Systematic review and meta-aggregate analysis of mental health service users’ perspectives on romantic and intimate relationships and their support needs

We conducted a systematic review and meta-aggregate synthesis to collate qualitative evidence about mental health service users’ views on their needs for romantic and intimate relationships and support measures. Four databases were searched in April 2024 (PROSPERO ID: CRD42024503997). Eligible studies involved (i) adult participants with any mental health condition who had received/were receiving care from mental health services; and (ii) had qualitative data specific to romantic/intimate relationship needs and support implications. Quality appraisal was conducted using the JBI Critical Appraisal Checklist for Qualitative Research. Data extraction and synthesis were conducted using meta-aggregation and the level of confidence in the synthesised findings was assessed using the GRADE-CERQual approach. We included 17 studies and extracted 100 specific findings. From these, 17 categories were created and grouped into four synthesised findings: (i) individuals with mental health conditions have a desire for romantic and intimate relationships; (ii) mental health conditions can directly hinder romantic and/or intimate relationships at the individual-level; (ii) psychosocial factors impact romantic and/or intimate relationships; and (iv) services are lacking and can act as obstacles for service users to engage in/discuss romance and/or intimacy. We found that service users had clear needs relating to romantic and intimate relationships, but experienced multiple challenges in meeting these needs. In general, mental health services tended to not provide support in this area. Implications for practice include: (i) recognising romantic and intimate relationship needs as part of routine mental health care; (ii) making sexual health and healthy relationship information available; (iii) offering spaces for group discussion and support; and (iv) facilitating social activities to meet others and build social skills and confidence.