Table 2.

YouBelong Home using the TIDier format (Template for Intervention Description and Replication)

TIDier format Item	YBH Intervention Description using the TIDier format	YBH area endorsed by CHaRISMA study	YBH area refined because of CHaRISMA study
Brief name	YouBelong Home (YBH), a 16-week pre- and post-discharge reintegrating people hospitalised with Severe Mental Illness (SMI) back into their families and local communities.		Refined The intervention has increased from 14 weeks to 16 weeks
Why	YBH is informed by theoretical understandings on belonging, mental health recovery, culture, family care and human rights. These are reflected in YBH values and principles. These are used in a model of practice that combines relationship-centred practice, culturally centred practice, family-focused mental health recovery and assertive community mental health. 1. Personal identity formed in social relationships. 2. Belonging to family, community and culture, is a basic human need and pivotal for mental health. 3. Recovery from SMI is an active participatory process led by the person in recovery. 4. Community-based mental health services should be the centre piece of mental health care, providing the person in community with ease of access to care ‘in community’. 5. Provision of community-based services and supports, including innovative practices, should only be implemented if they are of high quality, scalable for significant impact in the community and sustainable. 6. The family unit, the local community from which a person recovering from SMI comes, and tribal culture (in Uganda and other African countries) are essential resources in the recovery process. 7. Building opportunities and skills for families, particularly of the main carer in the family empowers families and strengthens their capacity to respond to the range of issues associated with having a family member recovering from SMI. 8. Cultural context, awareness and sensitivity should be the core driver in education of families and communities in mental health. 9. The decentralized health system in Uganda is a key resource. 10. Human rights values and principles.	The focus on recovery, belonging, family and relationship centred and culturally centred practice was affirmed.	An explicit human rights values principle was added.
What: Materials	Memorandum of Understanding (MOU): YBU has a formalised written MOU with BNRMH, stating YBH team’s role and functions and collaborative arrangements. YBH has 5 Standard Operating Procedures: ‘Introductions’, ‘Income Generating Activities’, ‘Medication adherence’, ‘Dealing with challenging behaviours’, ‘Conflict resolution’ and ‘Crisis management’. Pre-discharge: The predischarge assessment phase is a co-production process utilising 5 tools. i. General health assessment and mental health assessment (with service user) ii. The Rosenberg Self Esteem Scale Tool (with service user) iii. The Internalized Stigma of Mental Illness Inventory-9 item Version (with service user) iv. Mapping of resources and assets in the service user’s family and network of social relationships (service user and the family carer) v. Co-produced personal empowerment plan for post discharge (outcome of assessments) Post discharge: Material used in this phase are mental health education resources packaged in terms using local languages that are cultural and belief sensitive.	Importance of the MOU with the hospital and close relationships with the nursing staff confirmed. A dialogical process of assessment and communication based in empowerment values.	Improvements were made to the interface between YBH and hospital ward processes. The pre-discharge assets and resource maps were simplified to ensure they capture what is necessary for an empowerment focused assessment. Refinements to the following Standard Operating Procedures: ‘Medication adherence’, ‘Crisis management’, ‘Conflict resolution’, ‘Income Generating Activities’ and  ‘Dealing with challenging behaviours’ Arrangements were made with the hospital for the YBH team to write in case notes. Mental health education resources were changed using local languages that are culturally and belief sensitive.
What: Procedures	Predischarge assessment phase: Co-production meetings with service users in the hospital convalescence ward to undertake assessment and co-produce an empowerment plan. Meetings (x2) are held with a family member, including one in the home setting. YBH transports service users’ home in the YBH bus with celebration of home coming with food. Post discharge activities: Through home visits and phone support, strategies that might be employed are mental health psychoeducation, medicine access, family relationship and personal development counselling, access to livelihoods support, links to community leaders and addressing stigma and discrimination. Termination and referral of the YBH service user to the nearest health centre for medication refills. Continuous quality improvement: Through reflective processes, shared working and case management, evaluation and research culture, and feedback loops between YBH and the hospital. YBH staff have access to hospital wards and meet with key hospital staff.		The pre-discharge phase was extended from 2 to 4 weeks to strengthen the preparation of the service user for returning home. More attention on psychoeducation about a service user’s diagnosis and treatment and on motivational interviewing for service users recovering from substance use disorders. Additional hospital visit by family member prior to discharge to support family understanding of care needs. Modifications in the post-discharge phase. Increased focus on IGAs and tightening of the structure of phone support practices. Team working processes and critical reflective practices strengthened.
Who	• YBH is delivered by employed trans-disciplinary staff from disciplines of social work, occupational therapy and mental health nursing. • Staff have community mental health knowledge, communication skills, team working skills, cultural understandings and personal qualities and values (i.e., empathy, compassion, belief in human rights, empowerment and change). • There is mental health and social work leadership. • Staff are engaged in regular training and development about aspects of the YBH intervention, such as interviewing, assessment, case management and community development.	Endorsed the configuration of a MD team for the delivery of YBH.
	The YBH intervention has three modes of delivery through: i) Individual case work ii) Family work iii) Community development. The pre-discharge work in the hospital setting is initiated by YBH workers, subject to the service user consent. It is conducted on a face-to-face basis. The post-discharge work is conducted face-to-face initially and then replaced by telephone calls with individuals and families. The community development work in the post-discharge phase is delivered with individual community leaders, with groups of community leaders or local community members and with staff at district health centres.	Endorsed
Where	In Uganda, the YBH intervention is delivered in the districts of Kampala and Wakiso. In the pre-discharge phase, the intervention occurs in the hospital convalescent ward and includes family home visits. The post-discharge work is in the service user’s home environment, which can be a village or urban dwelling. It also takes place in the local community and health centre.
	The intervention will occur once the person is ready for discharge from the hospital. There are 4 weeks of pre-discharge work, with 2–3 assessment sessions tailored to the circumstances of the service user. Post-discharge activities occur over 12 weeks and comprise 2 blocks, each 6 weeks in length; block 1 comprises two home visits, block 2 comprises 2–3 phone calls followed by one termination visit.
	All participants receive the same intervention which is personalised and based on needs, family situation and personal empowerment goals. Role plays and case analysis help fidelity.	The use of role plays and case analysis to assist consistency of implementation across the YBH team.