Significant concerns about the use of the MHA, including the increasing rates of people being detained for treatment and the disproportionate numbers of people from ethnic minority groups who were being detained under the MHA, have been noted over many years. It is in this context that the UK Government ordered a review of The Mental Health Act (MHA). The independent MHA Review, centred on four principles: choice and autonomy; least restriction; therapeutic benefit; and the person as an individual.
Few interventions have been shown to reduce the use of compulsory admissions. Crisis planning and advance Choice Documents have been shown to reduce the rates of detention overall by 25% as shown in systematic reviews. The use of Advance Choice Documents (ACD) showed a positive effect for people from ethnic minority groups in reduction of use of MHA. The new MHA bill passing through parliament has included ACDs to reduce coercive care.
The first implementation study of ACDs is now underway at the South London and Maudsley NHS Foundation trust. This follows the robust principles of choice, autonomy and coproduction to develop a clear plan to be used when someone experiences a crisis in future. ACDs are made using effective Shared-Decision-Making approach, with service user, clinicians and relevant others working with an independent ACD facilitator.
In this session, the speakers will introduce the evidence base that underpins the use of advance choice. The speakers will cover the steps in practical implementation of the programme in a large Trust with high levels of deprivation, psychosis and significant diversity of population. The presenters will cover how to develop and ACD with a service user, the barriers in implementation and the practical means to integrate such a project into day to day work that clinicians provide in resource limited settings.
Learning objectives
In this webinar you will learn about the:
• persisting ethnic disparities in mental health care and the data on ethnic disparities in the Mental Health act use
• understand the previous research into what interventions work in reducing the risk of coercive admissions in mental health
• how to develop and ACD with a service user, who has been previously detained under the MHA, and how to foster a therapeutic dialogue
• measurement as applicable to real life settings to evaluate an implementation study - understanding the study design."
Speakers
Chair: Dr Lade Smith, Royal College of Psychiatrists, London
Dr Lade Smith, Royal College of Psychiatrists, London
Dr Mariam Namsaba
Dr Rajesh Mohan, South London and Maudsley NHS Foundation Trust, London
Mr Steve Gilbert, Steve Gilbert Consulting, Birmingham
Funding
RCPsych International Congress is financially supported by the purchase of exhibition stand packages. A full list of confirmed exhibitors can be found here: Exhibiting Organisations at International Congress 2026
Availability
This webinar is part of the Congress webinar 2026 package. If you attended all four days of Congress, you will have access to these as part of your Congress package. Otherwise the Congress webinar 2026 package can be purchased below.
