Sexual incidents including harassment, assaults and rapes are “commonplace” in mental health units, mainly carried out by patients, the NHS’s care regulator has reported.
A total of 1,120 sexual incidents – 65 a week – occurred on mental health wards in England during April, May and June, according to the Care Quality Commission.
The figures included 29 alleged rapes. Another 457 incidents, more than a third of the total, involved sexual assault or sexual harassment of patients or staff.
Other cases involved patients exposing themselves, using sexual words when verbally abusing someone and having sex when it was unclear if they had the mental capacity to decide to do so.
“Sexual incidents are … commonplace on mental health wards,” said Dr Paul Lelliott, the regulator’s deputy chief inspector of hospitals and lead for mental health.
“People who have used services [have] described the distress they experience when other patients speak to them using sexualised language or when they observe other patients behave in a sexually disinhibited manner due to their mental ill-health.
“Some told us that they had received unwanted sexual advances from other people or that they have engaged in sexual acts when mentally unwell that they have regretted afterwards.”
Lack of staff was a factor in some of the incidents, the CQC said. They took place in communal areas, patients’ rooms, toilets, bathrooms, gardens and other areas with staff on duty.
Patients were responsible for the behaviour outlined in 95% of the 1,120 incidents; the other 5% involved staff, according to 919 reports about the incidents filed to the NHS’s national reporting and learning system, which records all patient safety incidents.
The nature of some patients’ conditions means they “can at times act in disinhibited ways or may lack the mental capacity to make sound decisions about relationships”, Lelliott added. With some patients, their history of sexual abuse may mean they are at risk of suffering exploitation again.
Sophie Corlett, director of external relations at the mental health charity Mind, called the figures “appalling”. She said: “Many patients on such wards will be living with symptoms of post-traumatic stress disorder and a great deal will have been victims of sexual abuse in the past. Sexual safety incidents can have a re-traumatising effect and can be hugely damaging in someone’s recovery.”
In one incident the CQC recounted a woman on a mixed-sex acute mental health ward was the subject of “relentless” attention from a male fellow patient who had sex with her twice. “The sexual exploitation … has completely scarred me for life,” she said.
The CQC is now drawing up plans to reduce sexual behaviour, including new national guidance and education of staff about what constitutes sexual harassment or abuse and how to respond if they see it occurring.
The Department of Health and Social Care said: “Sexual abuse of any kind is completely unacceptable anywhere in the NHS and we expect allegations to be taken extremely seriously, informing the police as necessary.
“The safety of patients is our number one priority which is why the CQC is currently working with NHS Improvement on how Trusts report and act on these incidents, with their findings due later this year.”
Catherine Gamble, the Royal College of Nursing’s professional lead for mental health, said the findings were “of great concern”.
“The CQC is right to identify lack of trained staff as a factor that leads to unsafe environments. Staff and the public know that patients are safer when they have access to sufficient trained mental health nurses who have regular, consistent clinical supervision.”
Patients being treated in “outdated, unsuitable buildings that are simply not appropriate for the 21st century” is another problem that can facilitate sexual incidents, she added.