: 

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

It is increasingly being recognized that individuals who access acute mental health services are at risk of sexual assault. The the overall aim of this study was to explore the mechanisms and structures that were put into place following the investigation and in so doing examine the wider questions of sexual safety in acute mental health settings. 

McGarry J (2018) ‘Hiding in plain sight’: Exploring the complexity of sexual safety within an acute mental health setting, International Journal of  Mental Health Nursing, July 2 2018

Sexual behaviours on acute inpatient psychiatric ward

This study assessed 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. 

Bowers L, Ross J, Cutting P, Stewart D (2013) Sexual behaviours on acute inpatient psychiatric wards, Journal of Psychiatric and Mental Health Nursing, April 21 (3), pp. 271–279

‘I was raped by Santa Claus’: Responding to disclosures of sexual assault in mental health inpatient facilities

Sexual violence is significantly higher among those with mental illness than the rest of the population. The risk of sexual violence posed to patients during inpatient admissions is now also beginning to be recognized, but remains a challenging area of practice. This Australian paper introduces a trauma-informed care approach for responding to disclosures of sexual violence by people with serious mental illness, taking into account the complexities of caring for individuals who might be unable to provide coherent accounts of assaults and/or who might be experiencing varying degrees of psychosis. 

Ashmore T, Spangaro J, McNamara L (2015) ‘I was raped by Santa Claus’: Responding to disclosures of sexual assault in mental health inpatient facilities, International Journal of Mental Health Nursing, April 24 (2), pp. 39-148

Further resources

• Hughes, E., Lucock, M., & Brooker, C. (2019). Sexual violence and mental health services: A call to action. Epidemiology and Psychiatric Sciences, 28(6), 594-597
• National Collaborating Centre for Mental Health. Sexual Safety Collaborative: Standards and guidance to improve sexual safety on mental health and learning disabilities inpatient pathways (2020)
• Survivors Voices. The charter for engaging survivors. This charter is for any organisation that may be engaging with survivors of abuse (many of whom may be ‘hidden’ survivors).