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Self-harm and digital technology overuse in young people with lived mental health experience

Self-harm and digital technology overuse in young people with lived mental health experience

by | May 22, 2024 | News

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Self-harm and digital technology overuse in young people with lived mental health experience

New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, in partnership with YoungMinds – the UK’s leading children’s mental health charity – has found high levels of problematic mobile phone use, disturbed sleep, and self-harm among young people with mental health conditions.

The research, published in PLOS ONE, is the first prospective study of its kind, and provides the basis for a comprehensive resource that will allow researchers to investigate the mental health impact of digital technology use in young people.

365 young people aged between 13 and 25 years old who are currently or have recently accessed secondary mental health services were recruited from the South London and Maudsley NHS Foundation Trust. Using innovative study design, co-produced with young people with lived experience, and sourcing data from participants’ electronic health records, smartphones and social media accounts, researchers were able to build an accurate picture of each participant’s behaviour. Participants provided data over the course of 6 months to establish how patterns of social media and smartphone use can be associated with self-harm and mental health.

More than 80% of the participants had self-harmed at least once, and high levels of depression, anxiety, and disturbed sleep were all prevalent. 54% reported using social media after midnight on a weekday, and 59% reported using their smartphones after midnight on a weekday.

“While there has been extensive debate about the relationship between social media and smartphone use and rates of self-harm, studies up to this point have largely been limited by their design, and have only been able to demonstrate associations rather than providing any insight into the relative timings of different behaviours or underlying mechanisms. Our comprehensive approach will allow us to properly investigate the impact of digital technology on youth mental health.”
Dr Rina Dutta

Reader in Suicidology and Psychiatry and the study’s senior author, King’s IoPPN

Among those studied, nearly a quarter reported using social media for more than 5 hours a day on weekdays and more than 40% used their smartphone above this threshold.

Despite spending excessive amounts of time online and about a third of participants reporting they had recently been the victim of bullying, researchers found that traditional methods of bullying, such as social exclusion, were more common than cyberbullying.

“The high prevalence of self-harm in our sample of young people with prior interactions with mental health services serve as a reminder that there needs to be increased investment in prevention and early intervention services for those at risk.”
Dr Amanda Bye

King’s Maudsley Partnership for Children and Young People Translational Research Fellow and the study’s first author, Kings Maudsley Partnership

Hannah Kinsey, Head of Training and Service Design at YoungMinds said, “We are hugely proud to be part of this research and the work that has gone into ensuring that young people’s voices are central at every stage of the study. The findings reveal that more needs to be done to stop the harmful impacts of social media on young people, especially those who have already struggled with their mental health.”

Dr Angela Hind, Chief Executive at the Medical Research Foundation, said, “Smartphones and social media are ubiquitous among young people, yet we know little about the impact on their mental health. This research reveals some important insights into how digital technology is being used by young people with lived experience of mental health conditions, and lays the foundation for future studies in this area – which are much-needed. Ultimately, we hope these findings will lead to better support for young people who are struggling with their mental health.

This study was possible thanks to funding from the Medical Research Foundation and the Medical Research Council. This work was also part supported by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre (BRC) and King’s College London, and the NIHR Clinical Research Network (CRN) South London.

Cohort profile: The Social media, Smartphone use and Self-harm in Young People (3S-YP) study – a prospective, observational cohort study of young people in contact with mental health services (DOI 10.1371/journal.pone.0299059) (Amanda Bye, Ben Carter, Daniel Leightley, Kylee Trevillion, Maria Liakata, Stella Branthonne-Foster, Samantha Cross, Zohra Zenasni, Ewan Carr, Grace Williamson, Alba Vega Viyuela, Rina Dutta) was published in PLOS ONE.

For more information, please contact Patrick O’Brien (IoPPN Media Manager)

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Day workshop in Cognitive Behavioural Therapy effectively reduces depression in 16-18 year olds

Day workshop in Cognitive Behavioural Therapy effectively reduces depression in 16-18 year olds

by | May 17, 2024 | Research

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Day workshop in Cognitive Behavioural Therapy effectively reduces depression in 16-18 year olds

The Brief Educational workshops in Secondary Schools Trial found a day-long CBT course is an effective means of improving young people’s mental health.

