Intimate relationships and sexuality for adults with an intellectual disability: exploring the views of adult intellectual disability service providers and their staff members

Introduction: Research suggests that people with an intellectual disability (PWID) have historically been suppressed in their expression of relationships and sexuality. Adult ID service structures, staff member’s attitudes and PWID’s family viewpoints have been reported to influence this suppression. In Ireland, three other factors are noteworthy; a restrictive legislative framework; a conservative culture influenced by religion; and the adaption towards the biopsychosocial model of care and advances in Special Needs Education. This current study aims to explore the current attitudes and views of Irish Adult ID service providers and their staff on PWID’s expression of relationships and sexuality. Method: A mixed methods design was employed. During the quantitative phase, staff (n=86) completed an online survey to assess their ‘attitudes to sexuality’ relating to PWID. Meanwhile, qualitative methods were utilised to analyse Adult ID service provider ‘Relationship and Sexuality’ policy documents (n=5). These methods were also used to analyse staff participants open-ended questionnaires (n=86). Findings: Thematic Analysis was applied to the ‘Relationship and Sexuality’ policy documents and staff open-ended questionnaires. Five themes were generated from the policy documents; ‘Rights of PWID’, ‘Values’, ‘Training and Educational Supports’, ‘Welfare and Protection’, and ‘Supportive Structures’. Policies were interpreted to contain mixed messages on these themes, while also providing a dominant reference towards the protection of PWID. Three themes generated from the questionnaire; ‘Unsupported and Frustration’, ‘Taboo Subject Matter’, and ‘Vulnerability and Access to Education’. Participants reported a lack of service supports, dominant conservative viewpoints and PWID vulnerability. Staff ‘attitudes to sexuality’ were reported to be affected by demographic factors of age, education, practising religion and reading of service policy. Discussion: This study provided a comprehensive current account of Adult ID service provision regarding relationships and sexuality in Ireland. It highlighted the need for updated service policy, improved service practices, and enhanced provisions for staff and the PWID that they support. Implications for future research and clinical practice are also discussed, in terms of improvements in education, training, and the need for increased discourse on the subject matter.