In conversation with Alison Kelly, CEO of Sexual Health Quarters
Discussing relationships, consent and sexual wellbeing can feel challenging for many disability professionals. Yet these conversations are an important part of supporting people’s rights, choice and independence.
At the October edition of The Possibilities Forum, Mosaic Community Care CEO Rob Wilton sat down with Alison Kelly, CEO of Sexual Health Quarters (SHQ) to discuss how sector professionals can confidently support people with disability when discussing consent and relationships.
The fireside chat explored some of the challenges professionals face when navigating these conversations, as well as practical ways to build confidence and provide person-centred support.
Below, Alison shares her insights and advice.
[This discussion has been transcribed from the live event and retains the conversational nature of the original discussion.]
Why are conversations about relationships, consent and sexual wellbeing often avoided in disability services?
Alison Kelly (AK): There are a number of reasons why these conversations can be difficult.
People working in the sector are often very focused on person-centred care, doing the right thing and providing the best possible support. Sometimes, we care deeply about the person, but we don’t necessarily feel 100% confident in knowing exactly what to say or what the right answer might be. As a result, we may avoid, delay or downplay a conversation because we want to provide good support and don’t want to get it wrong.
Cultural differences, personal beliefs, backgrounds and upbringing can also influence how comfortable we feel discussing these topics. Sometimes there may be a generational or cultural gap, and we don’t feel we have the language or phrases that come naturally in those conversations.
Other factors can be time, environment and opportunity. We might not feel it’s the right place or the right moment. It’s important to recognise that there is a spectrum of reasons why these conversations may be avoided. Sometimes it’s intentional, but sometimes it’s simply because people don’t want to do harm and doing less feels more comfortable in that interaction.
Many disability professionals worry about saying the wrong thing. How can they respond when participants raise questions about relationships, intimacy or sexuality?
AK: Many people avoid conversations about relationships, intimacy and sexuality because they’re worried about saying the wrong thing. But often, the most important thing isn’t having the perfect answer. It’s being willing to listen, be curious, and create a space where people feel heard, respected, and supported.
Resources, workshops, education and even having a few simple phrases ready can be a great starting point.
When someone trusts you enough to share a personal question or concern, that’s an opportunity to build connection. You don’t need to know everything. Sometimes the most valuable response is simply saying, ‘Thank you for sharing that. Let’s find the answer together.’
What’s important is not missing that moment of connection. When those conversations happen, we don’t want to stigmatise, reject or unnecessarily delay them.
How can professionals balance duty of care with a participant’s right to make their own choices?
AK: There are a few important parts to this.
The first is understanding why someone may be vulnerable. Vulnerability can look different for different people. It may relate to cognitive capacity, communication, relationships, health conditions, impulse control or personality traits.
Knowing the person, understanding their relationships, goals and what is important to them is a really good starting point.
The next step is understanding the decision that needs to be made and ensuring the person has the information and support needed to understand that decision fully.
Supported decision-making and dignity of risk are important concepts. It’s about helping people understand their options, risks and consequences, without rushing the process.
Our role is not to make decisions for people. Our role is to ensure that people have the information, support and opportunities they need to make informed decisions about their own lives, while balancing dignity, choice, and appropriate safeguards.
Organisations also have a role through training, resources, documentation and review processes that support staff to navigate these situations well while maintaining a person-centred approach.
What are some common misconceptions about consent and decision-making for people with disability?
AK: Consent is part of everyday life. It isn’t just about sexuality; it’s about choice, communication, understanding, and respect.
A good starting point is understanding that consent happens all the time in all of our lives. It’s not just related to sexuality or sexual behaviour. We all provide and communicate consent in different ways.
It’s important to create environments where people can communicate comfortably, where they understand what’s being discussed and where they feel safe to express themselves. Communication, cognition and the environment all play a role in that.
There can sometimes be assumptions about a person’s sexuality, sexual expression, preferences or relationships. We need to move away from assumptions and create environments where people can safely express who they are.
Sexual health may also be broader than people realise. It includes puberty, reproductive health, menopause, STI testing, preventative health care and pregnancy. These are all important aspects of a person’s health and wellbeing and shouldn’t be overlooked.
When should professionals seek additional support and what services are available?
AK: There is a huge amount of expertise available across the sector. If a situation falls outside your knowledge, confidence or skill set, it’s important to seek additional support.
SHQ (Sexual Health Quarters) provides training, webinars, resources and referral pathways on topics relating to sexuality and disability. There are also organisations such as SECCA (Sexuality Education Counselling and Consultancy Agency) that provide consultation and education.
Support may also come from counsellors, psychologists, independent advocates, legal services and other specialist providers. A good starting point is reaching out, talking to others and exploring the resources available. Some of these are listed in the resource pack or will be provided as a follow up after the event. There are many services that can help expand your knowledge and provide support when it’s needed
Continue the conversation
The discussion doesn’t end here. Read our event recap to explore more of the ideas, challenges and opportunities raised during The Possibilities Forum. To hear about future Mosaic events, workshops and community activities, sign up to our mailing list for monthly updates.