Australian Catholic University, Fitzroy, Victoria, Australia.
Forensicare, Fairfield, Victoria, Australia.
Int J Ment Health Nurs. 2021 Apr;30(2):382-389. doi: 10.1111/inm.12795. Epub 2020 Oct 13.
Mental health clinicians work within a recovery framework that is rights based and emphasizes positive and respectful approaches to working with mental health consumers. Mental health nurses' practice is also predicated on holism and inclusiveness, yet consumers' sexuality is sometimes neglected and rights in this area overlooked. Also overlooked is sexuality as an area for investigation, particularly from a consumer perspective, even though it constitutes part of consumers' broader remit of sexual health. This paper reports findings from a case study where consumers were asked about their ability to negotiate and sustain sexual expression while residing in a long-stay mental health rehabilitation facility. There were three main findings. First, the physical space of the facility, inclusive of consumers' bedrooms, was policed by mental health clinicians with ongoing intrusions into consumers' privacy, which inhibited their sexual expression. The creation of barriers to sexual expression is counter to polices that promote recovery. Second, consumers reported significant medication-related weight gain which negatively affected their self-image and sexual sense of self. Third, the consumers spoke about their sexuality in ordinary, everyday language devoid of any hallmark of psychosis. This highlights the importance of relating to consumers about their sexuality and sexual needs from a humane rather than technical framework. Further, it foregrounds the relational aspect of the mental health nurses' role rather than the technical aspect. Yet sexuality is a topic that is often neglected, indicating that an upskilling of the mental health nursing workforce is required, to strengthen communication and relationship skills.
心理健康临床医生在基于权利的恢复框架内工作，强调积极和尊重的方法与心理健康消费者合作。心理健康护士的实践也基于整体论和包容性，但消费者的性取向有时被忽视，这方面的权利也被忽视。性也被忽视为一个研究领域，特别是从消费者的角度来看，尽管它构成了消费者更广泛的性健康范围内的一部分。本文报告了一项案例研究的结果，该研究要求消费者就他们在长期精神健康康复设施居住期间协商和维持性表达的能力发表意见。主要有三个发现。首先，设施的物理空间，包括消费者的卧室，都受到心理健康临床医生的监管，他们不断侵犯消费者的隐私，这抑制了他们的性表达。对性表达设置障碍与促进康复的政策背道而驰。其次，消费者报告说，他们因药物治疗而体重显著增加，这对他们的自我形象和性自我意识产生了负面影响。第三，消费者用普通的日常语言谈论他们的性，没有任何精神病的特征。这突出了从人道而不是技术框架与消费者讨论性和性需求的重要性。此外，它突出了心理健康护士角色的关系方面，而不是技术方面。然而，性是一个经常被忽视的话题，这表明需要对精神健康护理人员进行技能提升，以加强沟通和关系技巧。
