The RESPECT Study (Randomised Evaluation of Sexual health Promotion Effectiveness informing Care and Treatment)

People with serious mental illness (SMI) (people who experience long term, relapsing mental health
problems that require ongoing support from NHS mental health services) often have additional
physical health problems yet don't have these addressed for a number of reasons including lack of
motivation, not reporting symptoms to their health workers, and what is known as "diagnostic overshadowing"
which means that physical ailments can be misinterpreted as a part of their mental illness.
There is now a movement towards helping people with SMI get their health needs met (including
health checks at GP, assessment of physical health in mental health care) yet one important area of
health has been forgotten; sexual health. People with SMI, just like everyone else, hope to have safe
and satisfying sexual relationships, and indeed this is an important part of building a life of recovery
from mental illness. However the reality for people with SMI is often more bleak. They are more at
risk of sexually acquired infections such as HIV and hepatitis B (and C) and more likely to face
violence and exploitation in their relationships. An examination of published studies (a review) which
has looked at whether there are any ways of working that can show that they help promote sexual
health and safer relationships has been undertaken. This found that all the studies were from USA,
and were very different in how they had been delivered. This has made it difficult to know what might
help people with their sexual health and relationship needs in the UK. Therefore, there is a need to
develop an a package of care (intervention) that is relevant to the needs of people with SMI in the UK,
and establish whether this is practical, whether it is acceptable and useful for people it is aimed at
(Feasibility study). This type of study examines the practical issues in establishing such a study and
therefore can iron out any of these problems before funding is granted to do a much larger study
which has enough people participating to be able to evaluate whether it makes a real difference to
people (when compared with a group of people who wont receive the extra intervention). We have a
group of people with lived experience (PWLE) who will be working at all stages of the project to make
sure that what we produce is acceptable, practical, safe and comfortable. We will develop an
intervention that will be delivered by specially trained mental health workers. People who agree to
take part will be allocated by chance to the extra intervention (as well as usual care) or to just usual
care by chance (randomly allocated). We will collect information on how many people we are able to
NIHR Health Technology
Assessment Programme
14/172/01
Professor Elizabeth Hughes - University of Huddersfield
Revised Application - Committee / Board Review
Page 9 of 57
Summary (in Plain English)
sign up to the study, the numbers of people who drop out along the way, missed appointments for the
intervention, as well as trying out the questionnaires chosen to assess sexual health knowledge,
motivation, behaviour,and use of sexual health services and GP services for family planning. We will
interview a small group of people about their experience of being part of the study. We will prepare a
report and make recommendations as to whether this should be further funded, and write papers for
academic and lay audiences about what we have learnt. We plan to make use of social media (Twitter
and blogs) to make sure that our findings are available to everyone including people who use
services, and those who run and commission mental health services, as well as mental health
workers