Description: Background: Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic approaches translate into the mental health context, and by indicating what is specific about supporting self-care for mental health. Methods: A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for serious and enduring mental health conditions, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together. Results: Participants reported improvement in self-care outcomes (e.g. empowerment; less use of Accident and Emergency services). These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision making around medication are important issues in supporting self-care in mental health. Conclusions: Generic elements of support for self-care - e.g. peer support groups, personal planning - have value when translated into a mental health context. Support for self-care in mental health should focus on core, mental health specific qualities - issues of control, enabling staff-service user relationships and shared decision making - rather than simply the provision of standardised service components. The broad empirical basis of our research indicates the wider relevance of our findings across mental health settings.