RNSystematic ReviewInternational journal of mental health nursing2025

The Factors That Affect Sexual Safety on Adult Mental Health Inpatient Units: A Scoping Review and Content Analysis.

Karen Dixon, Melissa Petrakis, Ellie Fossey and 2 others

PMID 40528559

WHAT IT FOUND

Consumers and staff in adult mental health units described unsafe spaces, disbelieved reports and limited trauma training as threats to sexual safety.

Women-only areas helped some feel safer, but did not alone solve it.

Key findings

01Women-only or gender-segregated spaces were reported to increase perceived safety in 12 of 15 included studies, but environment changes alone were not sufficient to ensure safety.

02Consumers said they were not listened to, disbelieved or devalued when reporting sexual safety concerns, and some chose not to report.

03Staff in nine included studies said they lacked capability or resources to prevent, respond to and discuss sexual safety, and training was recommended.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

This was a scoping review, not a test of whether any change improves sexual safety. The authors did not check the quality of the included studies, so the strength of evidence behind each recommendation is not known. Most included studies were qualitative (12) or mixed methods (3), so they describe experiences and views rather than prove that an intervention works. Two included studies were organisational or government reports, which may not have undergone peer review. Only English-language papers and reports from 2007 onward were included, and only adults aged 18 to 65 years, so it may miss experiences of younger people, older people and non-English services. Only acute mental health inpatient units were included; sub-acute and residential services were excluded, even though they are bed-based.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not conclude that gender-segregated wards, trauma-informed care or staff training have been proven to make mental health units safer. This review synthesised perceptions and recommendations, did not appraise study quality, and some included studies reported that single-sex environments alone did not ensure safety.

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