Advance Choice Documents for Black African and Caribbean people with previous compulsory admission

Introduction

Advance Choice Documents have been recommended based on legal and ethical arguments and evidence that advance statements can reduce use of compulsory psychiatric admission. The aim of the project was to develop and implement an Advance Choice Document (ACD) resource for Black African and Caribbean people who have previously been detained under the Mental Health Act and the people that support them.

 

Methods

Three stakeholder workshops (including service users, carers/supporters and mental health staff) informed the development of an ACD template; the Trust’s Recovery College course to provide information on ACDs; and skills training delivered with the Simulation training team on how stakeholders could create and use an ACD. To support the development of the ACDs, a facilitator manual was also developed for the project facilitator, as was a job description for future facilitators.

 

Results

The ACDs developed were largely reported as appropriate, acceptable, and feasible to staff and service users. The ACD template was also able to inform the development of a digital ACD.  The information provision training and skills training were generally considered to be informative by attendees. Attendees of the Recovery College course appreciated the involvement of a peer-trainer. Those attending the Simulation training valued enacting scenarios in realistic settings.

Discussion

Flexibility was necessary throughout the project to adjust to staff capacity to attend training or attend ACD development meetings, facilitator capacity, and accessibility of trainings for service users and carers/supporters.

Conclusion

The project developed an ACD development resource that was agreeable to all stakeholders and provides an example of the importance of co-production in producing resources meaningful to all involved. It also highlighted the need for facilitators to supported to keep strictly protected time or full-time availability to help support the development of ACDs.