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

Mental health inpatient units aim to be safe places for consumers to recover but existing literature suggests this is not always the case. Women are particularly vulnerable to sexual safety incidents due to their higher prevalence of experiencing sexual assault and harassment in the broader community. This review aimed to identify and synthesise the factors that affect sexual safety on adult mental health inpatient units in the published literature, from the perspectives of staff and consumers. The literature search of four databases (CINAHL, Ovid Medline, PsychINFO and AMED) and other sources, yielded 15 studies that met the inclusion criteria. Content analysis identified four categories: (1) the built environment, (2) leadership, (3) the consumer voice and (4) staff capabilities and resources. Recommendations to promote sexual safety included the creation of separate flexible areas for women or others with sexual safety vulnerabilities such as gender diverse people. Clear guidance from leadership was identified as necessary to promote good practice when managing and responding to sexual safety incidents and creating reliable systems for consumers to feel safe when reporting their concerns. Trauma-informed principles must be embedded into everyday practice including the routine completion of a trauma history upon admission and staff training is recommended to promote and respond to sexual safety incidents. This training should be delivered and/or co-designed by consumers. This review highlights the need for further research into the effectiveness of interventions designed to address these factors that affect sexual safety on mental health inpatient units.