New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London has found that providing 16-18 year olds with a day-long course in Cognitive Behavioral Therapy (CBT) was both a clinically and cost-effective means of improving their mental health.

The trial, known as Brief Educational workshops in Secondary Schools Trial (BESST) and published in The Lancet Psychiatry, was successfully adapted from the DISCOVER program, which was designed to help adults manage their feelings of stress. The study has been funded by the National Institute for Health and Care Research (NIHR).

Around one in 12 young people in England currently experience anxiety or depression. Despite this, the large majority remain untreated, and almost a quarter (24%) have no contact with specialist Child and Adolescent Mental Health Services (CAMHS).

This study recruited 900 students from 57 schools in England. Half were provided with signposting to mental health services and the standard care their school would usually provide. The other half were invited to a day-long workshop on CBT coping techniques for managing mood, anxiety, and stress, and provided with follow up phone calls to help incorporate those skills into real-life situations.

Researchers found that participants who attended the workshop showed significant improvements in their depression, anxiety, wellbeing and resilience after a six-month follow up.

“More than half of adult mental disorders start before the age of 15, and when we approached schools, we found that there was overwhelming number of young people actively seeking support. There is clearly an urgent need for early intervention to ensure that symptoms of poor mental health don’t persist and worsen. Our study set out to establish if there was a clinically and cost-effective way to do that at scale.

Dr June Brown

Associate Professor in Clinical Psychology and the study's lead author, King’s IoPPN

Dr June Brown said, “One of our main challenges was to adapt an adult therapeutic intervention which would be attractive and engaging for teenagers. In addition, previous studies have either been aimed at all students, some of whom aren’t necessarily in need of assistance, while others have taken a more targeted approach that potentially stigmatises those who might need support. Giving students the opportunity to self-refer means that we work with students who recognise that they’d like help.

“Our study shows that this intervention can be delivered at low cost by mental health professionals who can bridge the gap between schools and CAMHS.”

“Since the pandemic there is an increased need to support schools and adolescents with their mental health. While we found improvements in depression; anxiety; wellbeing; and resilience, the largest effect was seen in those students that had higher symptoms of depression at the start of the study, meaning that we reached and improved those students most vulnerable to depression.

Professor Ben Carter

Professor of Medical Statistics and the study's senior author, King's IoPPN

Professor Ben Carter, “The ultimate success of this has laid the groundwork for these workshops to be rolled out nationwide to provide an early intervention against depression and anxiety.” 

Karen Crowe, Senior Tutor for the Sixth Form & Curriculum Leader for Psychology at St Nicholas Catholic High School in Cheshire said, “Our school seeks to prioritise mental wellbeing and promote strategies that improve students’ mental health. We believe it is important to teach students how to become self-regulating individuals who can manage their own stress, which is why the school fully supported the BESST trial. We value techniques that provide students with skills to resolve problems, cope better with expectations, and build confidence, so the trial’s aims perfectly complement our school’s mission and ethos.”

Olivia Black, a student at St Nicholas Catholic High School who took part in the BESST trial said, “The study gave me new ways to manage my stress and remain productive during my studies. It was such a helpful process that allowed me to develop my personal strategies for maintaining good mental health. The skills and confidence gained from this trial motivated me to help start up our ‘breathing space’ initiative where sixth formers support younger students with their mental health.”

Can a brief accessible CBT programme in schools improve the mental health of 16–18-year-olds? Clinical and cost-effectiveness of a cluster randomised controlled trial in Brief Educational Workshops in Secondary Schools Trial (BESST) (DOI 10.1016/S2215-0366(24)00101-9) (June Brown, Kirsty James, Stephen Lisk, James Shearer, Sarah Byford, Paul Stallard, Jessica Deighton, David Saunders, Jynna Yarrum, Peter Fonagy, Timothy Weaver, Irene Sclare, Crispin Day, Claire Evans, Ben Carter) was published in Lancet Psychiatry. 

