Background
Improving support for persons with long-term mental health challenges is a key concern in global mental health care. In recent years, peer support (PS) has been recognised as a person-centred and recovery-oriented approach for persons with mental health conditions. While most PS research originates from high-income countries, there’s a notable gap in the literature and structured programs within low- and middle-income countries, including India.

Aim
This study aimed to develop and validate a culturally adapted PS program for persons with mental health conditions tailored to the Indian context.

Methods
An exploratory qualitative design was used, following the three-phase approach: (I) a systematic literature review, (II) qualitative in-depth interviews with diverse mental health stakeholders (N = 31), and (III) development and expert validation. Interviews were conducted by KV in both face-to-face and online settings, using English, between June and December 2023. Each session lasted between 75 and 120 min and was audio-recorded with the participant’s consent. A purposive sampling strategy was employed, and data collection continued until data saturation was achieved.

Results
The finalised program, validated by experts using Lawshe’s CVR (≥ 0.71), is structured around seven key themes: Core Principles of Peer Support, Structure and Process of Peer Support Groups, Content and Focus of Peer Support Interactions, Roles and Responsibilities, Guidelines for Safe and Effective Peer Support, Challenges in Peer Support Groups, and Ethical Considerations.

Conclusions
This developed peer support program (PSG) has been systematically designed to help form and facilitate peer support groups for persons with mental health conditions, and it now requires feasibility and effectiveness testing through larger experimental trials.