Neglected sexual needs: A qualitative study in Iranian patients with severe mental illness.

Background: This paper has attempted to explore views of patients with severe mental illness and their care providers about sharing sexual problems with care providers in these patients within the context of Iran.

Method: A total of 17 in-depth semi-structured interviews were conducted in one of the psychiatric hospital in Tehran: 4 with patients, 2 with patient's family, and 11 with health providers who had been employed for 5 years in psychiatric wards at least. All participants were selected by purposive sampling. Using conventional qualitative content analysis data reduction was done.

Findings: A total of 89 codes about the reasons for lack of communication between clinician and patients, about sexuality were extracted. These are classified in two categories. The first is "Clinicians avoidance from addressing sexual issues" and second is "Patients avoidance from expressing their sexual problems."

Conclusion: Despite having sexual needs, severe mental illnesses patients do not disclose it due to poor communication between clinician and patients, about sexuality. So, physician had to be pioneer in communicating with them. Therefore, to enhance clinicians' sexual knowledge and effective communication skills with patients, especially those with severe mental illnesses, training is completely necessary.