Table 7.

Process evaluation interview/focus group topic summary

Context • Past experience of mental health services, use of safety plan, or similar • Existing/usual coping strategies • Existing/usual support (formal/informal) Recruitment • Acceptability of trial procedures • Motivation to take part/expectations • Suggested improvements/changes acceptability of randomisation Intervention (SPI + TAU participants only) • SPI session °Location, timing, setting °Barriers/facilitators °Level of understanding °Expectations of SP use •SAFETEL intervention researcher ° Engagement with researcher — barriers/facilitators ° Acceptability/level of participant comfort ° Helpful/unhelpful aspects • Safety plan use ° Use in practice ° Circumstances of use ° Barriers/facilitators • Follow-up calls ° Facilitators/barriers to engaging ° Acceptability ° Helpful/unhelpful aspects ° Using call — changes to SP/coping strategies • Overall ° Level of support ° Changes implemented ° Comparison to other services/interventions/coping strategies used ° Suggestions for improvement Since recruitment (3 months in Phase II, 6 months in Phase III) • Changes made/experienced • Other services or support • Use of Safety Plan or related coping strategies General • Helpful or unhelpful aspects of participation • Suggested improvements of other feedback NHS Liaison Psychiatry staff • Level of contact with SAFETEL team, knowledge of study • Current context and services available at site, e.g. discharge/referral procedures • Acceptability of trial procedures and fit within hospital context • Acceptability of intervention elements • Feasibility of delivering the intervention • Barriers/facilitators for implementing • Knowledge of other similar interventions/services • Suggestions for improvements/other feedback SAFETEL researchers delivering intervention Recruitment • Acceptability, feasibility, and facilitators/barriers affecting the following: ° Identification of potential participants ° Approaching potential participants ° Recruitment procedures: information, consent, baseline data collection, randomisation SPI session • Setting — appropriateness, acceptability, variability • Factors affecting SPI development — barriers/facilitators, strategies used to overcome issues Follow-up calls • Acceptability • Feasibility • Practical changes implemented • Barriers and facilitators to engaging participants • How participants used calls Safety Plan use • Participant engagement with SP • Perceived barriers/facilitators to implementing SP use Participant feedback • Perceived/reported helpful/unhelpful elements of intervention • Perceived/reported barriers/facilitators to engaging with study/intervention • Participant suggestions for improvement • Awareness of past SP use or other similar service use Overall • Other reflections on trial and intervention procedures — positive/negative aspects, facilitators/barriers • Impact on staff — wellbeing, training, support • Perceived impact on participants of study and intervention engagement Suggested adaptations