Table 2 Emergent themes from the telephone interviews

1. General views on sexual expression^{b, c, d, e}

Stance on condoning the expression of sexuality and intimacy and patients having relationships in secure forensic-psychiatric care

Positive^{b, c}

Negative^{d, e}

2. Screening procedures^{a, b, c, d, e}

Procedures put in place to screen for any risks or vulnerabilities related to sexual activities. These could include sexual contact with another patient, a partner outside the institution (this can be a long-standing partner, a new partner, a prostitute)

Relationship with partner

outside the institution^{a, b, c, e}

Vulnerability of patient^{a, b, c, e}

Relationship between patients^{a, b, c}

3. Safe sex^{a, b, c, d}

Safe sex put in place when considering patients being sexually active

Distributing condoms^{a, b, c, d}

Access to contraception^{a, b}

Sexually transmitted diseases^{a, c}

4. Private space^{a, b, c, d, e}

Patients having privacy in a designated area to carry out sexual activity

Conjugal suites^{a, b, c}

Bedrooms^{b, c}

On leave^{a, b, e}

5. Public opinion^{a, b, c, d}

Perception of public opinion on patients having sexual relationships and expressing their sexuality

Restrictive/punitive^{a, b, c, d}

6. Patients’ responses^{a, b, c, d, e}

Response of service users to policies on sexual expression

Few complaints^{a, b, e}

Seen as restrictive^{a, c, d}

7. Policy implementation^{a, b, c, d, e}

Views of staff on implementation of policy on sexual expression

Considerable difficulty^a

Occasional difficulty^{c, d}

Issue not raised^{b, e}

8. Future plans^{a, c, d, e}

Future plans and ideas that could help in the development of policies on sexual expression in forensic-psychiatric care

Maintaining long-term relationships^d

Male homosexual relationships^e

Learning from others^{a, d, e}

National discussions^{a, c}