Improving the Experiences of Black African Caribbean Men Detained Under the Mental Health Act: A Co-Produced Intervention Using the Silences Framework (ImprovE-ACT)

Aim: To inform, develop and explore the feasibility of a co-produced intervention to improve the experiences of Black African-Caribbean (BAC) men detained under the Mental Health Act (MHA) Background: The latest UK Government figures show that BAC people are detained significantly more than their non-Black peers under the MHA.

Current evidence suggests that there is a desperate need for a wide-scale intervention to inform best practice, focusing on co-production and user involvement with marginalised groups such as BAC men. There is also a gap in research evaluating interventions outside of London.

Objectives: Review the evidence regarding interventions used to address the over-representation of BAC men detained under the MHA; Explore BAC men s experiences of the mental health detention journey; Explore professionals views to identify key areas for improvement; Co-produce a tailored intervention aimed at improving BAC men s experiences of detention; Assess whether the intervention can be delivered to an adequate level; Conduct a qualitative evaluation to explore acceptability of intervention and identify any challenges; Consult with policy makers to inform and produce recommendations for practice improvement and change.

Methods: This five stage mixed methods study will use The Silences Framework (TSF) and Experience Based Co-design (EBCD) to guide the research and identify the complexities around BAC men s experiences, in their own words, focussing on what is important to them in relation to detention.

First, a rapid evidence review with reflexive analysis will take place to culturally inform and underpin the research design to frame and understand research to date on the experiences of BAC men detained under the MHA.

Next, 15-25 EBCD narrative interviews with BAC men and members of their social networks, and 15-20 semi-structured interviews with professionals involved in the assessment or detention process (e.g. psychiatrists, GPs, mental health nurses, AMHPs, police officers, social workers, care coordinators) will be conducted, resulting in the production of a trigger film and theory of change driven collaborative workshops to co-develop the intervention and a logic model for testing it in practice.

The feasibility of the intervention will be then tested at small scale with BAC men who have been assessed or detained under the MHA, to assess recruitment rates over a period of 9 months and the adequacy of intervention delivery, as well as to explore any challenges and intervention acceptability. The final stage 'planning for silences' will include dissemination.

A comprehensive impact strategy will be implemented throughout all stages of the research to ensure that policy makers are equipped to act on the emerging recommendations and to enable change.

Timelines for delivery: The research programme will take 48 months to complete (01.01.2021-31.12.2024), as outlined in the Gantt Chart.

Anticipated impact and dissemination: To maximise audience and impact, findings will be disseminated through peer reviewed publications, official reports, practitioner magazines, conferences, parliamentary reports, media and online platforms.

The study will help raise awareness of the issues that lead to over-representation of BAC men detained under the MHA and enable change through lobbying directed at policy makers.