For more information, please contact Patrick O’Brien (Media Manager)

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Celebrating International Nurses Day 2024: A Thank You to Our Nurses!

Celebrating International Nurses Day 2024: A Thank You to Our Nurses!

by | May 12, 2024 | Blog Post

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Celebrating International Nurses Day 2024: A Thank You to Our Nurses!

As we commemorate International Nurses Day this year, we want to shine a spotlight on the incredible work of nurses in Child and Adolescent Mental Health Services (CAMHS). These nurses play a vital role in supporting the well-being and mental health of children and young people, often in challenging and complex circumstances.

In CAMHS, nurses are not only caregivers but also advocates, educators, and sources of comfort for both service users, their families and carers. They provide essential mental health care services, helping young people navigate through difficult emotions, cope with challenges, and develop resilience.

This year, we wanted to do something special to show our appreciation. We encouraged our CAMHS staff members to take a moment to say thank you to a CAMHS based nurse who has made a difference in their lives or the lives of others.

The response was overwhelming, with heartfelt messages pouring in from across the directorate. We hope these messages of gratitude not only warm the hearts of our nurses but also served as a reminder of the impact they have on the lives of patients, families, and colleagues alike. Happy International Nurses Day to all our incredible nurses. Here’s to celebrating you today and every day.

Read all the messages below: 

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Mike Brodie – Lambeth CAMHS

“I want to shout out Mike, our amazing Children’s Nurse who has a long history working in Lambeth CAMHS. Mike has worked within many teams in Lambeth CAMHS over the years and is currently the Clinical Service Lead for our Lighthouse (front door) team.

Mike is always on hand to offer time, guidance, help and support to our young people parents and carers as well as his colleagues. His hard work and dedication has assisted Lambeth with consistently reaching the contact within 28 days target. His is a compassionate and caring nurse. Lambeth CAMHS wouldn’t be the same without him. Thanks Mike Happy International Nurses Day!

Charlotte Chesson – Bethlem Adolescent Unit (BAU)

“I would like to nominate Charlotte Chesson because she is kind, caring, always so calm and chilled, very popular with the young people. Not long after I started my role I remember walking past a young person’s bedroom, Charlotte was in there with her stroking her hand whilst she was sleeping. It was evident how much Charlotte cared and that memory has stayed with me.”

– Ward Social Worker

“Charlotte defo needs celebrating!!! Charlotte is always bringing a calm and empathic approach to the ward, incredibly organised and great at delegating and ensuring the team gets things done, despite being busy is very present with the young people and it’s clear to see she has built good rapport with many of the young people.”

– Ward Trainee Youth Intensive Psychological Practitioner

Paul Hunt

“Very dedicated to his role across all his years at CAMHS. Always keeps his calm even in crisis situations with our young people.”

– Ward Assistant Psychologist

Natalie Gagg – Bethlem Adolescent Unit (BAU)

“Natalie has the perfect balance of being firm but fair, very funny, certainly has a connection / very popular with the young people who she knows really well.  She’s very committed, always happy and upbeat and brings a positive vibe/her whole self when she is on shift on the ward.”

– Ward Social Worker

“Such a wonderful nurse! So caring, kind, hardworking and all knowing! Her ability to juggle everything that is going on and hold everyone in mind is amazing. Hearing her laugh brightens up my day.”

– Ward Trainee Youth Intensive Psychological Practitioner

“I think Natalie has to be the most passionate Nurse on BAU. She has huge amounts of empathy towards the young people that they respond well to and has a strong work ethic that demands everyone to work at their best which is what you want and need in an inpatient environment. She is incredibly bubbly, and this rubs off on other people around her. We need more Natalies!”

– Ward Trainee Youth Intensive Psychological Practitioner

Gillene Thomas

“Calm and controlled, champions our international nurses wherever possible and is supportive to colleagues.”

