"Sex isn't everything": views of people with experience of psychosis on intimate relationships and implications for mental health services.

Discrimination Intimate relationships Mental health services Psychosis Qualitative Romantic relationships Stigma Therapeutic alliance

Journal

BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559

Informations de publication

Date de publication:
14 06 2021
Historique:
received: 11 01 2021
accepted: 19 04 2021
entrez: 15 6 2021
pubmed: 16 6 2021
medline: 29 6 2021
Statut: epublish

Résumé

The experience of psychosis and associated discrimination can be a barrier to forming and maintaining romantic relationships. Sexual health interventions within mental health services often focus on contraception and reducing risk. There are no known studies that seek to understand what support, if any, people who experience psychosis want regarding psychosocial aspects of intimate relationships. To address this gap in the literature, qualitative data was collected to investigate how people with experience of psychosis conceptualise romantic relationships and what support they would like in this area of their lives. Semi-structured interviews were conducted with 10 mental health service users (four women, six men) with experience of psychosis. Interviews were analysed from a critical realist social constructionism perspective using thematic analysis. Stigma was a prominent theme, described as impacting numerous aspects of romantic relationships. Power imbalance within services meant participants were wary of having conversations about relationships with professionals and identified a therapeutic alliance as a prerequisite. However, abusive relationships were highlighted as a needed area for support by services. Services should be trauma-informed and help those in abusive relationships. The power and autonomy of people with experience of psychosis should be maintained in any discussions or interventions regarding intimate relationships. A strong therapeutic alliance is essential for any work in this area.

Sections du résumé

BACKGROUND
The experience of psychosis and associated discrimination can be a barrier to forming and maintaining romantic relationships. Sexual health interventions within mental health services often focus on contraception and reducing risk. There are no known studies that seek to understand what support, if any, people who experience psychosis want regarding psychosocial aspects of intimate relationships.
METHODS
To address this gap in the literature, qualitative data was collected to investigate how people with experience of psychosis conceptualise romantic relationships and what support they would like in this area of their lives. Semi-structured interviews were conducted with 10 mental health service users (four women, six men) with experience of psychosis. Interviews were analysed from a critical realist social constructionism perspective using thematic analysis.
RESULTS
Stigma was a prominent theme, described as impacting numerous aspects of romantic relationships. Power imbalance within services meant participants were wary of having conversations about relationships with professionals and identified a therapeutic alliance as a prerequisite. However, abusive relationships were highlighted as a needed area for support by services.
CONCLUSION
Services should be trauma-informed and help those in abusive relationships. The power and autonomy of people with experience of psychosis should be maintained in any discussions or interventions regarding intimate relationships. A strong therapeutic alliance is essential for any work in this area.

Identifiants

pubmed: 34126943
doi: 10.1186/s12888-021-03262-7
pii: 10.1186/s12888-021-03262-7
pmc: PMC8201737
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

307

Références

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Auteurs

Rebecca White (R)

Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, UK. rebecca.white@manchester.ac.uk.

Gillian Haddock (G)

Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, UK.
Great Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PL, UK.

Filippo Varese (F)

Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, UK.
Great Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, M13 9PL, UK.

Maria Haarmans (M)

Cathie Marsh Institute, Centre on Dynamics of Ethnicity (CoDE), Department of Sociology, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, UK.

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Classifications MeSH