The study constituted:
- A scoping review of interventions that support unpaid carers of adult mental health inpatients to identify an evidence base for the use of particular interventions that support carers.
- Phase 1: Semi-structured interviews and focus groups with carers (n=14), practitioners (n=15) and Responsible Clinicians (n=4) to explore their views on what involvement and support around s.17 leave carers want, what works well, barriers and facilitators, and what practitioners feel is feasible in practice.
- Phase 2: A non-randomised controlled study to test the s.17 standard for signals of efficacy. Intervention wards (implementing the s.17 standard) and control wards (business as usual) were recruited from each of six NHS trusts. Structured telephone interviews were conducted with carers at three time points: 1) following the patient’s admission to hospital under s.2 or s.3 of the Mental Health Act (1983); 2) within two weeks of the patient experiencing s.17 leave with the carer; and 3) six months following baseline. Interviews included a series of outcome measures, plus a qualitative element in the second interview. Due to low carer recruitment, analysis of the quantitative measures was not undertaken. Carers of patients detained in an intervention ward who supported s.17 leave before the baseline interview could be undertaken, were invited to take part in a one-off qualitative interview to discuss their experiences of s.17 leave. A total of 13 carers were interviewed for phase 2.
- Practitioners working on intervention wards were invited to take part in an interview or to complete an online survey to share their experiences of how the s.17 standard had been used in practice and the barriers and facilitators to implementation. 13 practitioners on intervention wards completed an interview/survey.
- Research, clinical and/or managerial (RCM) staff with experience of undertaking research with carers and/or implementing new interventions in inpatient wards were invited to take part in an interview or complete an anonymous online survey. 108 RCM staff completed an interview/survey.
The project advisory group included unpaid carers of people with mental health problems and experience of giving support during s.17 leave, people with lived experience of detention under the Mental Health Act and s.17 leave with unpaid carers, practitioners, researchers and representatives from carer organisations and the Department of Health and Social Care. The advisory group were involved with: the ethics application; review of data from phase one; the development of the s.17 standard; wording of the consent forms, information sheets and other documentation; piloting of interviews; the content and visual elements of recruitment materials (including posters), strategies to engage ward staff, recruit carers and implement the s.17 standard; and the design and content of materials including an information leaflet for carers and guidance document for practitioners.
