Opportunity lost? Psychiatric medications and problems with sexual function: a role for nurses in mental health

Aim. To explore patients’ non‐adherence to psychiatric medication with mental health nurses. Background. The ability of consumers to maintain normal sexual behaviours is complicated by abnormally high incidence of sexual problems arising from the medications they are prescribed. Sexual side effects of psychiatric medications are identified as a major reason for non‐adherence to psychiatric medication regimes yet it remains an issue mental health nurses tend to avoid in their practice with consumers. Design. An exploratory, descriptive qualitative approach. Method. Individual interviews were conducted with 14 nurses currently working with adult consumers of mental health services. Data analysis followed the framework approach developed by Ritchie and Spencer as the process for identification of the main themes. Results. Problems with sexual function in relation to psychiatric medication issues was one major theme to emerge from this research. More specifically the participants referred to: assessment of sexual function, the side effects of psychiatric medication, consumer embarrassment, and, the pros and cons of information. Participants recognised that sexual side effects were likely to have an impact on adherence to medication and that this was an important consideration but most did not discuss this issue with consumers. Consumer embarrassment and the belief that knowledge itself might cause non‐adherence were the two main reasons for not discussing this topic. Conclusions. Problems with sexual function of consumers presents an important practice consideration for nurses working in mental health settings. There is an urgent need for strategies to enhance awareness and confidence among nurses in exploring this topic with consumers. Relevance to clinical practice. Mental health nurses can adopt a leadership role in recognising the relevance of sexuality in care and treatment for consumers of mental health services. Strategies to assist in developing skill and confidence in this domain are required as a matter of priority.