People with mental illness are more likely to contract sexually transmitted infections and blood-borne viruses than the general population. They are also at higher risk of becoming victims of domestic or sexual violence and of having an unplanned pregnancy. Despite this, the sexual health of people with mental illness is often overlooked in the healthcare environment. This has an adverse effect not only on morbidity and mortality but also on quality of life and recovery outcomes.

This article introduces a systematic approach for including sexual health enquiry and promotion in holistic mental health nursing practice. It is relevant for staff who work in inpatient and community settings.

The STARTER model is a step-by-step tool that has been designed by the author for mental health nurses to encourage conversations about sexual health. It considers that mental health nurses may be limited by lack of training, and by personal or organisational barriers, but encourages them to look at how these can be overcome, as well as when it is necessary to refer to external agencies that can provide support and services that may be more appropriate for the individual patient.