Change in Policy on Sexuality Urged for Forensic Inpatients

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SAN ANTONIO -- Mentally ill forensic inpatients should be able to appropriately express their sexuality. Dr. John Young said at the annual meeting of the American Academy of Psychiatry and the Law.

"We're all sexual beings," said Dr. Young, a forensic psychiatrist practicing in Middletown, Conn. "We need to show patients that kind of respect."

Because there are sometimes problems with inpatients making sexual advances toward one another, institutions may be "forced" to talk about the rules governing inpatients' sexual expression anyway, he continued. The question would then become how to begin the process.

First, hospital psychiatrists need to define the goals of any new policy regarding sexuality and get others to support them. "It's also practical to notice what rules already exist" regarding patients' sexual expression, Dr. Young said. "'There are rules people believe exist in the hospital, but then you can't find them written down anywhere."

He also recommended getting input on the subject from various hospital constituencies, including the hospital's recreation and security departments. "The patients also have something to tell us. We should encourage creativity and collegial learning from one another."

But paying more attention to patient sexuality can also have its hazards, Dr. Young warned. For example, "one I worry about is if patients have new ways of being jealous of one another about sexuality, they could become more violent," he said. "And patients will feel pressure by their peers and may not want to have sex or think about their sexuality. We also must consider the possibility of sexually transmitted diseases and pregnancies that may occur if we allow patients to express their sexuality. …