Kidney-specific psychosocial assessment and support

INTERVENTION: Participants will receive 6 months of the intervention and 6 months of standard care, and will be individually randomised into immediate and delayed intervention groups. The multi‐component intervention is named Kidney PASSPORT and is coordinated by an Assistant Psychological Practitioner (APP). Adapted from an approved Institute of Apprenticeship role, the APP will be fully embedded into the kidney collaborative care team, to support evidence‐based psychological practice specific to kidney patients. Whilst the APP role is centred on the prevention of subthreshold common mental health difficulties, where indicated by patient need, they will be able to support referral for treatment. A Band 3 healthcare assistant already in renal services (hence having practical knowledge of kidney replacement therapies and the challenges facing patients) will be appointed and through generic and specific competency‐based training, will carry out the APP role with weekly supervision of their caseload. In light of the COVID‐19 pandemic, they can operate virtually by telephone, email or videoconference where required. APP competencies include: 1. The identification and monitoring of common mental health difficulties and wider psychosocial needs, by administering and interpreting psychometrically sound short form screening 2. Supporting self‐management and kidney education as part of the collaborative care team 3. Signposting to community/charitable services of support 4. Collaboration with appropriate health and social care organisations and professionals 5. The organisation and facilitation of patient user groups 6. Education of colleagues/staff to enhance the CONDITION: Common mental health difficulties for people with kidney disease ; Mental and Behavioural Disorders PRIMARY OUTCOME: ; 1. Recruitment rate: % of those eligible and approached who have consented to study participation at 3 months; 2. Retention rate: % that remain in the study until the end of follow up at 12 months; INCLUSION CRITERIA: 1. Aged 18 years and above 2. Under the active care of a Nephrologist 3. Patient Health Questionnaire (PHQ)‐2 score OR Generalized Anxiety Disorder (GAD‐2) score =3 4. Capable of giving informed consent, completing self‐report measures, and using written self‐help materials in English SECONDARY OUTCOME: ; 1. Consent to screen rate: % of those approached who consent to the screening survey at 3 months; 2. Screening positivity rate: % of those screened who score 3 or more on the PHQ‐2/GAD‐2 at 3 months; 3. Randomisation acceptability assessed through qualitative interviews. Interviews will take place at 6 months for the immediate group and 12 months for the delayed group.; 4. Adherence to intervention and fidelity of intervention delivery, assessed using Assistant Psychological Practitioner self‐report against a quantitative checklist and qualitative interviews with participants. Checklists and Interviews will be undertaken at 6 months for the immediate group and 12 months for the delayed group.; 5. Completion of outcome measures: proportion of missing data at 0, 3, 6 and 12 months (immediate group) and 0, 6, 9 and 12 months (delayed intervention group);