Using photovoice to elicit experiences and inform the co-design of approaches to prevent and reduce Mental Health Act use
The Mental Health Act allows professionals to admit people to hospital against their will. People from black and minority ethnic communities are more likely to get care this way. This can be distressing, reduces trust, and is costly. The government’s review of these laws recommended more research to understand the rise in use of compulsory care. The review asked for the views of service users, carers and mental health staff.
The research will ask people about their experiences of compulsory admission to hospital using a law that is called the Mental Health Act. People from black and ethnic minority communities more often experience this. We want to find ways of reducing care like this.
We will work with mental health services in London, Manchester, Leeds, Birmingham, Bradford, Oxford and Derby. Service users will be of diverse ethnic backgrounds and over the age of 18. In each city, we will recruit 20 service users who have experienced at least one compulsory admission to hospital in the previous year. We will use a creative process involving photography to capture their experiences. The first meeting will explain the approach. We will ask people to take photos about their experiences of compulsory admission. In two more meetings, we will ask people to add titles, captions, or descriptions to tell their stories. We want to know what may prevent compulsory care. The captions can be written, or audio or video recordings. Twenty mental health staff from across the seven cities will do the same.
We will then share this information with five service users, five carers and five staff members, in each of the seven cities. Staff can be psychiatrists, psychologists, social workers, nurses, police, lawyers, commissioners, and policy experts. This group will meet three times and design a new approach, to reduce the number of people receiving compulsory care. A fourth meeting will bring everyone together to consider their experience when they tried to apply the approach, specifically what works, for whom and how. Using information provided by participants, we will estimate the economic costs of existing and alternative care pathways and co-designed systems. We will investigate how costs might change because of better approaches to support those at risk of compulsory detention.
We will ask everyone how they found working on the project using a questionnaire. They will be able to write freely. This will help us understand what helped and if anything changed for them.
We will share our findings throughout the process.