Amanda Broughton

“You are a confident, experienced and a skilled leader who inspires our newer nurses everyday – thank you for your dry sense of humour too!”

Jide Akintomide

“Jide is Jide and I am thankful for his containment, support and trust throughout the years.“

Nina Hammond – Snowsfields Adolescent Unit & Southwark CAMHS

“Skilled and knowledgeable beyond her years.  Will say ‘yes’ to anyone asking for some help and has an anecdote for every scenario.”

“Thank you Nina. Your commitment to our young people and staff is amazing. You bring your lovely personality and passion to everything you do, making a positive impact on those around you. Your dedication does not go unnoticed, and I am grateful for all that you do.”

Amy-Rose Olah

“She always makes space even though she is always very busy, juggling several issues. She is quick to think and gives thoughtful answers when there may be issues that come up. She is supportive of the young people and the therapies. She knows her ward so well. She is kind, gentle and firm at the same time which again I can see that these are qualities that young people respond so well too.”

– Ward Art Psychotherapist

David Condon – CAMHS Community Matron

“Kind, experienced, proactive, thoughtful and helpful – what more do you want from a senior nurse?”

Jacob Rolling

“Making his mark already in the team, passionate, creative and bakes!”

Latoya Morgan – Lewisham CAMHS

“Shout out also to Latoya for all that she does, under the radar a lot of the time, for NDT!”

Lee Wadsworth

“Our in house Reducing Restrictive Practice expert, thank you for championing youth and parent involvement in this sensitive work.”

Holly Dawson

“I would like to give a shout-out to Holly Dawson from Symbol Team:

Holly’s dedication to supporting young people and their carers is evident every day as she consistently goes above and beyond to ensure their well-being. She concerns herself not only with the individuals directly under her care but also with other clients and, notably, our team. She consistently strives to improve teamwork and thinks of ways to support everyone surrounding her. 

Working alongside Holly is a pleasure, as her passion for her work and dedication characterise her. We are truly grateful for the impact she makes within the team. Thank you, Holly, for your invaluable contributions.”

Femi Lawal

“Thank you for being so diligent in your care for young people and an example to all.”

– Ward Assistant Psychologist

Janet Millanaise-Taylor

“Janet has such a lovely calming way about her, I think that she demonstrates compassionate care in both her interactions with the young people and also how she speaks about them in handover to MDT.”

– Ward Occupational Therapy Apprentice

Joely Horner

“Flourished in her new role as RMN and always advocates for the young people. Her baked cookies are also 10/10!.”

– Ward Assistant Psychologist

Olivia Akenzua

“I wanted to nominate Olivia, she is so quick off the mark with every aspect of her work. Very organised and so brilliant with each of the young people. She knows everything about all of them and her hard work is clear.”

– Ward Trainee Youth Intensive Psychological Practitioner

Kerry Gribble – Croydon CAMHS

“A big shout out to Kerry , who is so passionate about being physical health lead in Croydon CAMHS and always has a smile on her face – we appreciate you Kerry!!”

Letisha Spencer

“Letisha is new, but she has hit the ground running, feels like she has been part of the team for ages. She is warm and uses her sense of humour to connect with the young people. She has taken initiative and empowered the young people to take some responsibility whilst they are on the ward in the form of corridor reps. Generally she works very hard and deserves a shout out”

– Ward Trainee Youth Intensive Psychological Practitioner

Georgia Reed

“Amazing nurse who cares about staff as well as young people. Very good at boundary setting. Lights up the room with her fun presence!”

– Ward Assistant Psychologist

Nicola Jenkin – Lewisham CAMHS

“She works tirelessly, she is extremely knowledgeable and willing to spend time discussing issues and sharing that knowledge. Nicola really embodies ‘grace under fire’ as she remains consistent, warm and cheerful in spite of any pressure.”

“Nicola deserves all this love and appreciation!“

“Nicola is an extremely hard working and empathetic colleague and a professional for the service users. She is professional, supportive and friendly, a great colleague to have!”

