Implementing Sexual Safety in Inpatient Mental Health: Staff Perspectives on Training

The sexual safety of people in mental health inpatient units is an increasingly important concern. Following provision of a co-designed staff training package (the Welcome Project) to support sexual safety on an Australian adult mental health inpatient unit, this qualitative study aimed to gain an understanding of barriers and enablers to implementation of sexual safety practices from the perspective of staff in this setting. Data was collected through semi-structured interviews with eleven clinicians. Directed content analysis was used to map data against the Consolidated Framework for Implementation Research and the Capability Opportunity and Motivation Model of behaviour change. The findings describe barriers and enablers to sexual safety related to key aspects of these frameworks: knowledge about sexual safety, knowledge about trauma-informed care, time to talk about sexual safety, role clarity, reluctance to talk about sexual safety, culture, leadership, physical environment, staffing, consumer and carer peer workers, and acuity. While training improved awareness, results from this study suggest that education alone was insufficient to support routine sexual safety discussions. Future implementation requires a multilevel approach that combines targeted training with clear role expectations, as well as adequate staffing, supportive leadership, and organisational commitment to sexual safety. In conclusion, while staff knowledge is important, the physical environment and leadership need to be considered and strategies in place to support clinicians to implement sexual safety training and routinely have conversations with consumers about sexual safety during inpatient admissions.