Partnering With Teens With Past Suicide‐Related Crises: Development, Application and Refinement of Safety Procedures for Co‐Design

BACKGROUND: Growing interest in participatory co-design approaches for digital mental health interventions necessitates attention to the development of safety protocols for safely partnering with individuals with suicide-related risk. Historically, adolescents with suicidal thoughts and behaviours (STB) have been excluded from such approaches, discounting the importance of youth voice. METHODS: This case study provides an overview of the development and use of safety protocols for participatory co-design with adolescents with histories of suicide-related crises who identify as ethnic-racial minoritised or lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ+). We also explored teen co-designer perspectives on the safety protocols employed, using applied thematic analysis to identify themes informing co-design safety for adolescents with suicide-related risk. RESULTS: No safety issues emerged during co-design sessions, with the majority of adolescent distress levels remaining the same before and after meetings. Adolescent co-designers endorsed many components of the safety protocol, with recommendations for improvements mainly addressing the need to adapt the protocol based on the unique needs of each teen. CONCLUSION: Future work can draw from lessons learned in this case study to enact participatory co-design approaches that acknowledge and leverage the strengths and resilience of young people with STB. PATIENT AND PUBLIC CONTRIBUTION: Adolescents with histories of suicide-related crises who identify as ethnic-racial minoritised or lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ+) were involved as partners in this study, which followed principles of participatory co-design to improve a virtual reality intervention to enhance suicide prevention for hospitalised youth.