- Mental health services should ensure that they provide a safe environment for every person admitted to an adult acute inpatient unit. Sexual activity, or unwanted sexual advances from others, is one of a range of risks that need to be considered, assessed and managed. Any sexual activity in an adult acute inpatient unit is incompatible with the acute treatment environment and is unacceptable. Any sexual activity between staff and patients is an offence and should be dealt with through existing criminal and disciplinary processes. Services should develop local policies and procedures consistent with this guideline to promote sexual safety and guide staff in preventing sexual activity, and responding appropriately to allegations of sexual assault or harassment.
People with a mental illness are vulnerable to sexual risk because of their illness and frequent history of sexual abuse, especially women. People with a past history of trauma may experience some aspects of hospital admission and mental health care as traumatic, highlighting a need for more trauma informed care. The gender sensitivity and safety in adult acute inpatient units project report (May 2008) identified a range of issues relating to the treatment and care of patients in acute inpatient environments, including a need for clearer policy and guidelines to promote more consistent and responsive practice.
This Chief Psychiatrist’s guideline sets out the relevant legislation and policy, and establishes minimum standards for the clinical management of sexual activity, and the appropriate staff response to patients who report inappropriate sexual activity in adult acute inpatient units. It provides guidance on decision making processes and clarifies the circumstances where clinical discretion may apply.
The guideline is intended to assist mental health service managers, clinical directors and clinical staff in their obligations to promote a therapeutic culture and environment that recognises sexual vulnerability, and actively manages sexual behaviour to minimise sexual risk and support disclosure of sexual assault and harassment. Services are expected to develop local policies based on the guideline to promote awareness of gender related issues and sexual safety. The guideline provides a framework for local innovation and best practice in implementing the principles.
Reviewed 29 December 2022