“Nicola goes above and beyond for patients, families and her colleagues. She is always available for advice and support and I am proud to be able to nominate such a wonderful role model.”

“Nicola, who works tirelessly to help yp and families and a great colleague to work with!” 🙂

“She regularly goes above and beyond for her families.  She is selflessly committed to their welfare. Added to this she a thoughtful and supportive colleague who generously shares her thinking and knowledge.”

“I have worked with Nicola since she started within CAMHS, and she has always had a welcoming approach.  Nicola is also there when you want help and make sure her team members are okay.  Nicola works extremely hard.”

“Nicola has been amazing in her role as a nurse for Lewisham CAMHS, we could not function without her!”

“I would also like to express my gratitude to Nicola. She has been really welcoming and wonderful to work with. She takes time out of her very busy schedule to make sure other members of the team are doing okay. She’s extremely hard working  and kind. In my very limited time here it’s been a very pleasant experience to interact and work with her.”

“Nicola’s long service and dedication to Lewisham CAMHS, not only in a therapeutic capacity but with her specialist prescribing skills and even a period leading our safeguarding make her a worthy candidate for a shout out.  Along with our other wonderful nurses we really appreciate her!” 💐

“Nicola has been tirelessly supporting families with ADHD in Lewisham for years. Nicola is patient, kind and resilient when being asked to do more than she can. She is compassionate and works very hard to make sure no one is forgotten. She tries hard to be flexible to accommodate people who need prioritising due to risk. Thank you Nicola!!”

“I have a term to sum up Nicola…An absolute STAR!!! She’s very diligent, dedicated and goes above and beyond for not only our service users, but her colleagues.

 She’ll happily help anyone navigate this service. A real representative of our Trust Values…Kindness, Respect & Together

 Nicola, we salute you beyond Nurses Day, thank you!” 😊

Isabella Awilo

“Always tries to find the time to have 1:1 engagement with the young people even on a busy shift.”

– Ward Assistant Psychologist

Fran Lada

“A big shoutout to Fran, for all the amazing work, dedication, and thoughtful care she provides to the Hope Project, and the children and families she supports. We really appreciate it, thanks Fran!”

– Clinical Psychologist Southwark CAMHS

Ziza Godji

“Her experience and expertise always makes the staff and ward feel safe and managed well.”

– Ward Assistant Psychologist

Catherine Olaseinde

“Her calming presence makes staff and young people warm to her on shift.”

– Ward Assistant Psychologist

Charlotte Bates

“She is so knowledgeable about every aspect of running the ward and all the young person. She is caring and fair with her decision making and doesn’t get angry when I ask her lots of annoying questions! You can really see the hard work she puts into ever shift and how this really helps the team. Her psychology knowledge can also really add to MDT discussions and help her when implementing the DBT approach we have adopted on the ward.”

– Ward Trainee Youth Intensive Psychological Practitioner

Bethlem Adolescent Unit (BAU) Nurses

“Can I give a shout out to all the nurses at BAU, for always staying calm and always carrying on. I’m forever amazed by how they continue to find creative ways to support young people, even when there are stressful things happening on the ward.”

– Ward Family Therapist

Victor Coker

“Goes the extra mile for staff wellbeing i.e. birthday cakes!”

– Ward Assistant Psychologist

Patricia Onyike

“Rain or shine she always greets the young people, families and staff with a smile.”

– Ward Assistant Psychologist

Mary Lansana

“Despite being a new addition to the team (PICU ward), her senior presence ensures the shift runs as smooth as possible. She is a role model for all!”

– Ward Assistant Psychologist

“Mary was the first person who welcome me to SAU, 20 years ago on my first day on the ward. She has the gift in making you feel heard, listened to and make your work feel valued even when she is juggling a busy ward.

She is gentle, consistent in her approach, calm for the young people but able to put firm containing boundaries. She always has a smile even at her most stress personally or professionally. She has been a great source of warmth and support to all of us at SAU and particularly the young people and their families too. I certainly miss her loads. She makes you feel you belong!”

