Previous work has shown in Manchester has shown that about 1/3rd of eligible participants will be detained under the 1983 Mental Health Act at some stage during their first episode, but that the majority of such cases will be able to give informed consent to be assessed.

Mental health service users are being involved in the design and rolling out of the project in the following ways:

1. A pilot study of first episode psychosis with 6 month follow−up has been conducted in Manchester (population 420,000) between November 2003 and November 2004. The acceptability of the instruments was confirmed: 75% of eligible first episode psychosis participants agreed to take part in the study.

2. As part of the UK MHRN, a Department of Health funded service user research group (SURGE), has been established and the project will take continuing advice from this group concerning acceptability and feasibility.

Potential research participants will be identified by members of clinical teams through Community Mental Health Teams, Child and Adolescent Mental Health Services and outpatient and inpatient mental health facilities. Local NHS staff will identify potential eligible participants and seek verbal consent for the person to be approached by the designated member of the research team.

If this is forthcoming, the Clinical Research Officer (CRO) (who will hold an honorary clinical contract for the NHS Trust) will approach the potential participant at their convenience, explain the study and provide an information sheet. With the potential participant's verbal consent the CRO will then re-approach the person a minimum of 24 hours later to provide further explanation, answer questions and obtain written consent if it is forthcoming.

For patients who are currently detained under a section of the Mental Health Act 1983, an extra step will be involved. The responsible medical officer will be asked by the Research Assistant to confirm that, in their clinical judgment, the individual is able (has capacity) to give informed consent. If not, the person will not be approached.

In the case of minors, parental written consent will also be sought. Approximately 5% of potential participants will be 16 years old or under.