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. 2023 Feb;47(1):4-10.
doi: 10.1192/bjb.2021.107.

Sexual and reproductive health needs assessment and interventions in a female psychiatric intensive care unit

Elana Covshoff  1 , Lucy Blake  2 , Elizabeth Mary Rose  2 , Adenike Bolade  2 , Robert Rathouse  2 , Aleishia Wilson  2 , Arthur Cotterell  2 , Rudiger Pittrof  1 , Faisil Sethi  3
Affiliations

Sexual and reproductive health needs assessment and interventions in a female psychiatric intensive care unit

Elana Covshoff et al. BJPsych Bull. 2023 Feb.

Abstract

Aims and method: To assess the sexual and reproductive health (SRH) needs of women admitted to a psychiatric intensive care unit (PICU), and acceptability of delivering specialist SRH assessments and interventions in this setting. Within a quality improvement framework, staff were trained, a clinical protocol developed and clinical interventions made accessible.

Results: Thirty per cent of women were identified as having unmet SRH needs and proceeded to a specialist appointment, representing a 2.5-fold increase in unmet need detection. Forty-two per cent of women were assessed, representing a 3.5-fold increase in uptake. Twenty-one per cent of women initiated SRH interventions, of which 14% had all their SRH needs met. Staff, patients and carers highlighted the acceptability and importance of SRH care, if interventions were appropriately timed and patients' individual risk profiles were considered. Barriers to access included lack of routine enquiry, illness acuity and impact of the COVID-19 pandemic.

Clinical implications: SRH needs for PICU admissions are greater than previously realised. Providing a nurse-led SRH assessment is acceptable, feasible and beneficial for PICU patients.

Keywords: In-patient treatment; education and training; human rights; psychiatric nursing; sexual and gender identity disorders.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Clinical assessments. SHRINE, Sexual and Reproductive Health Rights, Inclusion and Empowerment programme; SRH, sexual and reproductive health; STI, sexually transmitted infection.
Fig. 2
Fig. 2
SRH needs and SHRINE interventions. CAO, contraception advice/options; GYN, gynaecology care; O/U, other (including counselling, signposting, unknown); PCC, preconception care; SAS, sexual assault support; SDF, sexual dysfunction/function; SHRINE, Sexual and Reproductive Health Rights, Inclusion and Empowerment programme; SRH, sexual and reproductive health; STIAT, sexually transmitted infection advice/testing; TOPD, termination of pregnancy discussion.
Fig. 3
Fig. 3
Patient flow. PICU, psychiatric intensive care unit; SRH, sexual and reproductive health; SHRINE, Sexual and Reproductive Health Rights, Inclusion and Empowerment programme.
See this image and copyright information in PMC

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