– Ward Art Psychotherapist

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Conscious memories of childhood maltreatment contribute to psychopathology

Conscious memories of childhood maltreatment contribute to psychopathology

by | May 1, 2024 | News

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Conscious memories of childhood maltreatment contribute to psychopathology

New analysis from the Institute of Psychiatry, Psychology & Neuroscience at King’s College London has found that an individual’s conscious recollection of child maltreatment is strongly associated with psychopathology.

The research, published in JAMA Psychiatry, analysed studies of both ‘retrospective’ and ‘prospective’ measures of childhood maltreatment, and their association with psychopathology – a collection of symptoms ranging from internalising problems like depression and anxiety to externalising problems such as antisocial behaviour and substance abuse.

Retrospective measures refer to first-person, subjective recollections of childhood events, while prospective measures typically refer to third-person accounts of childhood events, such as from parental testimony or official records.

In a meta-analytic review of 24 studies covering 15,485 individuals, psychopathology was more strongly associated with retrospective measures of childhood maltreatment than prospective measures, suggesting that it is the personal memories of abuse or neglect at a young age and the meanings we attached to them that may contribute to psychopathology later in life.

Child maltreatment encompassed a range of traumatic experiences between birth and the age of 18, including physical, sexual and emotional abuse; or physical or emotional neglect.

Researchers found that the associations between retrospective measures of child maltreatment and psychopathology were particularly strong when the assessment of psychopathology was based on self-reports and focused on emotional disorders such as depression or anxiety.

Furthermore, retrospective reports of emotional abuse showed stronger associations with psychopathology compared to retrospective reports of other types of maltreatment.

Researchers suggest that the findings could have important implications for the treatment of mental health issues that stem from childhood maltreatment. In particular, it highlights the potential role of autobiographical memories of childhood maltreatment, which has not been explored in dominant theories on the outcomes of maltreatment.

Psychoanalytic and physical theories of mental ill-health generally focus on unconscious memories that cannot be accessed by a person’s voluntary recollection. In contrast, our findings support theories that one’s individual interpretation of events, conscious remembering, and the associated thought patterns are more strongly linked with psychopathology than the mere events themselves.”
Dr Jessie Baldwin PhD

Visiting Researcher, IoPPN and Senior Research Fellow, UCL

Our results indicate that evidence-based treatment for trauma-related psychopathology, such as trauma-focused cognitive behavioural therapy, and novel memory therapeutics may hold the key to softening the impact of childhood maltreatment on mental health.”
Miss Oonagh Coleman

PhD Student, King's IoPPN

The role of autobiographical memory in psychopathology has been largely underappreciated outside the work on Post-Traumatic Stress Disorder (PTSD). Advancements in this area can provide novel insights into prevention and treatment for the broad range of psychological disorders emerging after traumatic experiences in childhood.”
Professor Andrea Danese MD

Professor of Child & Adolescent Psychiatry , King's IoPPN

The study’s authors note that the associations between retrospective measures of child maltreatment and psychopathology might be inflated, particularly for emotional disorders, due to recall bias. For example, evidence suggests that increases in depressive symptoms over time may lead to small increases in retrospective reports of maltreatment. However, other recent research from the team suggests that recall bias is unlikely to explain the findings, suggesting that individuals’ memories of maltreatment may contribute to the development of psychopathology.

This research was possible thanks to funding from the Wellcome Trust, Mental Health Research UK, Medical Research Council, National Institute for Health Research Biomedical Research Centre at South London, Maudsley NHS Foundation Trust, and the Medical Research Council.

Prospective and Retrospective Measures of Child Maltreatment and their Association With Psychopathology (Jessie R. Baldwin, PhD; Oonagh Coleman, MSc; Emma R. Francis, PhD; Andrea Danese, MD, PhD) (DOI: 10.1001/jamapsychiatry.2024.0818) was published in JAMA Psychiatry.

