• People with serious mental illness engage in sexual activity

• there is evidence that they experience higher rates of exploitation and violence, as well as STIs, unplanned pregnancy, and blood borne viruses

• theories proposed to explain this include:

• acute exacerbation of psychiatric symptoms

• co-morbid drug and alcohol problems

• previous experience of sexual abuse

• sexual stigma

• lack of social skills (assertiveness, negotiation re condoms etc)

• No UK research into sexual behaviour in people with SMI

• We need to understand the sexual behaviours in order to start to design interventions to promote sexual health

• We also need to understand how mental health clinicians screen, assess, signpost, provide education re sexual health.

• Work Plan

• focus groups with clinical staff

• focus groups with service users

• pilot the NATSAL-3 (UK general population sexual behaviour survey) with a sample of service users (acceptability, feasibility and validity of this survey) (can then compare with normative data

•

NIHR HS&DR application 2015: The aim of this research will be to understand the NHS current response to sexual health and mental health, identify gaps and needs, and develop care pathways and training resources to address those gaps to ensure that people with mental health problems have parity of access to sexual health information, advice, screening and if need be treatment. (£500K)

• NIHR PGfAR (or HTA) application 2016: aim to develop an intervention to promote sexual health amongst people with mental illness and problems of addiction. This will form the basis of a trial which will recruit across CLAHRC-YH (£2million).