Patient’s awareness of the relationship Is the patient aware of who is initiating sexual contact? Is delusion or misidentification affecting the patient’s choice (eg, is the patient mistaking the other person for his or her spouse)?

Can the patient state what level of sexual intimacy he or she would be comfortable with? Can the patient avoid exploitation? Is the behaviour consistent with previously held beliefs and values? Does the patient have the capacity to say no to uninvited sexual contact?

Is the patient aware of potential risks? Does the patient realize that the relationship might be time-limited (eg, if a placement is temporary)? Can the patient describe how he or she will react when or if the relationship ends?

Adapted from Series and Dégano with permission from the Royal College of Psychiatrists.¹⁰