Professional experiences on use of the mental health act in ethnically diverse populations: a photovoice study
Background There are long-standing ethnic and racial inequalities in experiences and outcomes of severe mental illness, including compulsory admission and treatment (CAT).Aims To gather professional experiences about (1) remedies for ethnic inequalities in the use of the Mental Health Act ((MHA) 198...
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| Language: | English |
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Mental Health |
| Online Access: | https://mentalhealth.bmj.com/content/28/1/e301406.full |
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| author | Roisin Mooney Paul McCrone Rose McCabe Kamaldeep Bhui Brian Brown Colin King Andrew Molodynski Nusrat Husain Jacqueline Sin Karen Newbigging Michael Larkin Neil Caton Raghu Raghavan Doreen Joseph Anthony Zigmond Michelle Yeung Julie Carr Phuong Hua Frank Keating Tara Morey Claire Dempsey Rahul Battacharya Nuwan Dissanyake Rochelle Ramkisson Laura Dixon Kopal Tandon Gary Roberts Paul Illingworth Jo White Karen Persaud Sayeeda Basharat Tripti Kandia Sandra Griffiths Michael Molete |
| author_facet | Roisin Mooney Paul McCrone Rose McCabe Kamaldeep Bhui Brian Brown Colin King Andrew Molodynski Nusrat Husain Jacqueline Sin Karen Newbigging Michael Larkin Neil Caton Raghu Raghavan Doreen Joseph Anthony Zigmond Michelle Yeung Julie Carr Phuong Hua Frank Keating Tara Morey Claire Dempsey Rahul Battacharya Nuwan Dissanyake Rochelle Ramkisson Laura Dixon Kopal Tandon Gary Roberts Paul Illingworth Jo White Karen Persaud Sayeeda Basharat Tripti Kandia Sandra Griffiths Michael Molete |
| collection | DOAJ |
| description | Background There are long-standing ethnic and racial inequalities in experiences and outcomes of severe mental illness, including compulsory admission and treatment (CAT).Aims To gather professional experiences about (1) remedies for ethnic inequalities in the use of the Mental Health Act ((MHA) 1983 and 2007) and (2) recommendations for improving care experiences and for reducing ethnic inequalities.Method We undertook a participatory research process using photovoice to gather experience data. Photographs were assembled and narrated by 17 professionals from a variety of disciplines. We undertook a thematic analysis.Results Ineffective communications between inpatient and community services, insufficient staff capacity, a lack of continuity of care and language and cultural constraints meant MHA assessments were lacking information, leading to elevated perceptions of risk. Practitioners felt helpless at times of staff shortages and often felt CAT could have been prevented. They felt voiceless and powerless and unable to challenge stereotypes and poor practice, especially if they were from a similar demographic (ethnicity) as a patient. Interdisciplinary disagreements and mistrust led to more risk-aversive practices. The legislation created an inflexible, risk-averse and defensive process in care. Police involvement added to concerns about criminalisation and stigma. There were more risk-averse practices when team members and families disagreed on care plans. More rehabilitation and recovery-orientated care are needed. Legislative compliance in a crisis conflicted with supportive and recovery-orientated care.Conclusion Clear standards are needed, including specific protocols for MHA assessment, police interactions, alternatives to admission, early intervention and continuity of care. |
| format | Article |
| id | doaj-art-9110494cc8e545b1a5af62958818bc0e |
| institution | Kabale University |
| issn | 2755-9734 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Mental Health |
