New Development Advance Choice Documents (ACDs)

Welcome to this educational video resource, which explores the benefits Advance Choice Documents has for people who use mental health services. Please note that the term patient, service user and people who use mental health services are references used in this production and there are differences in preferences in the use of the expressions.

This learning resource has been co-produced with the SLaM Recovery College and has been funded by Health Education England.

The Mental Health Act Reform story in brief

The Mental Health Act was reviewed in 2017-2018 and concerns were raised that:

  • There were too many out of area placements
  • There was an increased use of the MHA
  • There was a massive over representation of people from the Black and Minority Ethnic population

154 recommendations were made with four new guiding principles:

  1. Choice and autonomy
  2. Least restriction
  3. Treating the person as an individual
  4. Therapeutic benefit

As of May 2023, it is unclear which recommendations will become law. However, South London and Maudsley NHS Foundation Trust began development of Advance Choice Documents. Patient involvement and choice is core to our Trust strategy ‘Aiming High: Changing Lives’. Production of this programme is to inform clinicians, people who use services, carers, advocates and other stakeholders about good practice to support Advance Choice Document development.

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New Development Advance Choice Documents (ACDs)

What are these? These are documents that are co-produced between people who use mental health services and the clinical teams they work with. Carers can also be involved They set out a person’s wishes for how they would want to be treated should they become unwell in the future.

Why we are promoting ACDs? ACDs are one of the recommendations within the government’s Mental Health Act Review Bill, which has not yet become law. The Bill recommendation was that ACDs be used for people who have been detained under the Mental Health Act. However, South London and Maudsley NHS Foundation Trust has taken a broader approach to this, suggesting that they should be offered to all people who use our services. 

We think it is good practice. The Trust takes the approach that ACDs will be beneficial to helping people to think about what matters most if they were to become unwell in the future. People who use services are at the centre of everything we do and having an ACD is pivotal in this happening.

Where to find more information about this new development. The educational resource which has been co-produced with the Recovery College is available at the following link.

The programme is modular and has specialist modules for involving people using acute adult mental health services, learning disability services, people with autism and children and young people.

It contains a lot of information and can be viewed intermittently, you do not need to sit through the whole programme in one session.

The resource is for everyone and is aimed to give a broad introduction to ACDs and share what we consider good practice when working with people to develop these plans.

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