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Additional file 1: SupplementaryFile 1. COREQ checklist. SupplementaryFile 2. Interview Guide for Young People. SupplementaryFile 3. Interview Guide for Support People. Supplementary File 4. EIPS factors that could improve thehospitalisation experience and its effectiveness – Views of Young People andSupport People.

Background A documented gap in support exists for service users following discharge from acute mental health services, and structured interventions to reduce relapse are rarely provided. Peer-facilitated self-management interventions have potential to meet this need, but evidence for their effectiveness is limited. This paper describes the development of a peer-provided self-management intervention for mental health service users following discharge from crisis resolution teams (CRTs). Methods A five-stage iterative mixed-methods approach of sequential data collection and intervention development was adopted, following the development and piloting stages of the MRC framework for developing and evaluating complex interventions. Evidence review (stage 1) included systematic reviews of both peer support and self-management literature. Interviews with CRT service users (n = 41) regarding needs and priorities for support following CRT discharge were conducted (stage 2). Focus group consultations (n = 12) were held with CRT service-users, staff and carers to assess the acceptability and feasibility of a proposed intervention, and to refine intervention organisation and content (stage 3). Qualitative evaluation of a refined, peer-provided, self-management intervention involved qualitative interviews with CRT service user participants (n = 9; n = 18) in feasibility testing (stage 4) and a pilot trial (stage 5), and a focus group at each stage with the peer worker providers (n = 4). Results Existing evidence suggests self-management interventions can reduce relapse and improve recovery. Initial interviews and focus groups indicated support for the overall purpose and planned content of a recovery-focused self-management intervention for people leaving CRT care adapted from an existing resource: The personal recovery plan (developed by Repper and Perkins), and for peer support workers (PSWs) as providers. Participant feedback after feasibility testing was positive regarding facilitation of the intervention by PSWs; however, the structured self-management booklet was underutilised. Modifications to the self-management intervention manual and PSWs’ training were made before piloting, which confirmed the acceptability and feasibility of the intervention for testing in a future, definitive trial. Conclusions A manualised intervention and operating procedures, focusing on the needs and priorities of the target client group, have been developed through iterative stages of intervention development and feedback for testing in a trial context. Trial Registration ISRCTN01027104 date of registration: 11/10/2012 Electronic supplementary material The online version of this article (10.1186/s13104-017-2900-6) contains supplementary material, which is available to authorized users.

Introduction:\ud Crisis resolution teams (CRTs) provide assessment and intensive home treatment in a crisis, aiming to offer an alternative for people who would otherwise require a psychiatric inpatient admission. They are available in most areas in England. Despite some evidence for their clinical and cost-effectiveness, recurrent concerns are expressed regarding discontinuity with other services and lack of focus on preventing future relapse and readmission to acute care. Currently evidence on how to prevent readmissions to acute care is limited. Self management interventions, involving supporting service users in recognising and managing signs of their own illness and in actively planning their recovery, have some supporting evidence, but have not been tested as a means of preventing readmission to acute care in people leaving community crisis care. We thus proposed the current study to test the effectiveness of such an intervention. We selected peer support workers as the preferred staff to deliver such an intervention, as they are well-placed to model and encourage active and autonomous recovery from mental health problems.\ud Methods and analysis:\ud The CORE (CRT Optimisation and Relapse Prevention) self management trial compares the effectiveness of a peer provided self-management intervention for people leaving CRT care, with treatment as usual supplemented by a booklet on self-management. The planned sample is 440 participants, including 40 participants in an internal pilot. The primary outcome measure is whether participants are readmitted to acute care over 1 year of follow-up following entry to the trial. Secondary outcomes include self-rated recovery at 4 and at 18 months following trial entry, measured using the Questionnaire on the Process of Recovery. Analysis will follow an intention to treatment principle. Random effects logistic regression modelling with adjustment for clustering by peer support worker will be used to test the primary hypothesis.

Additional file 2: DS4. CRT service user interviews (stage 2)â main themes.

Additional file 5: DS7. Feasibility testing (stage 4)â main themes from PSW focus group.

Additional file 7: DS9. Pilot trial (stage 5)â main themes from PSW focus group.

Additional file 1: DS1–DS3. CRT Service User Interviews (stage 2)—participant characteristics. Stakeholder Focus groups (stage 3)—participant characteristics. Feasibility testing (stage 4) and piloting (stage 5)—participant characteristics

Additional file 3: DS5. DS5 Stakeholder focus groups (stage 3)â main themes.

Additional file 6: DS8. Pilot trial (stage 5)â main themes from participant interviews.

Additional file 4: DS6. Feasibility testing (stage 4)â main themes from participant interviews.

Background: The process of communication at the time of a mental health diagnosis is an important but under researched area in mental health settings. Aims: To understand the satisfaction levels, information requirements and support needs of people with a lived experience of diagnosis and what influences this. To explore what health professionals consider to be the barriers and facilitators to the communication process at the time of a mental health diagnosis. To synthesise strategies for support and best practice recommendations into a model of communication for use at the time of a mental health diagnosis. Methods: A systematic review (of 30 quantitative and qualitative papers), two qualitative studies (n=45 people with lived experience of diagnosis; n=19 health professionals) and two survey based quantitative studies (n=101 people with lived experience of diagnosis; n=131 health professionals) were undertaken. Results: There has been limited research into this area of mental health communication. The majority of individuals who experience a diagnosis want information; however, this is not always satisfactorily addressed. For clinicians, there was a lack of known specific health professional training programmes, and factors such as health professional background and confidence handling distress influenced beliefs and practice. Models of communication appraised by people with a lived experience of diagnosis were highly acceptable, however, consistently barriers, such as stigma and the need to address the changing circumstances of individuals, were identified as areas requiring further attention. The synthesised result is a more dynamic, multifaceted and less linear model of communication. Conclusion: Talking with an individual about a mental health diagnosis can be a non-linear, complex and changeable situation. The resulting model is offered to help further develop health professional communication training and support individuals at the time of mental health diagnosis.