Affective and sexual needs of residents in psychiatric facilities

INTRODUCTION: The expression of affectivity and sexuality are fundamental human rights. However, people diagnosed with severe mental disorders (SMDs) living in psychiatric facilities may find it difficult to fulfil their needs, which may be neglected and misunderstood by mental health professionals (MHPs). This paper summarizes current knowledge on this topic using a narrative review. EVIDENCE ACQUISITION: PubMed, PsycINFO, Web of Science and Scopus were searched for studies of the affectivity and sexual needs of service users with SMDs living in residential and other long-term-stay facilities. Of the 451 articles initially retrieved, 26 met the inclusion criteria of this review. EVIDENCE SYNTHESIS: The findings were reported under six main headings: sexual, affective and relational needs of mental health service users, views of MHPs on users’ sexuality, policies on the regulation and responses to users’ sexual and affective needs, sexual education and training aimed at both mental health service users and professionals, HIV/sexually transmitted diseases (STD) risk assessment and prevention programs, and contraception. CONCLUSIONS: Sexual relations are generally prohibited or discouraged within residential facilities, but it has nevertheless been found that many residents are sexually active. The denial of their sexual needs by residential staff and the absence of any dedicated setting for sexual relations within facilities are sources of substantial distress for residents. Studies have also found a lack of knowledge of STDs among users and discomfort of MHPs in dealing with the topic. Hence, educational and training interventions for both users and MHPs should be implemented. Specific policies and guidelines could be coproduced to enhance patients’ emotional and relational capabilities and encourage them to adopt healthier and safer sexual practices.