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RESPECT: Randomised Evaluation Sexual Health Promotion Evidence for Care and Treatment: A feasibility study of an intervention to promote sexual health for people with serious mental illness (SMI)

People with serious mental illness (SMI) (these are people who experience long term, relapsing mental health problems that require ongoing support from NHS mental health services) often have additional physical health problems. However, these are often not addressed for a number of reasons including lack of motivation, not reporting symptoms to their health workers, and what is known as "diagnostic overshadowing" which means that physical ailments can be misinterpreted as a part of their mental illness.

There is now a movement towards helping people with SMI get their health needs met (including health checks at GPs, and assessments of physical health in mental healthcare) yet one important area of health has been forgotten; sexual health. People with SMI, just like everyone else, hope to have safe and satisfying sexual relationships, and indeed this is an important part of building a life of recovery from mental illness. However, the reality for people with SMI is often more bleak. They are more at risk of sexually acquired infections such as HIV and hepatitis B (and C) and more likely to face violence and exploitation in their relationships.

People with SMI have poor sexual health and this includes abusive relationships, low rates of contraception, and increased risk of sexually transmitted infections and blood borne viruses. The reasons for poor sexual health are complex and may relate to co-morbid drug and alcohol use, history of sexual abuse and hyper-sexuality during acute phases of illness. Reviews of trials of sexual health interventions for people with SMI have concluded that there is currently no reliable evidence to base interventions in the UK. People with SMI don’t engage in routine healthcare, therefore it is argued that sexual health promotion occurs within the mental health services, and delivered by a trained mental health clinician (e.g. registered mental health nurse).

Working in collaboration with colleagues from the University of Huddersfield, Brighton and Sussex Medical School and University College London, this study aims to develop an evidence-supported and co-produced manualised sexual health intervention designed for people with serious mental illness in the UK. We will also assess the acceptability of the intervention delivered within mental health services and the feasibility of conducting a randomised trial of this intervention.

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Trials and Statistics Research in the Department of Health Sciences