{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T08:12:43Z","timestamp":1789805563825,"version":"4.0.1"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Mental Health Nurs"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The sexual safety of people in mental health inpatient units is an increasingly important concern. Following provision of a co\u2010designed staff training package (the Welcome Project) to support sexual safety on an Australian adult mental health inpatient unit, this qualitative study aimed to gain an understanding of barriers and enablers to implementation of sexual safety practices from the perspective of staff in this setting. Data was collected through semi\u2010structured interviews with eleven clinicians. Directed content analysis was used to map data against the Consolidated Framework for Implementation Research and the Capability Opportunity and Motivation Model of behaviour change. The findings describe barriers and enablers to sexual safety related to key aspects of these frameworks: knowledge about sexual safety, knowledge about trauma\u2010informed care, time to talk about sexual safety, role clarity, reluctance to talk about sexual safety, culture, leadership, physical environment, staffing, consumer and carer peer workers, and acuity. While training improved awareness, results from this study suggest that education alone was insufficient to support routine sexual safety discussions. Future implementation requires a multilevel approach that combines targeted training with clear role expectations, as well as adequate staffing, supportive leadership, and organisational commitment to sexual safety. In conclusion, while staff knowledge is important, the physical environment and leadership need to be considered and strategies in place to support clinicians to implement sexual safety training and routinely have conversations with consumers about sexual safety during inpatient admissions.<\/jats:p>","DOI":"10.1111\/inm.70362","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T07:39:47Z","timestamp":1789803587000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementing Sexual Safety in Inpatient Mental Health: Staff Perspectives on Training"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1756-7241","authenticated-orcid":false,"given":"Karen","family":"Dixon","sequence":"first","affiliation":[{"name":"Occupational Therapy Department, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences Monash University Peninsula Campus  Frankston Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4885-932X","authenticated-orcid":false,"given":"Melissa","family":"Petrakis","sequence":"additional","affiliation":[{"name":"Social Work Innovation, Transformation and Collaboration in Health (SWITCH) Research Group, Social Work Monash University  Caulfield East Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8002-5763","authenticated-orcid":false,"given":"Ellie","family":"Fossey","sequence":"additional","affiliation":[{"name":"Occupational Therapy Department, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences Monash University Peninsula Campus  Frankston Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9979-2201","authenticated-orcid":false,"given":"Linda","family":"Barclay","sequence":"additional","affiliation":[{"name":"Occupational Therapy Department, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences Monash University Peninsula Campus  Frankston Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11135\u2010024\u201002022\u20105"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010017\u20100605\u20109"},{"key":"e_1_2_11_4_1","unstructured":"Australian Bureau of Statistics.2022.\u201cNational Study of Mental Health and Wellbeing 2020\u20132022.\u201dhttps:\/\/www.abs.gov.au\/statistics\/health\/mental\u2010health\/national\u2010study\u2010mental\u2010health\u2010and\u2010wellbeing\/2020\u20102022."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.202000038"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732316654870"},{"key":"e_1_2_11_7_1","unstructured":"Care Quality Commission.2020.\u201cPromoting Sexual Safety Through Empowerment.\u201dhttps:\/\/www.cqc.org.uk\/publications\/major\u2010report\/promoting\u2010sexual\u2010safety\u2010through\u2010empowerment."},{"key":"e_1_2_11_8_1","unstructured":"Clarke H.2007.\u201cNowhere to Be Safe: Women's Experiences of Mixed\u2010Sex Psychiatric Wards. Network VWaMH (Ed) Victorian Women and Mental Health Network 4\u201d."},{"key":"e_1_2_11_9_1","first-page":"14","article-title":"Outrage Becomes Determination: Advocating to Raise Awareness of Women's Experience in Mixed\u2010Sex Psychiatric Wards","volume":"94","author":"Clarke H.","year":"2008","journal-title":"Health Issues"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2019.06.036"},{"issue":"1","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering Implementation of Health Services Research Findings Into Practice: A Consolidated Framework for Advancing Implementation Science","volume":"4","author":"Damschroder L. J.","year":"2009","journal-title":"Implementation Science"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010022\u201001245\u20100"},{"issue":"6081","key":"e_1_2_11_13_1","first-page":"22","article-title":"Mental Health. The Safety Scandal","volume":"117","author":"Dent E.","year":"2007","journal-title":"Health Service Journal"},{"key":"e_1_2_11_14_1","unstructured":"DHHS.2011.\u201cService Guideline on Gender Sensitivity and Safety: Promoting a Holistic Approach to Wellbeing.\u201dhttps:\/\/www.health.vic.gov.au\/publications\/service\u2010guideline\u2010for\u2010gender\u2010sensitivity\u2010and\u2010safety."},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.70081"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12559"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2019.00462","article-title":"Safewards Impact in Inpatient Mental Health Units in Victoria, Australia: Staff Perspectives","volume":"10","author":"Fletcher J.","year":"2019","journal-title":"Frontiers in Psychiatry"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305279065"},{"key":"e_1_2_11_19_1","unstructured":"Hegarty K. 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Ensuring Sexual Safety in Acute Mental Health Inpatient Units: Sexual Safety Project Report.\u201dhttps:\/\/www.mhwc.vic.gov.au\/sites\/default\/files\/2026\u201005\/The\u2010right\u2010to\u2010be\u2010safe\u2010sexual\u2010safety\u2010project\u2010report.pdf."},{"key":"e_1_2_11_29_1","first-page":"1003","volume-title":"A Guide to Designing Interventions","author":"Michie S.","year":"2014"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u20105908\u20106\u201042"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010019\u20104683\u2010z"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010019\u20104812\u20108"},{"key":"e_1_2_11_33_1","unstructured":"Office of the Chief Psychiatrist.2024.\u201cChief Psychiatrist's Annual Report 2023\u20132024.\u201dhttps:\/\/www.health.vic.gov.au\/publications\/chief\u2010psychiatrists\u2010annual\u2010reports."},{"key":"e_1_2_11_34_1","unstructured":"Office of the Chief Psychiatrist WA.2020.\u201cChief Psychiatrists Sexual Safety Guidelines.\u201dhttps:\/\/www.chiefpsychiatrist.wa.gov.au\/standards\u2010guidelines\/sexual\u2010safety\u2010guidelines\/#:~:text=Sexual%20safety%20refers%20to%20being feel%20uncomfortable%2C%20afraid%20or%20unsafe."},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.70072"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.13370"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/01612840.2019.1591548"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpm.12614"},{"issue":"28","key":"e_1_2_11_39_1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.7748\/ns.22.28.11.s16","article-title":"Women's Needs Being Neglected on Acute Mental Health Wards","volume":"22","author":"Parish C.","year":"2008","journal-title":"Nursing Standard"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1080\/00981389.2011.622674"},{"key":"e_1_2_11_41_1","unstructured":"State Govt Victoria.2021.\u201cRoyal Commission Into Victoria's Mental Health System (Final Report Summary and Recommendations Parl Paper No. 202 Session 2018\u201321 (Document 1 of 6)).\u201dhttps:\/\/rcvmhs.vic.gov.au."},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_11_43_1","volume-title":"Policy Position Paper #5: Sexual Safety in Psychiatric Inpatient Units","author":"VMIAC","year":"2021"},{"key":"e_1_2_11_44_1","volume-title":"Preventing Gender\u2010Based Violence in Mental Health Inpatient Units","author":"Watson J.","year":"2020"},{"key":"e_1_2_11_45_1","unstructured":"World Health Organization.2019.\u201cTransforming Services and Promoting Human Rights. 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