Developing an intervention to support discussion between mental health staff and patients after a Mental Health Act assessment

Background Being detained in a mental health hospital is the most ethically contentious area of mental health.

With growing concern about the increasing number of detentions and poor patient experiences, it is a priority area for research and practice. Mental Health Act assessment, when the decision is made to detain a patient or not, is vital to this experience. Although this assessment can be distressing and confusing for patients, research on this process is minimal.

My previous study found that assessment experiences are rarely discussed by mental health staff with patients.

Guidance from other areas, such as restraint, advises that it is good practice to have a post-event review since it improves understanding, relationships with services, and patients' sense of procedural justice.

Procedural justice is an evaluation of whether a legal process is fair, the people involved have the authority, completed in a reasonable manner, and the patient is involved.

Aims To co-design a novel intervention to support discussion between mental health staff and patients after a Mental Health Act assessment to increase patients' understanding and sense of procedural justice and inform their future care. Objectives 1.

To conduct interviews and build upon my previous research to gain an understanding of a broader range of patient's lived experience of MHA assessment, what support they received afterwards, and their suggestions for a post-MHA assessment intervention. (WP1) 2.

To conduct focus groups to explore mental health staff's views and to identify the facilitators and barriers to post-MHA discussions (WP1). 3. To facilitate workshops to co-design a prototype intervention with stakeholders for post-MHA assessment. (WP2) 4.

To refine this prototype intervention through preliminary testing (WP3) Methods This proposal is an intervention development study based on the Medical Research Council framework over three work packages: Work package one -Qualitative data collection and thematic analysis with four to five staff focus groups and fifteen to twenty patient interviews (Objectives 1 and 2).

Work package two- Two creative-based workshops with fifteen to twenty attendees. Through sharing WP1 findings, they will generate ideas and develop a prototype (Objective 3).

Work package three - First, with six staff to user test the intervention using an adapted talking aloud method and real-world testing with six patient participants.

In a cyclic process after each test, gained feedback is used to refine the prototype (Objective 4) Patient and public involvement Through a Patient Advisory Group and using peer researchers, patients will be involved in data collection, collaborative analysis, co-designing and testing of the novel intervention, and dissemination.

Anticipated impact and dissemination This intervention will increase patient well-being as well as improve procedural justice and engagement with services. Thus, it could lower the likelihood of readmission. Findings from WP1 and the intervention development process will be written up as scientific publications.

The study findings will be disseminated through my network of collaborators, presentations, social media, and a dedicated event.