Betterly Holly, Musselman Meghan, Sorrentino Renée
Resident Physician, Department of Psychiatry, Temple University Hospital, 3401 N Broad St, Philadelphia, PA 19140, USA.
Assistant Professor of Psychiatry and Behavioral Science, Lewis Katz School of Medicine at Temple University, 3500 N Broad St, Philadelphia, PA 19140, USA.
Gen Hosp Psychiatry. 2023 May-Jun;82:7-13. doi: 10.1016/j.genhosppsych.2023.02.006. Epub 2023 Mar 2.
Sexual assault in the inpatient psychiatric setting is a significant problem with serious, lasting consequences. It is important for psychiatric providers to appreciate the nature and magnitude of this problem to be able to provide an appropriate response when faced with these challenging scenarios, as well as to advocate for the implementation of preventive measures. This article provides a review of the existing literature regarding sexual behavior in the inpatient psychiatric unit, describing the epidemiology of sexual assaults in these settings, and exploring the characteristics of both victims and perpetrators, with a particular focus on factors of relevance to the inpatient psychiatric patient population. Inappropriate sexual behavior in inpatient psychiatric settings is common, however the varying definition of such throughout the literature serves as a challenge to clearly identifying the frequency of specific behaviors. The existing literature does not identify a way to reliably predict which patients are most likely to engage in sexually inappropriate behaviors on an inpatient psychiatric unit. The medical, ethical, and legal challenges that such cases present are defined, followed by a review of current management and prevention strategies, and suggested future directions for research.
住院精神科环境中的性侵犯是一个严重问题,会产生严重且持久的后果。精神科医护人员认识到这一问题的性质和严重程度非常重要,这样在面对这些具有挑战性的情况时能够做出适当反应,并倡导实施预防措施。本文回顾了关于住院精神科病房性行为的现有文献,描述了这些环境中性侵犯的流行病学情况,探讨了受害者和肇事者的特征,特别关注与住院精神科患者群体相关的因素。住院精神科环境中的不当性行为很常见,然而,文献中对此的定义各不相同,这对明确识别特定行为的频率构成了挑战。现有文献并未找到可靠预测哪些患者在住院精神科病房最有可能出现性行为不当的方法。界定了此类案件所带来的医学、伦理和法律挑战,随后回顾了当前的管理和预防策略,并提出了未来的研究方向。