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Relationships between residents in secure psychiatric units: are safety and sensitivity really incompatible?

  • Kalpana Dein (a1) and Paul Simon Williams (a2)
Extract

Since the 1960s, Western society has adopted a more liberal attitude to sexuality. Choice of sexual partners, sexual preferences, attitudes and practices are increasingly a matter of individual choice and freedom. These changes, however, have had little impact on the lives of psychiatric in-patients (Eiguer et al, 1974; Akhtar et al, 1977; Taylor & Swan, 1999). ‘Mental illness,’ it has been suggested, ‘is one of the few disabilities where people run the risk of losing their freedom in order to receive in-patient treatment’ (Cook, 2000). This loss of liberty and rights becomes more pronounced in secure settings where mentally disordered offenders can spend a substantial part of their adult (sexual/reproductive) lives. Prisoners in some US state prisons (of medium and low security) are afforded conjugal visits from their married partners, in view of the rights of the latter. Paradoxically, detention in secure units, which we consider a therapeutic and not a punitive measure, places constraints on the formation of new relationships and the maintenance of previously existing ones. New relationships are, in our experience, viewed with more concern than previously existing ones.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Akhtar, S., Crocker, E., Dickey, N., et al (1977) Overt sexual behaviour among psychiatric inpatients. Archives of General Psychiatry, 30, 180182.
Andrau, R. (1969) Sexualite et institution. Evolution Psychiatrique, 32, 503524.
Batcup, D. (1994) Mixed Sex Wards. Recognising and Responding to Gender Issues in Mental Health Settings and Evaluating their Safety for Women. Bethlem & Maudsley NHS Trust.
Buckley, P. F. (1999) Sexuality and Serious Mental Illness. Harwood Academic Publishers.
Buckley, P. F. & Hyde, J. L. (1997) State hospitals' responses to the sexual behaviour of psychiatric inpatients. Psychiatric Services, 48, 398399.
Commons, M. L., Bohn, J.T., Godon, L.T., et al (1992) Professionals' attitudes towards sex between institutionalized patients. American Journal of Psychotherapy, 46, 571580.
Cook, J. A., Razzano, L. A., Jayaraj, A., et al (1994) HIV risk assessment for psychiatric rehabilitation clientele: implication for community-based services. Psychosocial Rehabilitation Journal, 17, 106116.
Cook, J. A. (2000) Sexuality and people with psychiatric disabilities. Sexuality and Disability, 18, 195206.
Cournos, F., Horwath, E., Guido, J. R., et al (1994) HIV–1 infection at two public psychiatric hospitals in New York City. AIDS Care, 6, 443452.
Davison, S. (1999) Sexuality. In Couples in Care and Custody (eds Taylor, P. J. & Swan, T.), pp. 7085. Butterworth Heinemann.
Department of Health (2002) Women's Mental Health: Into the Mainstream. Strategic Development of Mental Health Care for Women. Department of Health.
Eiguer, A., Litousky De Eiguer, D. & Chapuis, F. (1974) Contribution a l'etude de la mixite et de la formation des couples en milieu psychiatrique. L'Information Psychiatrique, 50, 915929.
Fitzgerald, E. & Harbour, A. (1999) Marriages and partnerships for psychiatric patients or prisoners: European rights and law in the UK. In Couples in Care and Custody (eds Taylor, P.J. & Swan, T.), pp. 2329. Butterworth Heinemann.
Ford, E., Rosenberg, M., Holsten, M., et al (2003) Managing sexual behaviour on adult acute care inpatient psychiatric units. Psychiatry Services, 54, 346350.
Gordon, H., Oyebode, O. & Minne, C. (1997) Death by homicide in special hospitals. Journal of Forensic Psychiatry, 8, 602619.
Hales, H., Romilly, C., Davison, S., et al (2006) Sexual attitudes, experience and relationships amongst patients in a high security hospital. Criminal Behaviour and Mental Health, 16, 254263.
Hensley, C., Castle, T. & Tewksbury, R. (2003) Inmate-to-inmate sexual coercion in a prison for women. Journal of Offender Rehabilitation, 37, 7787.
Jennings, A. (1994) On being invisible in the mental health system. Journal of Mental Health Administration, 21, 374387.
Keitner, G. I., Baldwin, L. M. & McKendall, M. J. (1986) Copatient relationships on a short-term psychiatric unit. Hospital and Community Psychiatry, 37, 166170.
Keitner, G. & Grof, P. (1981) Sexual and emotional intimacy between psychiatric inpatients: formulating a policy. Hospital and Community Psychiatry, 32, 188193.
Kobbe, U. (1988) ‘Sexual atrophy’ in psychiatric patients: an essay review [in German]. Psychiatrische Praxis, 15, 192201.
Macgregor-Morris, R., Ewbank, J. & Birmingham, L. (2001) Potential impact of the Human Rights Act on psychiatric practice: the best of British values? BMJ, 322, 848850.
Mezey, G., Hassell, Y. & Bartlett, A. (2005) Safety of women in mixed-sex and single-sex medium secure units: staff and patient perceptions. British Journal of Psychiatry, 187, 579582.
Modestin, J. (1981) Patterns of overt sexual interaction among acute psychiatric inpatients. Acta Psychiatrica Scandinavica, 64, 446459.
Mosher, D. L. (1991) Scared straight: homosexual threat in heterosexual therapists. In Gays, Lesbians and Their Therapists (ed. Silverstein, C.). Norton.
Mossman, D., Perlin, M. L. & Dorfman, D. A. (1997) Sex on the wards: conundra for clinicians. Journal of American Academy of Psychiatry and the Law, 25, 441460.
Nibert, D., Cooper, S. & Crossmaker, M. (1989) Assaults against residents of a psychiatric institution. Journal of Interpersonal Violence, 4, 342349.
Payne, A. (1993) Sexual activity among psychiatric inpatients: international perspectives. Journal of Forensic Psychiatry, 4, 109129.
Ramrakha, S., Caspi, A., Dickson, N., et al (2000) Psychiatric disorders and risky sexual behaviour in young adulthood: cross sectional study in birth cohort. BMJ, 321, 263266.
Sullivan, G. (1993) Sexual dysfunction associated with anti-psychotic medications. Current Approaches to Psychoses, 5, 89.
Taylor, P. J. & Swan, T. (1999) Couples in Care and Custody. Butterworth Heinemann.
Thompson, S. C., Checkley, G. E., Hocking, J. S., et al (1997) HIV risk behaviour and HIV testing of psychiatric patients in Melbourne. Australian and New Zealand Journal of Psychiatry, 31, 566576.
Warner, J., Pitts, N., Crawford, M. J., et al (2004) Sexual activity among patients in psychiatric hospital wards. Journal of the Royal Society of Medicine, 97, 477479.
Wignath, C. M. & Meredith, C. E. (1968) Illegitimate pregnancies in state institutions. Archives of General Psychiatry, 18, 580583.
Windle, M. (1997) The trading of sex for money or drugs, sexually transmitted diseases (STDs), and HIV-related risk behaviours among multisubstance using alcoholic inpatients. Drug and Alcohol Dependence, 49, 3338.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
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Relationships between residents in secure psychiatric units: are safety and sensitivity really incompatible?

  • Kalpana Dein (a1) and Paul Simon Williams (a2)
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