Research: Mental health act reform

Research summary

• February 2021 to January 2025

The latest UK Government figures show that Black African-Caribbean (BAC) people are detained significantly more than their non-Black peers under the Mental Health Act (MHA). They can be subject to discriminatory practices that are unfair and traumatic for them and their families.

This project is part of a wider programme of research funded by the National Institute of Health Research. It aims to reduce the number of compulsory hospital admissions for people with mental health conditions and improve the experiences of patients, as well as their families and friends.

The research will be used to support the government’s newly announced reforms of the MHA and provide evidence to policymakers rolling out the reforms.

The team will use innovative research techniques to co-produce an intervention to improve Black African-Caribbean men’s experiences of detention under the MHA, and eventually reduce detention rates.

objectives

We will:

• engage with people with lived experience and self-advocates to guide and co-produce the research and enable change
• review the evidence regarding interventions currently used, to address the over-representation of BAC men detained under the MHA
• explore BAC men’s experiences of the ‘mental health detention’ journey
• explore professionals’ views to identify key areas for improvement
• co-produce a tailored intervention aimed at improving BAC men’s experiences of detention
• evaluate the feasibility and acceptability of the intervention, and measure the outcomes for
  progression to a full trial
• consult with policymakers to inform and produce recommendations for practice change
  and improvement

Research methodology

We are co-designing this research with BAC men and their significant others using The Silences Framework (TSF) and an Experience Based Co-design (EBCD) approach. This is a dedicated way of engaging with and hearing unheard views from vulnerable populations on mutually identified research.

Five key stages will be used to address the project objectives.

Stages one to two

Contextualisation and reflection: a rapid evidence review with reflexive analysis to understand research to date on the experiences of BAC men detained under the MHA.

Stage three

Verbalisation and intervention development including:

• EBCD narrative interviews with BAC men and members of their social networks will be co-edited with participants to create a powerful trigger film
• semi-structured interviews with professionals involved in the assessment or detention process to identify key areas for improvement
• feedback and co-design events, including theory of change workshops to agree on key components of intervention

Stage four

Acceptability and feasibility of intervention: a non-randomised study testing whether the newly developed intervention can be delivered to an adequate level with BAC men detained by the police.

Stage five

Review, recommendations and impact: a comprehensive impact strategy will be implemented
throughout the project to ensure that policymakers are equipped to act on the emerging recommendations and enable change.

EXPECTED OUTPUTS

We are aiming to:

• raise awareness among the public, professionals and policymakers of the issues that lead to the over-representation of BAC men detained under the MHA
• co-produce a tailored intervention aimed at improving BAC men’s experiences of detention with a view to race equality
• demonstrate whether it is feasible to test the intervention at a large scale