How can Advance Choice Documents be successfully implemented for use in the perinatal period to support women with a history of severe mental illness?

Advance planning tools allow people with severe mental illness (SMI) to set out their care and treatment preferences for when they are in crisis or need hospital admission. There is an evidence base showing that using advance planning tools can have positive outcomes for people with SMI. Evidence also shows that there are barriers to their

effective implementation, and there are gaps in research on how they can work best for certain groups of people with SMI. One such area where there is a knowledge gap is how advance planning tools can most effectively support women with SMI who are pregnant or in the first year following their pregnancy, ie the perinatal period.

Advance Choice Documents (ACDs) are a new type of advance planning tool that is being introduced in England. This PhD research project will explore how ACDs can be implemented most effectively to support women with SMI in the perinatal period. It will include four studies: 1) a systematic review of the existing evidence, 2) a qualitative

study exploring stakeholder perspectives on ACDs using structured interviews, 3) a series of consensus building workshops to adapt the existing ACD template and implementation process for use in the perinatal period, and finally 4) a pilot study evaluating the implementation of perinatal ACDs within an NHS perinatal mental health

team. This research will inform the further roll out of perinatal ACDs across the NHS and thus support the improvement of mental health care services.