Top

International Journal of Mental Health Systems

Published in:

Open Access 01-12-2016 | Research

Policies on sexual expression in forensic psychiatric settings in different European countries

Authors: Rajveer Tiwana, Stephanie McDonald, Birgit Völlm

Published in: International Journal of Mental Health Systems | Issue 1/2016

Abstract

Background

Sexual expression by forensic psychiatric patients is poorly researched.

Methods

Forensic experts representing 14 European countries were interviewed to explore the diverse ways in which sexual expression within forensic settings is handled.

Results

No country had a national policy, although many had local policies or shared practices. Progressive approaches to patient sexuality were evident in nine of the countries sampled. The UK appeared the most prohibiting and excluding, its protocols apparently based on risk aversion and lack of emphasis or consideration of patients’ sexual needs.

Conclusions

Uniform national policy supporting patients’ sexual expression would provide significant improvements.

Available only for authorised users

Brown SD, Reavey P, Kanyeredzi A, Batty R. Transformations of self and sexuality: psychologically modified experiences in the context of forensic mental health. Health. 2014;18(3):240–60. doi:10.1177/13634559313497606.PubMed

Gordon H, Lindqvist P. Forensic psychiatry in Europe. Psychiatr Bull. 2007;31:421–4. doi:10.1192/pb.bp.107.014803.CrossRef

Völlm B, Edworthy R, Furtado V. EPA-0119—Characteristics and needs of long stay patients in high and medium secure forensic psychiatric care: implications for service organisation. Eur Psychiatry. 2014;29(1):1–17. doi:10.1016/S0924-9338(14)77593-5.CrossRef

McCann E. The expression of sexuality in people with psychosis: breaking the taboos. J Adv Nurs. 2003;32(1):132–8. doi:10.1046/j.2648-65.2000.01452.x.CrossRef

Bartlett P, Mantovani N, Cratsley K, Dillon C, Eastman N. ‘You may kiss the bride, but you may not open your mouth when you do’: policies concerning sex, marriage and relationships in English forensic psychiatric facilities. Liverpool Law Rev. 2010;31:155–76. doi:10.1007/s10991-010-9078-5.CrossRef

Perlin ML, Lynch AJ. ‘All his sexual patients’: persons with mental disabilities and the competence to have sex. Wash Law Rev. 2014;89(2):1–37. doi:10.2139/ssm.1908733.

Howard League for Penal Reform. Consensual sex among men in prison. Briefing paper 1. London: Howard League for Penal Reform; 2013.

Salize HJ, Dressing H. Placement and treatment of mentally ill offenders–basic concepts and service provision in European Union Member States [Article in German]. Psychiatr Prax. 2007;34(8):388–94. doi:10.1055/s-2007-970838.CrossRefPubMed

Taylor PJ, Graf M, Schanda H, Völlm B. The treating psychiatrist as expert in the courts: is it necessary or possible to separate the roles of physician and expert? Crim Behav Ment Health. 2012;22:271–92. doi:10.1002/cbm.1843.CrossRefPubMed

10.

Marle HV. Forensic psychiatric services in the Netherlands. Int J Law Psychiatry. 2000;23(5–6):515–31. doi:10.1016/S0160-2527(00)00049-2.CrossRefPubMed

11.

Müller-Isberner R, Freese R, Jöckel D, Cabeza SG. Forensic psychiatric assessment and treatment in Germany. Int J Law Psychiatry. 2000;23(5–6):467–80. doi:10.1016/S0160-2527(00)00056-X.CrossRefPubMed

12.

Völlm B. Compulsory psychiatric detention and treatment in Finland. Psychiatr Bull. 2007;31:101–3. doi:10.1192/pb-bp.106.0094772.CrossRef

13.

Dein K, Williams PS. Relationships between residents in secure psychiatric units: are safety and sensitivity really incompatible? Psychiatr Bull. 2008;32:284–7. doi:10.1192/pb.bp.106.011478.CrossRef

14.

Wright ER, McCabe H, Kooreman HE. Institutional capacity to respond to the ethical challenges of patient sexual expression in state psychiatric hospitals in the United States. J Ethics Ment Health. 2012; 7:1–5. http://www.jemh.ca/issues/v7/. Accessed 10 May 2015.

15.

Lew K. Study on International Attitudes to Sexual Expression in Forensic Settings (Masters dissertation). Nottingham: University of Nottingham; 2014.

16.

McCann E. Exploring sexual and relationship possibilities for people with psychosis: a review of the literature. J Psychiatr Ment Health Nurs. 2003;10(6):640–9. doi:10.1046/j.1365-2850.2003.00635.x.CrossRefPubMed

17.

Mossman D, Perlin ML, Dorfman DA. Sex on the wards: conundra for clinicians. J Am Acad Psychiatry Law. 1997; 25(4):441-60. http://www.jaapl.org. Accessed 10 May 2015.

18.

Hales H, Romilly C, Davison S, Taylor PJ. Sexual attitudes, experience and relationships amongst patients in a high security hospital. Crim Behav Ment Health. 2006;16:254–63. doi:10.1002/cbm.CrossRefPubMed

19.

Bruan V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. doi:10.1191/1478088706qp063oa.CrossRef

20.

Marques JF, McCall C. The application of interrater reliability as a solidification instrument in a phenomenological study. Qualitative Rep. 2005; 10(3):439–62. http://www.nova.edu/ssss/QR/QR10-3/marques.pdf. Accessed 10 May 2015.

21.

Tapp J, Warren F, Fife-Shaw C, Perkins D, Moore E. What do the experts by experience tell us about ‘what works’ in high secure forensic inpatient hospital services? J Forens Psychiatry Psychol. 2013;24(2):160–78. doi:10.1080/1478994902012.760642.CrossRef

22.

Ruane J, Hayter M. Nurses’ attitudes towards sexual relationships between patients in high security psychiatric hospitals in England: an exploratory qualitative study. Int J Nurs Stud. 2008;45:1731–41. doi:10.1016/j.ijnurstu.2008.06.003.CrossRefPubMed

23.

Perlin ML. ‘Everybody is making love/or else expecting rain’: considering the sexual autonomy rights of persons institutionalized because of mental disability in forensic hospitals and in Asia. Wash Law Rev. 2008;83: 481–512. http://www.ssrn.com/abstract=1337164. Accessed 10 May 2015.

Title: Policies on sexual expression in forensic psychiatric settings in different European countries
Authors: Rajveer Tiwana
Stephanie McDonald
Birgit Völlm
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: International Journal of Mental Health Systems / Issue 1/2016
Electronic ISSN: 1752-4458
DOI: https://doi.org/10.1186/s13033-016-0037-y

At a glance: The STEP trials

Springer Medicine

Policies on sexual expression in forensic psychiatric settings in different European countries

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2016

A review of mental health recovery programs in selected industrialized countries

Managing mental illness in Ghana: the state of commonly prescribed psychotropic medicines

Frequent callers to telephone helplines: new evidence and a new service model

Consumers and their supporters’ perspectives on poor practice and the use of seclusion and restraint in mental health settings: results from Australian focus groups

Testing the Community-Based Learning Collaborative (CBLC) implementation model: a study protocol

Erratum to: Consumers and their supporters’ perspectives on poor practice and the use of seclusion and restraint in mental health settings: results from Australian focus groups