Exploring the acceptability of undertaking sexual health and behaviour research in people with Severe Mental Illness: A UK perspective

Background: People with severe mental illness (SMI) experience significant inequalities in physical health and die on average 15-20 years earlier than the general population. To address this, physical health is now higher on the health policy and practice agenda. However, sexual health is significantly neglected within current UK health policy, and there is a paucity of research within the UK despite the international literature suggesting the sexual health of people with SMI is poor. Methods: A range of methods were employed to explore the intersection of SMI and sexual health in the UK. A systematic review was undertaken to examine whether adults with SMI are more likely to engage in behaviours associated with increased risk of blood borne viruses/sexually transmitted infections compared to those with no history of SMI. A feasibility study examined recruitment processes and, explored participant feedback on the acceptability of a sexual health interview. Qualitative interviews explored mental health professional’s (MHPs) views in relation to the sexual health and relationship needs of people with SMI. Lastly, secondary data analysis of survey data examined the acceptability and experiences of people with SMI in the UK who participated in the RESPECT study. Results: Within the UK context, this thesis provides evidence that it is acceptable to speak to the SMI population about their sexual health and behaviour as well as preliminary evidence that it is feasible to recruit people with SMI to research in this area. Priorities for policy include bringing the sexual health and relationship needs to the forefront of guidance to ensure MHPs are aware of the legitimacy of supporting their service users with this aspect of their physical health. Conclusions: The research within this thesis provides important evidence that it is acceptable to undertake sexual health and behaviour research in people with SMI in the UK.