We investigated the parenting history, contraceptive behavior, and contraceptive needs of 35 male chronic mental patients seen at an urban outpatient psychiatric clinic. Most patients had fathered children, but 60% of the children less than 16 years of age were not being reared by their biological father. Forty-one percent of the patients who had sexual intercourse during the preceding year and had not wanted children reported that they or their sexual partner had not used contraception at the time of last intercourse. Patients were reportedly at significant risk of fathering unwanted children and sexually transmitted diseases. Strategies for preventing unwanted pregnancies within this population are discussed.
PIP: Female chronic mental patients are likely to have induced abortions, give up children for others to raise, and to engage in unprotected sexual intercourse. There are few studies, however, on the family planning attitudes and needs of male psychiatric patients. 35 male chronic mental patients aged 23-49 years of mean age 36 at the psychiatric outpatient clinic of a publicly-funded general hospital in the Harris County district of Houston, Texas, responded to interview questions about their social situation, medical and sexual histories, previous children, attitudes toward family planning and contraceptive practices, and sources of information about family planning. Findings on their knowledge of AIDS and health locus of control are reported under separate cover. The hospital serves predominantly indigent and uninsured patients. Men 50 years or older were excluded from consideration in the study because it was thought they would be less likely to father future children. The sample was comprised of 30 black males, 4 white males, and one Hispanic male of mean education 11 years. Five men were currently married and nine more had been married at some point in the past. Patients had been attending the clinic for an average of 7 years, in a range of 0.5-27 years, with 17% reporting histories of psychiatric hospitalization within the past year. Diagnoses taken from patients' charts included schizophrenia among 26, schizoaffective disorder among two, organic mental disorder among four, and major affective disorder among two; one patient had an Axis II diagnosis of a severe personality disorder. All patients were being treated with psychotropic medications and all but three were being treated with neuroleptics. The interviews took place over the course of 9 months. 18 patients reported having fathered a total of 41 children. 60% of the children less than 16 years old, however, were not being raised by their biological father. 57% of the men reported having had sexual intercourse within the last year, with 26% reporting three or more sex partners during the period. 41% of the men who had sexual intercourse during the preceding year and had not wanted children reported that they or their sex partner had not used contraception during the most recent episode of intercourse. Many patients in the sample were therefore at significant risk of fathering unwanted children and contracting and/or transmitting sexually transmitted diseases. The authors discuss strategies for preventing unwanted pregnancies within this population.