For more information, please contact George Fenwick (Senior Communications and Engagement Officer)

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£2.5m to roll-out Advance Choice Documents

£2.5m to roll-out Advance Choice Documents

by | Mar 25, 2024 | News

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£2.5m to roll-out Advance Choice Documents

A new project led by researchers at the Trust of South London and Maudsley and the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, will result in the largest implementation and study of Advance Choice Documents in Europe. For this project, the Maudsley Charity has committed over £2.5m in funding.

a young girl holding a leaf

By the end of the two-year project, the team aims to have Advance Choice Document resources in use across mental health services in the South London and Maudsley NHS Foundation Trust. An extensive implementation study will also be delivered which will, alongside tested resources, provide the basis for a ‘recipe book’ for Advance Choice Documents to support other trusts in using them across the country.

Advance Choice Documents are written when someone is well and set out how they would like to be treated during a future mental health crisis or relapse. Their introduction was recommended in the 2018 Independent Review of the Mental Health Act and by the parliamentary committee on the draft of the mental health bill in 2023.  Research has shown they can reduce detentions under the Mental Health Act and improve relationships with mental health professionals.

Black people are disproportionately likely to be detained under the Mental Health Act and there is a lack of trust in mental health services in this community. Wider adoption of Advance Choice Documents has the potential to help address these issues.

The new project builds on the success of the recent Advance Statement for Black African and Caribbean project (AdStAC) where researchers and clinicians at the IoPPN and South London and Maudsley NHS Foundation Trust have been working to improve Black service users’ experiences in mental health services by co-producing and testing resources for the implementation of Advance Choice Documents.

The new project will roll out and evaluate the use of Advance Choice Documents across the South London and Maudsley NHS Foundation Trust for anyone who has been detained under the Mental Health Act. This includes children and adolescents who will be treated at the new Pears Maudsley Centre for Children and Young People, set to open in south London in 2025.

“Reducing detentions of our service users under the Mental Health Act has been a Trust-wide priority, together with the PCREF priorities of reducing racial disparities in detentions under the Mental Health Act, as we know we have a disproportionate number of Black men detained on our inpatient wards. From our work on the AdStAC project, we know that Advance Choice Documents are more than just medical preferences; it’s about capturing the essence of a person—their values, their hopes, their fears. With this new funding from Maudsley Charity, we can get Advance Choice Documents offered to service users Trust-wide.”

Nathalie Zacharias

Director of Therapies, South London and Maudsley NHS Foundation Trust

Rebecca Gray, Chief Executive of Maudsley Charity, said:

“We are absolutely delighted to support this new, large-scale project which builds on the earlier work of this impressive team and has relevant lived experience at the centre of its design. Many people with a severe mental illness report that they have too little control and voice in the care they receive. These concerns are particularly high for Black patients, who are disproportionately impacted by severe mental illness and for whom we know trust in mental health services is not high.

“This project has the potential to address these issues and push the needle forward on the use of Advance Choice Documents across the country.”

Professor Claire Henderson, Clinical Professor of Public Mental Health at King’s IoPPN and Honorary Consultant Psychiatrist at South London and Maudsley NHS Foundation Trust, said: 

“Having worked on multiple research projects on these types of documents since the late 1990s, I am very happy to have the support of the Trust and Maudsley Charity to make Advance Choice Documents available to people who have previously been detained under the Mental Health Act, and in particular Black people, who experience disproportionately high rates of detention.”

Lorna, who is a carer and advocate for her son Ryan, who lives with psychosis said:

“I don’t want my son to be sectioned. I want to keep him well, so an Advance Choice Document is what we need. What will make him unwell would probably be him not taking his medication.

“I’m just hoping for a system where you put my son’s name in and the ideal thing is they’ll know where Ryan lives, that they’ll know to contact me or to contact somebody that will know what the next steps are.

“I think I know my son better than the health care professionals. I’ve felt through the journey I was never listened to. The big thing would be that reassurance that he would be taken care of in the way he wants to be taken care of even if I’m not there.”

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