Table 1 Summary of responses to online questionnaire
From: Policies on sexual expression in forensic psychiatric settings in different European countries
Country | Application of policy rules | Direction | Other forms of expression allowed | Patient/visitor interaction | Resources available to patients | Staff training | Patient awareness and involvement |
|---|---|---|---|---|---|---|---|
Belgium | Hetero- & homosexual relationships treated the same Same policies regardless of case history | Sexual intercourse prohibited inside institution Romantic/non-sexual relationships between patients prohibited Patients can marry | Holding hands Access to sexually explicit DVDs, magazines & novels | Patients not allowed into each other’s bedrooms Visitors allowed unsupervised access to patients’ bedrooms ‘Blind eye’ turned to potential sexual activity with spouse No conjugal visiting suite | Sexual education Condoms/contraception | Provided | No written policy; patients informed verbally Patients have opportunity to complain about policy Patient perspective not considered |
Denmark | Hetero- & homosexual relationships treated the same Decided on case-by-case basis | Sexual relationships with existing long-term partner permitteda Sexual and non-sexual relationships between patients prohibited Patients can marry | Access to sexually explicit DVDs, magazines & novels | Patients not allowed in each other’s bedrooms Visitors not allowed in patients’ bedrooms Conjugal visiting suite available | Condoms/contraception | No specific training | No written policy; patients informed verbally Patients have opportunity to complain about policy Patient perspective not considered |
Finland | Hetero- & homosexual relationships treated the same Same policies regardless of case history | Sexual relationships permitteda between patients or between patient and outside partner, including prostitutes Non-sexual relationships supported and seen as positive and prosocial Patients can marry | Kissing Hugging Caressing Massage Holding hands Access to sexually explicit DVD’s, adult magazines, erotic novels & pornographic websites | Patients not allowed into each other’s bedrooms Visitors not allowed into patient bedrooms No conjugal suite Visits take place in visiting area and can be unsupervised | Relationship counselling Sexual education Condoms/contraception | No specific training | No written policy; patients informed verbally Patients have opportunity to complain about policy Patient perspective not considered |
FYR Macedonia | Homosexual relationships not taken into consideration Decided on case-by-case basis | Sexual relationships permitteda between patient and existing long-term partner Sexual relationships between patients prohibited Non-sexual relationships allowed Patients cannot marry | Kissing Hugging Caressing Massage Holding hands Access to adult magazines | Patients allowed supervised access to each other’s bedrooms Visitors allowed unsupervised access to patient bedroomsa | Relationship counsellinga Condoms/contraception | No specific training | Not available for patients to see Patient perspective not considered |
Germany | Hetero- & homosexual relationships treated the same Decided on case-by-case basis | Sexual relationships permitteda between patient and existing long-term partner, and new partner outside the institution, including prostitutes Sexual relationships between patients prohibited Non-sexual relationships alloweda Patients can marry | Kissing Hugging Caressing Massage Holding hands Access to adult magazines & erotic novels | Patients allowed unsupervised access to each other’s roomsa Visitors allowed unsupervised access to patient bedroomsa Conjugal visiting suite available | Relationship counselling Sexual education Condoms/contraception | Provided | Policy readily available for patients to see Patient perspective not considered |
Latvia | Hetero- & homosexual relationships treated the same Same policies regardless of case history | Sexual intercourse prohibited within unit Sexual relationships permitted with partners from outside the institution Non-sexual relationships alloweda Patients can marry | No form of sexual expression allowed | Patients not allowed into each other’s bedrooms Visitors not allowed into patient bedrooms Conjugal visiting suite available in some facilities | None | Not known | Policy available for patients to see Patient perspective not considered |
Netherlands | Hetero- & homosexual relationships treated the same Decided on case-by-case basis | Sexual relationships permitteda between patient and existing long-term partner, and new partner outside the institution, including prostitutes Non-sexual relationships alloweda Patients can marrya | Kissing Hugging Caressing Massage Holding hands Access to sexually explicit DVD’s, adult magazines, erotic novels alloweda | Patients allowed unsupervised access to each other’s bedrooms Visitors allowed unsupervised access to patient bedroomsa Conjugal visiting suite available | Relationship counselling Sexual education Condoms/contraception | General training provided | Policy available for patients to see Patient perspective not considered |
Spain | Not known | Sexual relationships permitteda between patient and existing long-term partner Non-sexual relationships alloweda Patients can marry | Kissing Hugging Caressing Massage Holding hands Access to erotic novels | Patients not allowed into each other’s bedrooms Visitors not allowed into patient bedrooms Conjugal visiting suite available | Sexual education | No specific training | Not readily available for patients to see Patient perspective not considered |
Switzerland | Hetero- & homosexual relationships treated the same Same policies regardless of case history | Sexual relationships discouraged amongst patients Sexual relationships permitted between patient and existing long-term partner, and new partner Non-sexual relationships alloweda Patients can marry | Kissing Hugging Caressing Massage Holding hands No access to sexually explicit DVD’s, adult magazines, erotic novels or pornographic websites | Patients not allowed into each other’s bedrooms Visitors not allowed into patient bedrooms Sexual activity with partners allowed when patient is on leave | Relationship counselling Sexual education Condoms/contraception | Provided | Not readily available for patients to see Patient perspective considered in drafting of shared practice |
United Kingdom | Hetero- & homosexual relationships treated the same Officially, decided on case-by-case basis but in practice policy implemented uniformly | Sexual relationships between patients and between patient and partner outside the institution prohibited Patients can marry | Minor forms of physical contact but no intimate or extended contact Access to erotic novels alloweda | Patients not allowed into each other’s bedrooms Visitors not allowed into patient bedrooms Conjugal visiting suite not available | Relationship counselling Sexual educationa | No specific training | Abbreviated version available for patients to see Patient perspective not considered |