ABSTRACT 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.
Marraccini et al. (Sun,) studied this question.