Experience based investigation and Co-design of approaches to Prevent and reduce Mental Health Act Use (CO-PACT): A Protocol


Abstract Introduction The Independent Review of the Mental Health Act (MHA) in England and Wales confirmed increasing levels of compulsory detentions, especially for racialised communities. This research aims to: a) understand the causes of and propose preventive opportunities to reduce the disproportionate use of the MHA; b) use an adapted form of experience-based co-design (EBCD) to facilitate system-wide changes; and c) foreground the voices of service users at risk of detention to radically reform policy and implement new legislation to ensure the principles of equity are retained.

Methods and Analysis This is a qualitative study, using a comparative case study design. This study is composed of five work packages; photovoice workshops will be conducted in eight local systems with service users and health care professionals separately (WP1); a series of three EBCD workshops in each local system to develop approaches that reduce detentions and improve the experience of people from racialised communities. This will inform a comparative analysis and national fourth knowledge exchange workshop (WP2); an evaluation led by the PPI group to better understand what it is like for people to participate in photovoice, co-design and participatory research (WP3); an economic evaluation (WP4); and dissemination strategy (WP5). The impact of the involvement of patients and public will be independently evaluated.

Ethics and Dissemination This study is sponsored by the University of Oxford and granted ethical approval from the Health Research Authority (21/SC/0204). The outputs from this study will be shared through several local and national channels.


The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Open access article.


Mental health Act, Racialised populations, Photovoice, Experience based co design, Health inequalities


Mooney R., Newbigging, K., McCabe, R., McCrone, P., Halvorsrud, K., Raghavan, R., Joseph, J., Bhui, K. (2022) BMJ Open, 12(2), e060086.


Research Institute

Mary Seacole Research Centre