www.cqc.org.uk/sites/default/files/20180911c_sexualsafetymh_report.pdf
Here is the CQC report that the article refers to.
Here's some snippets which have a lot going on in them:
2.Clinical leaders of mental health services do not always know what is good practice in promoting the sexual safety of people using the service and of their staff
Clinical leaders may be uncertain about the behaviours that are acceptable on mental health wards and those that are not. Also, they may not always be aware of the impact that unwanted sexual behaviour has on patients and staff, and the impact that potential false allegations have on staff and people who use services. Clinical leaders’ opinions and approach to these difficult issues vary and may be affected by their personal values. This, and the absence of clear guidance or set of expectations, makes it challenging for staff to manage sexual incidents on mental health wards.
Clinical leaders may have a particular problem in deciding how staff should respond to what appears to be consensual sexual activity between patients. Those involved in the consultation told us how difficult it can be to balance their duty to protect people whose capacity to make decisions might be temporarily impaired, with their wish to respect patients’ right to a private life. This is likely to be a particular challenge on longer-stay wards.
Er ok. How might we reduce the possibility of sexual relationship forming in the first place?
and
3.Many staff do not have the skills to promote sexual safety or to respond appropriately to incidents
Although mental health staff wish to keep patients safe, in the absence of clear guidance from leaders they often feel ill-equipped to manage sexual safety incidents. This includes occasions when staff are themselves subject to sexual assault, abuse or harassment or have allegations made against them (including false allegations, by people who use mental health services).
Staff told us that they sometimes feel ‘paralysed’ and unable to act when a sexual incident occurs. Some staff do not know how to respond to these, or to disclosures from people who use mental health services, and may not always address them promptly and appropriately. This includes the question of determining whether patients have the mental capacity to decide to engage in sexual activity.
There is a pressing need for better staff development on these important issues. This development should be co-produced and must equip staff to:
•Develop the skills and confidence to have conversations with patients and with colleagues about the sexual health and sexual safety of patients, using appropriate language to support patients to feel comfortable talking about their experiences.
• Make a full assessment of patients that includes historical details about their sexual safety (both in terms of vulnerability and potential to display sexual behaviour that puts others at risk). This will enable them to sensitively identify potential risks and plan the person’s care.
• Understand the principles of trauma-informed care and embed these into every day practice.
• Respond to the needs of people who identify as lesbian, gay, bisexual, or non-binary or who are transgender.
• Ensure that staff are supported when faced with allegations of a sexual nature.
• Consider the difficult issues of mental capacity and consent with the involvements of the full multidisciplinary team working on the ward
•Identify a person who has particular expertise in this area who can lead this work on behalf of the provider. The lead would help to develop this work locally and could act as a valuable source of advice to staff throughout the organisation.
Why are we even discussing this in 2018? They DON'T do risk assessments for all patients as a matter of course??? Like WTF?
and
4. The ward environment does not always promote the sexual safety of people using the service
Most people admitted to hospital cannot choose their ward, or whether it is a same-sex or mixed-sex ward. For the great majority of NRLS reports, we could not tell whether the incident happened on a same-sex or a mixed-sex ward. However, we do know that in two thirds of cases where the report indicated that a female was the person affected, a man was alleged to be the person who carried out the incident. We know from our inspection programme that, on mixed- sex wards, it is often difficult to ensure that gender separation is maintained effectively and to ensure that patients cannot access bedroom areas intended for those of the opposite sex. The data also shows that a significant number of the incidents occur in communal areas.
Those we consulted with agreed that dormitory accommodation, or other arrangements where bedrooms are shared (by patients of the same sex), are unacceptable and do not offer privacy or dignity.
Significant investment would be needed to change all inpatient provision to single-sex wards and remove all shared rooms. It might also reduce flexibility of overall bed provision, meaning that more people would be admitted to wards a long way from their home areas which can also lead to increased clinical risk. Also, those we consulted with told us that it is harder to recruit staff to work on single-sex wards.
The diversity on a mental health ward reflects the diversity of the country. It is important that the ward environment meets the needs of everyone – and does not make predetermined gender-based assumptions. This may be particularly important for those people who identify as LGBT+.
Healthcare professionals and representatives of arms-length bodies that we consulted with agreed that CQC should not simply recommend that all mental health wards become single-sex.
As well as the cost and potential impact on out-of-area placements, this would not affect the significant proportion of incidents that involve people of the same gender or a staff member as the person who was affected by the unwanted behaviour.
However, we believe that where a patient has a history of sexual abuse or exploitation a clear care plan must be put in place and, where it is in the person’s interests and/or they express a preference, they should be cared for in a single-sex ward.
For wards that admit both men and women, the arrangements to keep the sleeping and bathroom areas apart must work in practice and communal areas should be closely supervised. Those we consulted with told us of examples where door security was not working properly and patients could move freely between different areas of the ward. CQC has encountered similar situations on inspections of mixed-sex wards.
So despite 2/3 of incidents against women being by men, and a suggestion of underreporting we aren't going to recommend single sex wards....
...after all, the well being of women is not worth the cost.
Question: If you knew your chances of a sexual assault would immediately be reduced by 2/3 by being on a women's only ward, would you prefer to be on a women's only ward???
Who writes and justifies this shit?
5. Staff may under-report incidents and reports may not reflect the true impact on the person who is affected
From our engagement work, we heard that staff and patients find it difficult to speak up when they observe, or are the person affected by, unwanted sexual behaviour. We were told that staff may become ‘desensitised’ to the issue because sexual incidents happen regularly, particularly on acute wards. This may discourage staff from reporting incidents.
This lack of encouragement may be made worse when staff struggle to find the time to report incidents when wards are very busy. This means that the actual number of such incidents may be higher than suggested by our findings.
Staff are not trained to deal with this. We already established this. Who is more likely to under report?
6.Joint-working with other agencies such as the police does not always work well in practice
The decision to charge a person detained in inpatient mental health services with a criminal offence is a sensitive matter. It requires close cooperation between police investigators, healthcare professionals and Crown prosecutors. There are examples across the country of successful partnerships between mental health providers and police services where officers are posted as liaison officers or investigators to handle reports of people who use services offending in the hospital (see case study on Cornwall Partnership NHS Foundation Trust, page 21).
Nothing to see here. Apart from an implied admission that they placing hugely unsuitable criminals in the company of very vulnerable people - and are fully aware that the system is fatally flawed in terms of communication of basic facts.
As I say, lots going on here which is terrifying.