FOCUS Bipolar: Families Opening Conversations for Understanding Signs

Inclusion Criteria for Group A - Parent with Bipolar Disorder:

1. Age: 18 years or older.
2. Confirmation of a lifetime Bipolar I or II diagnosis
3. Parent status: Has at least one biological child aged 7-21 years.
4. Capacity and willingness to consent: Able and willing to provide informed consent.
5. Study participation: Able to comply with study procedures (e.g., co-design sessions, interviews, assessments).
6. Language: Able to read, speak, and understand English.

Inclusion Criteria for Group B - Adult Caregiver:

1. Age: 18 years or older.
2. Caregiver status: The adult primarily responsible for the daily care and/or medical decisions for ≥ 6 months for a child aged 7-21 years whose biological parent has a lifetime, clinician-confirmed diagnosis of Bipolar I or II disorder.
3. Capacity and willingness to consent: Able and willing to provide informed consent.
4. Study participation: Able to comply with study procedures (e.g., co-design sessions, interviews, assessments).
5. Language: Able to read, speak, and understand English.

Inclusion Criteria for Group C - At-Risk Youth:

1. Age:

   1. Phase 1 (co-design) and Phase 2A (alpha testing): 13-18 years
   2. Phase 2B (beta testing): 13-18 years
   3. Phase 3 (screening): 7-21 years
2. Diagnosis status: Must not have a current diagnosis of Bipolar I or II disorder.
3. Parental diagnosis: Has at least 1 biological parent with a lifetime, clinician-confirmed Bipolar I or II diagnosis (as defined in Groups A and B).
4. Consent/Assent:

   1. For youth aged 18-21: Able and willing to provide informed consent (verbal)
   2. For youth aged 7-21: Parent/guardian/LAR able and willing to provide informed consent (verbal) and youth able to provide assent (verbal)
5. Participant ability: Able and willing to participate in study activities (e.g., co-design discussions, questionnaires, or screening assessments.
6. Language: English sufficient to comprehend study procedures and materials.

Criteria for Exclusion of Participants

A potential participant will NOT be eligible for participation in this study if any of the following criteria are met:

1. Unable to provide informed consent due to cognitive impairment or language barriers
2. Experiencing acute psychiatric instability at enrollment (e.g., acute psychosis or acute suicidality without stabilization)
3. Has a medical or psychiatric condition that, in the judgment of the Principal Investigator or study clinician, would place undue risk on the individual or interfere with standard clinical care