Background
Close family and friends play a vital role in the care of adults with bipolar disorder, often without being informed about the illness and ways to deal with it. High carer burden and relationship breakdown contribute to morbidity. Difficulties in implementing specialised long-term family/carer interventions in public settings necessitate the development of a range of psychoeducational approaches. We aimed to develop accessible carer guidelines, with information on bipolar disorder and its treatment, and suggestions about ways carers can deal with the illness, provide support and maintain their own wellbeing.

Method
The Delphi method was used to obtain consensus between expert carers, consumers and clinicians from different countries about what to include in the guidelines (n=141). The initial online survey was based on the existing literature. New suggestions from participants were included for rating in subsequent survey rounds. The guidelines will be made publicly available and their usefulness evaluated in follow-up questionnaires.

Results
Carer and consumer panel members were mostly female, above 40 and had extensive experience in dealing with bipolar disorder. Clinicians were predominately psychiatrists. High rates of consensus were evident amongst the three expert panels. Panel members highlighted common and situation specific caregiving challenges, and suggestions for managing them.

Conclusion
There is no "one-size-fits all" solution to the difficulties experienced by carers of adults with bipolar disorder, but accessible guidelines that address some of the challenges could be helpful. A brief online intervention will be developed to assist carers to apply the guidelines to their specific circumstances.