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

## TL;DR

This study outlines safety protocols for involving teens with suicide risk in co-designing mental health interventions, focusing on marginalized youth.

## Contribution

The paper introduces and evaluates safety procedures for co-design with teens who have experienced suicide-related crises.

## Key findings

- No safety issues occurred during co-design sessions with participating teens.
- Teens reported stable distress levels before and after meetings.
- Participants endorsed most safety protocol components but suggested individualized adaptations.

## Abstract

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.

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.

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.

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.

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.