Objective: The aim of this systematic review was to synthesize the best available qualitative evidence on the experiences and support needs of people with serious mental illness (SMI) regarding sexuality and intimacy within hospital and community settings. The objectives were to explore intimate relationship experiences of people with SMI, to uncover potential obstacles to the expression of sexuality and to present recommendations for mental health policy, education, research and practice. Introduction: Mental health services worldwide have seen major transformations in recent years through deinstitutionalization programs and more enlightened ways of organizing and providing mental health care. However, in terms of social and emotional wellbeing, issues persist for people with SMI, particularly relating to intimacy and the expression of sexuality. This systematic review may assist service providers to determine ways that they may better support people in establishing and maintaining satisfying intimate relationships and the full expression of their sexuality. Inclusion criteria: This review explored the intimacy and sexuality experiences, perceptions and concerns of people over the age of 18 years who were living with a SMI in hospital or community settings. This review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. Methods: The databases MEDLINE, CINAHL, PsycINFO, Embase and Web of Science were utilised in the review. The search included studies published from 1995 up to and including February 6, 2018 and were limited to those in the English language. Each paper was assessed by two independent reviewers for methodological quality using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Any disagreements that arose between the reviewers were resolved through discussion. Data extraction was conducted by two independent reviewers using the standardized qualitative data extraction tool from JBI. The qualitative research findings were pooled using JBI methodology. The JBI process of meta-aggregation was used to identify categories and synthesized findings. Results: Based on the thematic findings from the 21 studies, three synthesized findings were extracted from 10 categories and 83 findings: 1) the complexity of individual sexual experiences, 2) the clinical constructs of sexuality and 3) family and partner involvement. Conclusions: Having fulfilling and satisfying sexual and relationship experiences is a fundamental human right that can enhance an individual's quality of life. Being aware of the potential stresses and challenges that having a SMI can have on a relationship and involving partners in the treatment, may help to promote intimacy and recovery. Practitioners can use these findings to guide future policy, education and developments in practice. Further research is required to develop and evaluate interventions that target the identified barriers and help people with SMI to fulfil their unmet sexuality and intimacy needs.

People who identify as trans and gender non-binary experience many challenges in their lives and more interest is being paid to their overall health and wellbeing. However, little is known about their experiences and perceptions regarding their distinct psychosocial needs. The aim of this systematic review is to critically evaluate and synthesize the existing research evidence relating to the unique psychological and social experiences of trans people and identify aspects that may help or hinder access to appropriate psychosocial interventions and supports. The PRISMA procedure was utilized. A search of relevant databases from January 2010 to January 2021 was undertaken. Studies were identified that involved trans people, and addressed issues related to their psychosocial needs. The search yielded 954 papers in total. Following the application of rigorous inclusion and exclusion criteria a total of 18 papers were considered suitable for the systematic review. Quality was assessed using the MMAT instrument. Following analysis, four themes were identified: (i) stigma, discrimination and marginalization (ii) trans affirmative experiences (iii) formal and informal supports, and (iv) healthcare access. The policy, education and practice development implications are highlighted and discussed. Future research opportunities have been identified that will add significantly to the body of evidence that may further the development of appropriate health interventions and supports to this population.

Globally, there is an imperative in providing access to appropriate and responsive healthcare for all citizens (World Health Organization, 2016). There is an increased interest in how these concerns extend to wider populations such those people identifying as Lesbian, Gay, Bisexual, Transgender and Queer or Questioning (LGBTQ+) (Government Equalities Office, 2018). However, there remains significant gaps in the research evidence around the distinct supports and services available to meet the specific needs of LGBTQ+ populations. This is evident in the shortcomings that exist in the education and practice development requirements of nurses and other allied health professionals (McCann & Brown, 2020). International responses to discrimination and social exclusion are becoming more evident in health inequality and human rights legislative documents in order to address concerns that can impact significantly upon the lives LGBTQ+ people (Australian Human Rights Commission, 2015; Royal College of Nursing, 2016). For some LGBTQ+ people, issues related to minority stress can result in depression, anxiety, suicidality, loneliness and isolation (Institute of Medicine, 2011).

People who identify as LGBTQ+ and are in prison often experience many additional challenges. Once in prison, there is systemic discrimination against imprisoned LGBTQ+ people and a lack of understanding and concern regarding their care, treatment and support needs. While there is growing interest in their protection and that of other vulnerable populations in prison settings, little is known about their views and experiences regarding their distinct psychosocial needs. The aim of this systematic review is to critically evaluate and synthesize the existing research evidence relating to the unique psychological and social experiences of LGBTQ+ people in prison and identify aspects that may help or hinder access to appropriate psychosocial interventions and supports. The PRISMA procedure was utilized. A search of relevant databases from January 2010 to March 2021 was undertaken. Studies were identified that involved LGBTQ+ people, and addressed their views and experiences regarding their psychosocial needs whilst in prison. The search yielded 858 papers in total. Following the application of rigorous inclusion and exclusion criteria a total of 12 papers were considered suitable for the systematic review. Quality was assessed using the CASP instrument. Following analysis, three themes were identified: (i) interpersonal factors (ii) intrapersonal factors and (iii) institutional factors. The policy, education and practice development implications are highlighted and discussed. Future research opportunities have been identified that will add significantly to the body of evidence that may further the development of appropriate health interventions and supports specific to the LGBTQ+ population in prison.