Appendix 2.

Collaborative behaviours and relationship with other themes (theme 1)

Collaborative behaviour	Examples and relationship with other themes
Accepting and valuing the contribution of the other	Asking for help, referring to each other, valuing and appreciating each other. Hospital staff referred to each other. Staff sometimes mentioned feeling devalued or not listened to when attempting to make contributions. Relationship with: autonomy↔, relatedness↔, resources↔, motivation to collaborate↔
Creating goals and a common vision	Described theoretically by some participants as being important for collaboration. Participants did not describe a regular process by which this happens, and some reported that it does not happen in the hospital. ‘I think what we lack is that we sometimes don't see a common vision for our patient, and I think also each person understands mental illness in a different way, so that is where the main obstacle comes…Because we come from different backgrounds. How to unite these people of different backgrounds will be one major challenge.’ (Specialist 3) Relationship with: motivation towards common goal/value↔, relatedness↔
Creating and respecting boundaries and roles	Inside the hospital strong role boundaries were described, which were sometimes rigid – for example the role of doctor as ‘decision-maker’ (see Theme 3). Some participants, particularly school councillors reported that their role was not understood or respected. Some crossing of role boundaries by doctors, was causing frustration. ‘We did an assessment…the patient didn't have a problem that needed chest physio…So when I discussed with the doctor he was harsh and said to just do it. Although the patient from the assessment really didn't need it.’ (Physiotherapist 1) Relationship with: autonomy↔+–, relatedness↔+–, resources↔+–, motivation to collaborate↔+– (‘Respecting boundaries’ was one of the ways that autonomy was maintained, but sometimes in conflict with other collaborative behaviours, for example maintaining boundaries sometimes reduced sharing of information, resources and responsibility)
Sharing information and learning from each other	Communication was frequently one way, with just a brief referral form. Information was sometimes not shared, for example primary care staff not being aware that a patient had been admitted or discharged. From primary care interview: Family medicine specialist 1: ‘The department sends back a small slip saying, “thank-you for your referral we are currently seeing and following up this patient”.’ Student health centre doctor: ‘If you are very lucky, you will get that.’ Family medicine specialist 2: ‘If you are very fortunate.’ Student health centre doctor: ‘Most of the time nothing.’ Family medicine specialist 1: ‘Normally no diagnosis.’ Staff discussed training community members and psychoeducation of patients and families. Traditional healers wanted hospital staff to learn about them. Some staff discussed learning from each other, mainly from staff of the same profession. Relationship with: autonomy↔, relatedness↔, resources↔
Sharing decision-making and creating a plan	Included eliciting opinions, sharing opinions, listening and coming to a decision together. Shared decision-making was described outside the hospital (for example in families making decisions about seeking help for the first time) between members of the same profession (normally between specialists) and in the community mental health team, but decision-making inside the hospital was rarely shared (see theme 3). Relationship with: motivation to common goal/value↔, autonomy↔, relatedness↔, motivation to collaborate↔, resources←,→+–
Sharing responsibility and accountability	Included proactivity and assertiveness, autonomous helping and following the agreed plan. Staff in the same profession helped each other if one of their colleagues needed help. Some staff deliberately withheld ideas and were not proactive, to avoid blame (see Theme 6). Relationship with: autonomy↔+–, relatedness↔+–, motivation to collaborate↔+–
Sharing experiences, rewards and frustrations	Sharing feelings of enjoyment, stress or frustration. From junior doctor interview: ‘Take for example, some of the staff nurse, they do offer some consolation, “it is ok, this patient is always like this”.’ (MO1) Relationship with: motivation towards common goal/value→, relatedness↔, motivation to collaborate→
Sharing activities and resources	Community participants described joint events, between the hospital and non-governmental organisation workers, religious leaders and other community leaders. Community mental health staff described joint home visits. Relationship with: resources↔, relatedness↔, motivation to collaborate↔

→, collaborative behaviour increases the feature; ←, feature increases the collaborative behaviour; +–, relationship is both positive and negative (further information on relationships in supplementary File 3).