Matilda Brown, Emma Tassie, Sophie Carlisle, Elana Covshoff, Amy Ronaldson, Julie Williams, Shubulade Smith, Kylee Trevillion, Elizabeth Hughes, Margaret Heslin
{"title":"Barriers and facilitators to accessing sexual and reproductive health services for people with severe mental illness: a systematic review.","authors":"Matilda Brown, Emma Tassie, Sophie Carlisle, Elana Covshoff, Amy Ronaldson, Julie Williams, Shubulade Smith, Kylee Trevillion, Elizabeth Hughes, Margaret Heslin","doi":"10.1007/s00127-025-02844-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Despite increased prevalence of sexual and reproductive health problems among people with severe mental illness (SMI), uptake of sexual and reproductive healthcare in this group is poor. The reasons for this are unclear. Therefore, this review aimed to identify the barriers and facilitators to accessing sexual and reproductive health services from a service user perspective.</p><p><strong>Methods: </strong>Three electronic databases were searched using key words for \"sexual health\" and \"SMI\". Data were screened and extracted by two independent reviewers. The Joanna Briggs Institute Critical Appraisal Tools were used to assess quality of included studies.</p><p><strong>Results: </strong>Five studies were included and underwent a narrative synthesis. They were on access to HIV care (n2), access to family planning methods (n2) and access to general sexual healthcare (n1). Barriers relating to HIV care included cost; barriers relating to family planning included lack of awareness and not considering the issue; barriers to general sexual healthcare included psychotic symptoms, mental health prioritisation, stigma, lack of sexual health focus in mental health programs, difficulty initiating conversations, knowledge, culture/religion/ethnicity, and finances.</p><p><strong>Conclusions: </strong>Studies which examined access to HIV and family planning services did so in a way that limited participant responses. While only one study examined barriers and facilitators to accessing generic sexual health services, it did so robustly, although it focussed solely on young women and provided limited data on facilitators. Future work should focus on examining barriers, and facilitators, to accessing sexual healthcare in all people with SMI to better identify and address these challenges. PROSPERO ID CRD42023414740.</p>","PeriodicalId":49510,"journal":{"name":"Social Psychiatry and Psychiatric Epidemiology","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Social Psychiatry and Psychiatric Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00127-025-02844-0","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Despite increased prevalence of sexual and reproductive health problems among people with severe mental illness (SMI), uptake of sexual and reproductive healthcare in this group is poor. The reasons for this are unclear. Therefore, this review aimed to identify the barriers and facilitators to accessing sexual and reproductive health services from a service user perspective.
Methods: Three electronic databases were searched using key words for "sexual health" and "SMI". Data were screened and extracted by two independent reviewers. The Joanna Briggs Institute Critical Appraisal Tools were used to assess quality of included studies.
Results: Five studies were included and underwent a narrative synthesis. They were on access to HIV care (n2), access to family planning methods (n2) and access to general sexual healthcare (n1). Barriers relating to HIV care included cost; barriers relating to family planning included lack of awareness and not considering the issue; barriers to general sexual healthcare included psychotic symptoms, mental health prioritisation, stigma, lack of sexual health focus in mental health programs, difficulty initiating conversations, knowledge, culture/religion/ethnicity, and finances.
Conclusions: Studies which examined access to HIV and family planning services did so in a way that limited participant responses. While only one study examined barriers and facilitators to accessing generic sexual health services, it did so robustly, although it focussed solely on young women and provided limited data on facilitators. Future work should focus on examining barriers, and facilitators, to accessing sexual healthcare in all people with SMI to better identify and address these challenges. PROSPERO ID CRD42023414740.
期刊介绍：
Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic.
In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation.
Both original work and review articles may be submitted.
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