A policy to deal with sexual assault on psychiatric in-patient wards

Lawn & McDonald outline a clear policy that they have developed for dealing with sexual assault on in-patient psychiatric wards (Psychiatr Bull 2009; 33: 108–11). I welcome their account and in particular their flow chart and the accompanying guidance for its use. In their references they list the Royal College of Psychiatrists report CR52 Sexual Abuse and Harassment in Psychiatric Settings. I regret that they do not refer to the subsequent College Report CR145 Sexual Boundary Issues in Psychiatric Settings (online only) published in August 2007. To quote from the College website: ‘This revision of the original College Report CR52: Sexual Abuse and Harassment in Psychiatric Settings… has led to a review within a wider remit, taking into account major developments in the legal framework within which patients are treated and encompassing a broader discussion on sexuality. Issues of capacity and consent are relevant for all areas of care, and psychiatric professionals have to balance principles of autonomy and protection. Particularly relevant in this context are the Human Rights Act 1998, the Sexual Offences Act 2003, the Mental Capacity Act 2003, and additional legislation regarding standards of care for both adults and children. The area is one of high risk in terms of likelihood and impact because of the vulnerability of the patient group. Recommendations are made in the light of the Kerr/Haslam Report (2005), the Patient Safety Observatory Report 2 (NPSA 2006), and the government report Safeguarding Patients (2007)’ (www.rcpsych.ac.uk/publications/collegereports/cr/cr145.aspx).