Implicating the Institution: Who Is Responsible for Sexuality-Related Silence in Mental Health Settings?

There is a well-established and ongoing need to improve the way that sexuality, sexual expression, and relationships are addressed in mental health settings. Existing research has tended to focus on mental health clinicians’ knowledge, comfort, and competence, positioning communication tools and educational interventions as the best approaches for improving sexuality-related practice. In this chapter, I argue that effective and sustained change will not be achieved if the institutional context of clinicians’ practice is ignored. There is an urgent need to critically examine the broader workplaces and institutions that shape and constrain clinicians’ sexuality-related practice. To this end, I outline three broad areas for further critical examination: professional education, mental health service or workplace cultures, and research.