Navigating a Complex Health System: the Perceptions of Psychiatric Residents in Addressing Sexual and Reproductive Health of Women with Severe Mental Illness.

Abstract

This study's purpose was to examine attitudes and perceptions of resident psychiatrists regarding the sexual and reproductive health needs of their female patients with severe mental illness. The three aims were to investigate resident psychiatrists' (1) perceptions regarding the importance of providing sexual and reproductive health services to female patients in the outpatient behavioral health setting, (2) current engagement in providing sexual and reproductive health services to their female patients, and (3) perceived barriers and facilitators to addressing sexual and reproductive health in this vulnerable patient population. Fifteen resident psychiatrists were recruited from the behavioral health clinic at a safety-net public sector hospital for a structured interview. Interviews were recorded, transcribed, and then coded using MAXQDA© software. Resident psychiatrists recognized the importance of addressing sexual and reproductive health with their female patients and recognized their hypothetical ability to provide sexual and reproductive health counseling and services based on their training and resources. However, residents reported rarely providing these services, mostly addressing sexual and reproductive health only when necessitated by medication changes. Perceived barriers included lack of training or knowledge, discomfort, and limited appointment time. Resident psychiatrists perceive a need to address sexual and reproductive health with their female patients with serious mental illness but lack the confidence and resources to do so. Directed education and clear institutional guidelines are necessary to equip the next generation of psychiatrists with the tools needed to address the sexual and reproductive health needs of women with serious mental illness.