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The Royal College of Psychiatrists has called for all psychiatric units to carry out regular audits of sexual behaviour, complaints and allegations of harassment or abuse, to ensure incidents are not hushed up.

In guidance issued yesterday on sexual boundary issues in psychiatric settings, the college said that all units must have policies on acceptable sexual behaviour, harassment and abuse, to balance patients’ autonomy and protection.

The college said it was “very likely” that sexual incidents were under-reported, as staff were unclear what reporting them would achieve.

A National Patient Safety Agency report last July documented 122 sexual incidents, including consensual sex, on psychiatric wards from November 2003 to September 2005. However, a Community Care survey, based on freedom of information requests from 44 of 70 mental health trusts found over 330 sexual assault allegations from 2003-6, suggesting the NPSA figure was an underestimate.

The Royal College of Psychiatrists said patients and their carers should be involved in the setting up and review of policies and also called for better staff training on managing sexual boundaries, including recognising signs of abuse and assessing patients’ capacity to consent to sex.


The college’s report comes with the Committee of Health Care Regulatory Excellence developing guidance on behalf of the Department of Health on minimising inappropriate sexual behaviour by health staff and improving the detection of abuse, through its Clear Boundaries project.

Both follow the DH-commissioned Kerr Haslam inquiry, which reported in 2005 on the cases of two consultant psychiatrists who indecently assaulted patients in their care and why abuse went undetected for so long.

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