Let’s Talk 2 – Peer Support for Psychosis, Stigma and Disclosure 

People who experience psychosis often describe facing negative attitudes from others. These experiences are known as stigma, and when stigma leads to unfair treatment, this is called discrimination. Over time, many people begin to absorb these negative ideas and feel worse about themselves. This is known as internalised stigma, and it can make decisions about whether to talk about mental health experiences feel stressful and complicated. The recent Lancet Commission on Ending Stigma and Discrimination in Mental Health (2022) highlighted this as a global priority. 

Let’s Talk 2 is a major research study designed to help people think about how stigma affects them, explore their feelings about disclosure, and make decisions that support their own recovery.

What Is the Let’s Talk Programme? 

The original Let’s Talk programme is based on the Honest, Open, Proud model and is delivered one-to-one by trained Peer Support Workers (PSWs). These are mental health workers who have lived experience of psychosis themselves and understand the challenges of stigma first-hand. 

The programme provides: 

• A safe and supportive space to talk about experiences of stigma 

• Practical guidance on deciding whether, when, and how to talk about mental health 

• A structured workbook developed from evidence-based approaches 

• Up to 16 semi-structured sessions, focusing on hope, empowerment, and shared experience 

Early feasibility work showed this peer-led approach to be acceptable and helpful, leading to the development of the larger Let’s Talk 2 trial. 

What Is Let’s Talk 2 Testing?

Let’s Talk 2 is a multi-site randomised controlled trial, funded by the National Institute for Health Research (NIHR Efficacy and Mechanisms Evaluation programme). The study aims to find out whether the Let’s Talk peer-support programme helps to improve personal recovery, reduce self-stigma, and ease distress around disclosure compared with standard care. 

Over 32 months, adults receiving mental health care for psychosis will be randomly allocated to: 

Intervention Group 

Up to 16 one-to-one peer support sessions following the Let’s Talk workbook. 

Control Group 

Treatment-as-usual provided by their Early Intervention in Psychosis (EIP) or Community Mental Health Team (CMHT), with no additional peer-led sessions. 

Who Leads the Study?

• Chief Investigators:
  Dr Melissa Pyle
  Professor Tony Morrison 

• Clinical Trial Manager:
  Dr Emmeline Joyce 

The study is also supported by an independent Trial Steering Committee and an independent Data Monitoring Committee, which oversee trial progress, participant safety, and research quality. 

What Will the Study Measure?

The trial tracks progress at baseline, 4 months, and 12 months. 

Key outcomes include: 

• Primary outcome:
  Personal recovery at 4 months, measured using the Questionnaire About the Process of Recovery (QPR-15). 

• Secondary outcomes:
  Internalised stigma, disclosure-related distress, symptoms of anxiety (SIAS), depression (PHQ-9), psychosis symptoms, life satisfaction, and quality of life. 

Researchers will compare changes between the two groups to see whether people receiving Let’s Talk show greater improvements than those receiving usual care.

Who Can Take Part? 

We are looking for people who: 

• Are 16 years or older 

• Have a diagnosis of schizophrenia or another primary psychotic disorder, or are receiving EIP care 

• Feel that stigma has affected how they view themselves or how they talk about their mental health 

• Are currently open to a mental health team in one of the four study areas 

Participants also complete short screening questionnaires to check levels of internalised stigma and disclosure-related distress, as these are important for the research. 

Who cannot take part? 

People cannot join if they: 

• Have psychosis caused mainly by substances or a medical condition 

• Have a moderate–severe learning disability 

• Are at high immediate risk to themselves or others 

• Are already receiving another structured one-to-one psychological therapy 

Where Is the Study Taking Place?

Let’s Talk 2 is being delivered across four NHS Trusts in England: 

• Greater Manchester Mental Health NHS Foundation Trust (host site, via the Psychosis Research Unit) 

• Avon and Wiltshire Mental Health Partnership NHS Trust 

• North East London NHS Foundation Trust 

• South London and Maudsley NHS Foundation Trust 

Each location has its own team of Peer Support Workers and research staff who will recruit participants, deliver the intervention, and complete follow-up assessments. In total, the study aims to recruit around 352 participants (about 88 people per site). 

Safety, Ethics and Registration

The study has full NHS Research Ethics Committee and Health Research Authority (HRA) approval.
Everyone taking part gives written informed consent before any research procedures. 

The trial is registered on the ISRCTN registry and monitored by an independent Trial Steering Committee and Data Monitoring Committee to safeguard participant wellbeing. 

Funding and Governance

Let’s Talk 2 is funded by the NIHR Efficacy and Mechanisms Evaluation (EME) programme. 

Project Reference: NIHR163493
The views expressed are those of the authors, not necessarily those of the NIHR or EME. 

Do You Want to Take Part?

Click HERE for the Let’s Talk 2 leaflet 

Click HERE for the GMMH Let’s Talk 2 participant information sheet to find contact emails or to further discuss the study 

Click HERE for the SLAM Let’s Talk 2 participant information sheet to find contact emails or to further discuss the study 

The North-east London and Avon and Wiltshire sites will be up and running soon, which will mean a participant information sheet will then be provided.  

Click HERE for the NE London Let’s Talk 2 participant information sheet 

Click HERE for the Avon and Wiltshire Let’s Talk 2 participant information sheet