Sexual health in the mental health care setting: experiences and perceptions of health care providers

Abstract

From a biopsychosocial perspective, sexuality and sexual health are essential components of health and well-being and should not be excluded from other aspects of care. However, clients’ sexual health needs continue to be under addressed in the mental health context. Health care providers’ varied understandings of sexual health and its relevance to mental health may be a major contributing factor. This study aimed to develop a deeper understanding of the experiences and perceptions of sexuality and sexual health among mental health care providers. Qualitative in-depth interviews were conducted with psychiatrists, psychologists and mental health nurses to explore their experiences and perceptions of sexuality and sexual health and its relevance to their clients and professional roles. Interviews were transcribed verbatim and data analysed using thematic analysis. Three major themes were generated: Mind-body split, the therapeutic relationship, and autonomy. Sexual health was constructed as being either a sense of well-being that included sexual fulfilment or biological and belonging in the realm of physical biomedicine. The therapeutic relationship was both improved and threatened by discussion of sexual health. Participants’ constructions of mental health oscillated between granting autonomy to clients and withholding autonomy, serving to allow or deny sexuality. The findings indicate that mental health providers’ varied understandings of sexual health, including its relevance to mental health care, and attitudes toward mental health may contribute to the inconsistent delivery of sexual health care. Further research is required as to how best address this problem to improve practice and client care in mental health settings.