Accurate and appropriate cognitive screening has the potential to significantly enhance early psychosis care, yet no screening tools have been validated for the early psychosis population and little is known about current screening practices, experiences, or factors that may influence implementation. Using a hybrid type 1 design, the CogScreen study aims to validate two promising screening tools with young people with first episode psychosis (primary aim) and to understand the context for the implementation of cognitive screening in early psychosis settings (secondary aim). The present protocol outlines the implementation study, which aims to explore the experiences and practices, acceptability, feasibility, and determinants of cognitive screening in early psychosis settings from the perspective of key stakeholders. Young people with first episode psychosis (n=350), caregivers (minimum n=10), and service providers (minimum n=12) will be recruited from primary and specialist early psychosis services in Melbourne, Adelaide, and Sydney, Australia. Grounded in implementation science, two theoretical frameworks inform data collection and analysis: the Theoretical Framework of Acceptability and the Consolidated Framework for Implementation Research. A mixed methods design will be employed to collect and analyse data from questionnaires with young people with first episode psychosis, interviews with all stakeholder groups, and administrative processes. Quantitative data will be analysed using descriptive statistics. Qualitative data will be analysed through content analysis using deductive and inductive coding. Together with accuracy findings, results from the present implementation study will provide new insights about the practices, experiences, enablers and barriers to cognitive screening in early psychosis services.

Background: Family peer workers form connections with family/carers and can offer emotional support, psychoeducation and referrals based on their own lived experience. Although an increasing number of family peer support programs exist in the youth mental health sector, they are rarely described or reported on. There is a need for greater documentation of the experiences of family peer workers operating in the healthcare sector, in order to raise awareness of issues currently facing the workforce and support organisations to make positive changes. Methods: We present a detailed description of the family peer support program at Orygen in Victoria, Australia. In doing so, we highlight factors that impact effective program implementation and delivery from the perspectives of four family peer workers and two supervisors. Findings/Conclusions: Organisations should encourage self-care and social connections between family peer workers to reduce impacts of ongoing mental-ill health and workplace burnout and isolation. Staff should be educated about the field of family peer support to improve role clarity and foster a positive team environment. It is vital to develop a comprehensive position description, training program, and onboarding procedures to ensure new employees are adequately equipped. To improve staff retention and compensate those with further education, experience and skills, organisations may consider offering increased remuneration, negotiate longer-term contracts with a potential for a greater number of workdays, and should promote/hire senior lived experience positions. Further research is needed to formally investigate barriers and facilitating factors of program implementation in mental health settings.