Empowering Black voices in mental health care: the advance choice journey
Earlier this month, the Mental Health Bill 2024 was introduced into parliament to address outdated mental health practices. The Bill had its second reading on Monday 25 November 2024, bringing mental health reforms one step closer to becoming UK law.
Some of the key priorities of the new Bill are to give greater autonomy to people with mental health challenges, reduce racial discrimination and lower detention rates. As part of this, the Bill will give service users the right to create an advance choice document (ACD), which allows them to have a say in how they wish to be treated during a future mental health crisis or relapse.
An ACD is co-produced by the service user, mental health professional and a ‘facilitator’ who is responsible for capturing the patient's wishes in writing. Existing research has shown that ACDs can reduce detentions under the Mental Health Act and improve relationships between service users and mental health professionals. We already know that Black people are detained under the Mental Health Act more than any other ethnic group and tend to have a lack of say in their mental health care, resulting in a lack of trust in health services.
Through the recently completed Advance Statements for Black African and Caribbean (AdStAC) project, researchers and clinicians at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London and South London and Maudsley NHS Foundation Trust have been working to improve Black service users’ experiences in mental health services in South London by co-producing and testing an advance choice implementation resource with Black service users, mental health professionals and carers/supporters of Black service users.
ACDs were previously recommended by the Mental Health Act review (2018), chaired by Professor Sir Simon Wessely at the IoPPN, which reviewed the original Mental Health Bill developed in 1983. Despite this, they won’t be made statutory in the new Mental Health Bill 2024.
In this three-part blog we hear from Dr Nadine Keen, a Consultant Clinical Psychologist at South London and Maudsley NHS Foundation Trust, Fiona Crowe an ACD facilitator, and an anonymous service user, all of whom were involved in the AdStAC project and advocate for the implementation of ACDs in mental health services.
Read the series
Part one: A clinician's perspective: enhancing trust and autonomy
Part two: A service user's story: advocating for better mental health care
Part three: Co-production in mental health care: Insights from an advance choice document facilitator
