An overlooked opportunity: the absence of sexual health assessments in adolescent psychiatric inpatient care in the UK

Background Many young people admitted to adolescent psychiatric inpatient services in the UK have a history of sexual trauma. This study aimed to investigate whether sexual health assessments are conducted in these settings. Methods This study used quantitative analysis to review the clinical notes of 33 adolescents admitted to a psychiatric inpatient service over a 15-month period. In addition to studying the record of sexual health assessments, the number and type of risk behaviours, diagnoses and adverse childhood experiences were also reviewed to explore if there were any links between these factors. Results No sexual health assessment documentation was found for any of the patients. All young people had at least one adverse childhood experience recorded, 73% had six or more, and the most prevalent form of abuse recorded was sexual abuse (64%). Conclusions Adolescents admitted to psychiatric units have a high risk of sexual trauma and adverse sexual health outcomes; however, sexual health assessments are often neglected. Young people should be offered an opportunity to talk about sexual safety and health and relationships in inpatient settings, as this has the potential to reduce the risk of long-term negative sexual health and relationship outcomes. Implications for practice Assessment of sexual health and relationships in the inpatient environment should be prioritised by mental health services, as it could lead to more appropriate support, treatment and better preventative interventions. A trauma-informed approach could also lead to better holistic and patient-centred care.