Policy makers and mental health service providers need to take action to ensure that people with serious mental illnesses receive greater guidance about sexual health.
A UK survey of nearly 300 mental health workers, published in the February issue of the Journal of Clinical Nursing, found that although 80 percent agreed that promoting sexual health was an important part of their role, only 30 percent routinely discussed sexual health issues with service users.
It also discovered that up to 39 percent of respondents didn’t routinely wear gloves when performing clinical procedures that could expose them to HIV.
“We were encouraged by the respondents’ positive attitudes to sexual health promotion and the fact that the majority (78%) agreed that mental health workers should have mandatory training in the subject” says Dr. Elizabeth Hughes.
“But we were disappointed that less than a third were actually providing the advice and guidance that people with serious mental illnesses need.
“The fact that 14 percent felt uncomfortable discussing sexual health issues and 13 percent were uncomfortable discussing gay and lesbian issues may have some bearing on the low level of sexual health promotion recorded by this survey.
“Lack of awareness of the increased HIV risks faced by service users with schizophrenia was also a particular concern, as studies have shown that they have higher HIV infection rates than the general population. These range from 5 percent in Europe to up to 19 percent in North America.
“Despite this, UK sexual health strategies don’t mention people with serious mental illness as a high risk group, even though studies from various countries, including Australia, suggest that a fifth engage in risky sexual behaviour.”
Dr. Hughes feels that this lack of awareness could also be putting mental health professionals at risk of infection.
“Four out of ten people who took part in our study admitted they didn’t routinely wear gloves when they gave patients injections and glove wearing for other clinical procedures varied.”
“We are concerned by our findings because it means that people with serious mental illnesses are not routinely receiving sexual health information and intervention” says Dr. Hughes.
“Lack of awareness of the increased risks of schizophrenia and lower levels of glove wearing for some clinical procedures could also pose an infection risk for staff.
“As a result, we are calling for improved training on the sexual health risks faced by people with serious mental illness and better links between mental health and sexual health services.
“We would also like to see more research into the kinds of sexual risk behaviours that people with serious mental illness engage in and targeted intervention to make them more aware of, and reduce, the risks they expose themselves to.
“Finally we would like to see research to identify the prevalence of HIV, hepatitis B and C in people with serious mental illness, as this would be an important step in understanding how serious the problem is in the UK.”