| spelling | doaj-art-9110494cc8e545b1a5af62958818bc0e2025-02-09T04:10:09ZengBMJ Publishing GroupBMJ Mental Health2755-97342025-02-0128110.1136/bmjment-2024-301406Professional experiences on use of the mental health act in ethnically diverse populations: a photovoice study Roisin Mooney0Paul McCrone1Rose McCabe2Kamaldeep Bhui3Brian BrownColin KingAndrew MolodynskiNusrat Husain4Jacqueline SinKaren Newbigging5Michael LarkinNeil CatonRaghu Raghavan6Doreen Joseph7Anthony ZigmondMichelle YeungJulie CarrPhuong HuaFrank Keating8Tara MoreyClaire DempseyRahul BattacharyaNuwan DissanyakeRochelle RamkissonLaura DixonKopal TandonGary RobertsPaul IllingworthJo WhiteKaren PersaudSayeeda BasharatTripti KandiaSandra GriffithsMichael MoleteDepartment of Psychiatry, University of Oxford, Oxford, UKInstitute for Life Course Development, University of Greenwich, London, UKSchool of Health Sciences, City University, London, UKDepartment of Psychiatry, University of Oxford, Oxford, UKDivision of Psychology and Mental Health, The University of Manchester, Manchester, UKSchool of Social Policy, University of Birmingham, Edgbaston Campus, Birmingham, UKResearch and Innovation in Social Science, De Montfort University, Leicester, UKDepartment of Psychiatry, University of Oxford, Oxford, UKDepartment of Law and Criminology, Royal Holloway University of London, Egham, UKBackground There are long-standing ethnic and racial inequalities in experiences and outcomes of severe mental illness, including compulsory admission and treatment (CAT).Aims To gather professional experiences about (1) remedies for ethnic inequalities in the use of the Mental Health Act ((MHA) 1983 and 2007) and (2) recommendations for improving care experiences and for reducing ethnic inequalities.Method We undertook a participatory research process using photovoice to gather experience data. Photographs were assembled and narrated by 17 professionals from a variety of disciplines. We undertook a thematic analysis.Results Ineffective communications between inpatient and community services, insufficient staff capacity, a lack of continuity of care and language and cultural constraints meant MHA assessments were lacking information, leading to elevated perceptions of risk. Practitioners felt helpless at times of staff shortages and often felt CAT could have been prevented. They felt voiceless and powerless and unable to challenge stereotypes and poor practice, especially if they were from a similar demographic (ethnicity) as a patient. Interdisciplinary disagreements and mistrust led to more risk-aversive practices. The legislation created an inflexible, risk-averse and defensive process in care. Police involvement added to concerns about criminalisation and stigma. There were more risk-averse practices when team members and families disagreed on care plans. More rehabilitation and recovery-orientated care are needed. Legislative compliance in a crisis conflicted with supportive and recovery-orientated care.Conclusion Clear standards are needed, including specific protocols for MHA assessment, police interactions, alternatives to admission, early intervention and continuity of care.https://mentalhealth.bmj.com/content/28/1/e301406.full |
| spellingShingle | Roisin Mooney Paul McCrone Rose McCabe Kamaldeep Bhui Brian Brown Colin King Andrew Molodynski Nusrat Husain Jacqueline Sin Karen Newbigging Michael Larkin Neil Caton Raghu Raghavan Doreen Joseph Anthony Zigmond Michelle Yeung Julie Carr Phuong Hua Frank Keating Tara Morey Claire Dempsey Rahul Battacharya Nuwan Dissanyake Rochelle Ramkisson Laura Dixon Kopal Tandon Gary Roberts Paul Illingworth Jo White Karen Persaud Sayeeda Basharat Tripti Kandia Sandra Griffiths Michael Molete Professional experiences on use of the mental health act in ethnically diverse populations: a photovoice study BMJ Mental Health |
| title | Professional experiences on use of the mental health act in ethnically diverse populations: a photovoice study |
| title_full | Professional experiences on use of the mental health act in ethnically diverse populations: a photovoice study |
| title_fullStr | Professional experiences on use of the mental health act in ethnically diverse populations: a photovoice study |
| title_full_unstemmed | Professional experiences on use of the mental health act in ethnically diverse populations: a photovoice study |
| title_short | Professional experiences on use of the mental health act in ethnically diverse populations: a photovoice study |
| title_sort | professional experiences on use of the mental health act in ethnically diverse populations a photovoice study |
| url | https://mentalhealth.bmj.com/content/28/1/e301406.full |
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