Sexual knowledge of Queensland forensic mental health patients: A cross-sectional quantitative study

Elnike Brand; Ching Tham; Angela Ratsch; Edward Heffernan

doi:10.3389/fpsyt.2023.1160277

Sexual knowledge of Queensland forensic mental health patients: A cross-sectional quantitative study

Front Psychiatry. 2023 Apr 11:14:1160277. doi: 10.3389/fpsyt.2023.1160277. eCollection 2023.

Authors

Elnike Brand¹, Ching Tham², Angela Ratsch^{3

4}, Edward Heffernan¹

Affiliations

¹ Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
² Metro South Hospital and Health Services, Queensland Health, Brisbane, QLD, Australia.
³ Wide Bay Hospital and Health Service, Research Services, Hervey Bay Hospital, Hervey Bay, QLD, Australia.
⁴ Rural Clinical School, The University of Queensland, Brisbane, QLD, Australia.

Abstract

Forensic patients with serious mental illnesses (SMI) encounter significant challenges including active symptomatology, associated social and interpersonal impairments, psychotropic medication side effects and institutionalization, all of which negatively affect sexual functioning and possibly their acquirement of sexual knowledge. Evidence shows an increased prevalence of high-risk sexual behavior by this group however, there is an absence of literature examining the sexual knowledge of forensic patients. This quantitative cross-sectional study enrolled N = 50 patients currently under the treatment requirements of a Forensic Order and utilized the validated General Sexual Knowledge Questionnaire (GSKQ) to quantify the participants' sexual knowledge over the domains of physiology, sexual intercourse, pregnancy, contraception, sexually transmitted diseases, and sexuality. Male forensic patients scored lower than females on all domains of sexual knowledge. All participants had reasonable knowledge of physiology, sexual intercourse and sexuality; of concern were poor scores on pregnancy, contraception and sexually transmitted diseases. Thirty-five (70%) of the respondents indicated that they had some limited sex education, mostly at school. Only six (12%) received any sexual education from a health professional despite extensive contact with the forensic mental health services across many years. There is a need to assess the deficit in sexual knowledge of forensic patients in order to develop sexual health education, intervention and rehabilitative programmes that cater to the specific needs of this group to improve their sexual knowledge, encourage safe and positive sexual experiences, and enhance their quality of life.

Keywords: forensic; mental health—related quality of life; mental illness; sexual education; sexual knowledge.

Grants and funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The team considered that the non-provision of the “normal” remuneration in this highly marginalized group would be an exploitation of their vulnerability. Accordingly, participants are remunerated in line with the accepted and expected practice of contributing time and effort to research. WBHHS funding had been obtained to offer a $20 grocery voucher card to participants of the project. An accountable register had been maintained with coded participant details to record all grocery vouchers distributed.