I would like to highlight one specific aspect of the way psychiatric patients mean and live sexuality, and this is about intimacy. 

Psychiatric patients have a problem with boundaries. They struggle a lot in see, recognize and respect borders. Physical boundaries like a closed door, inner boundaries between conscious and unconsciuos, gender boundaries, and of course, boundaries between what is intimate and what is not. Sexuality is for lot of people something intimate, private, secret but not for psychiatric patients. 

Patients I met in my career usually live sexuality as a way to socialize. They can give hugs, kisses or something more, just to show how much they love someone: but to love someone is very close to love yourself if you don’t have any boundaries. 

Many years ago, for example, I met a patient, a young girl, who was suffering for her mother’s depression. That girl decided to ask a friend, to help her mother, to have sex with her mother. So this is a clear instance of what I said: for psychiatric patients sexuality is not that intimate, private, as for others. 

For my experience if there is something good you can do for psychiatric patients is help them to recognize boundaries. And one of the most important boundaries to recognize is that between what they should consider intimate or not.