Table 1 Summary of the four main barriers to recruiting psychosis carers

Poor relationships with mental health clinicians

A negative relationship with the referring clinician is likely to make the carer less receptive to the research study

Target those services that are carer friendly

Conflicting with the care recipient’s needs

If the care recipient does not approve of the study then it can make it difficult for the carer to be involved

Be transparent about the details of the project with any care recipients that make contact, while protecting participant confidentiality

Make study documentation available to the care recipient

Use terms such as ‘family and friends’ instead of carer

Lack of spare time

 Carers’ frustration at the delay between research and implementation

Research takes time, but carers are looking for immediate solutions to their problems

Keep carers updated about the progress of the study

Develop a clear and realistic dissemination and implementation plan, ideally with input from a lived experience group

 Impact of caregiving demands

It can be difficult to balance the time commitment involved in caring and being a research participant

Make the study design flexible and pragmatic to accommodate for the demands of caring

Minimise the burden of the research on participants, for example keeping questionnaires short

Allow for generous attrition rates (i.e. > 33%) in sample size calculations

Lack of services for mental health carers

Carers can be hard to reach as the usual means of advertising clinical trials are not available

Be creative in how you promote the research study, beyond the strategies usually employed in clinical trials

Consider making relationships with and promoting your project in settings beyond healthcare services

Encourage snowball recruitment