Advance Choice Documents - and the difference they can make for our mental health and finances

Advance Choice Documents are written or spoken records that allow people with fluctuating mental illness to say in advance, when they are well, what treatment they would like should they become ill.

They provide important information for family, friends and professionals about their wishes. A key part of this is sharing what should be done with finances, bills and all money matters at a point when someone may not be capable of doing this for themselves.

With the much needed update of the Mental Health Act England and Wales coming to fruition, the government is recognising the need to respect people’s decisions about their care, clinical treatment and domestic issues, during severe episodes of illness. 

The upcoming changes to the Mental Health Act now stress the importance of people being able to document their wishes and preferences for future periods of illness in an Advance Choice Document to guide decisions about their care if they are very unwell in future.

One part of an Advance Choice Document is being able to give instructions for how financial matters should be managed while someone is severely unwell. This is extremely important, given the financial challenges already faced by people living with severe and enduring mental health conditions. The average annual income for a person with a severe mental illness is just 75% of the average of people without – an annual difference of £6,500. And this situation often gets worse when people are unwell, with nearly seven in ten (68%) people with mental health problems experiencing a drop in income while receiving support from secondary services.

Having financial wishes as part of ACDs is clearly vital, as nearly six in ten (58%) respondents were not offered any support with their finances while under the care of secondary mental health services, and eight in ten (81%) said their crisis or relapse prevention plan did not mention finances.

Among people living with mental illness and health professionals, both nationally and internationally, there is increasing enthusiasm for people to use their own past experience of severe illness to help guide their future healthcare using ‘Advance Choice Documents’, which are also sometimes known as advance ‘directives’ or ‘statements’.

But a key factor holding people back from creating or recommending Advance Choice Documents is a lack of awareness and resources. AdvanceChoice.org’s aspiration is to fill this gap.

AdvanceChoice.org is a website and suite of videos that will explain what Advance Choice Documents are – and how they can help. It also provides a template to work with, which can be done with family and friends, or alongside a clinician.

Please visit AdvanceChoice.org to learn more.