Evaluating the role and effectiveness of co‐produced community‐based mental health interventions that aim to reduce suicide among adults: A systematic review

BackgroundCodesigned interventions are becoming more common in health services and, in particular, in the design and development of mental health programmes and interventions. However, previous research has established that the transition from codesign to implementation can experience several challenges and that this transition process has received little research attention.ObjectiveThe aim of this study was to explore the experience of staff members charged with the implementation of a codesigned intervention for young people and adolescents at risk of suicide.Setting and ParticipantsFive staff members involved in the implementation of the new codesigned programme took part in semi‐structured interviews.MethodThe study involved qualitative evaluation of staff experiences during the implementation of a new child and youth suicide intervention. Interviews were analysed using reflexive thematic analysis.ResultsThe analysis identified four themes of ‘disconnect’, ‘operational challenges, ‘service user’ and ‘being authentic’. ‘Disconnect’ captures the difficulties of implementing a codesigned programme which leads to ‘operational challenges’ in meeting broader expectations while ensuring the feasibility of the programme. The third theme, ‘service user’, captures the realisation that the young people accessing the new service were different to those involved in the codesign process. The final theme, ‘being authentic’, highlights how staff needed to be responsive and flexible while remaining true to the principles proposed in the codesign.DiscussionThis study yielded some valuable insights into the challenges around the implementation of a codesigned intervention, an under‐researched area. The findings suggest that adaption of the design may be necessary, if it is not informed by implementation constraints, making it necessary for the implementation team to be well‐briefed on the initial design and given plenty of time to make the necessary adjustments in a coproduction process. Limitations for the generalisation of the results include a small sample of staff and particular challenges that may be unique to this study.ConclusionThe present study highlights that for health services undertaking codesign approaches, appropriate time and resources need to be considered for the implementation phase of an initiative, to ensure that there is effective translation from design to implementation and that new codesigned services can be effective within operational constraints.Patient and Public ContributionThe authors would like to thank and acknowledge the young people with a lived‐experience and their carers who participated in the codesign process and research evaluation component of this study. We also wish to thank the clinical staff, peer workers and family peer workers who participated in the evaluation.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Theme Datamentioning

confidence: 99%

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Are codesigned programmes more difficult to implement? A qualitative study of staff perceptions on the implementation of a new youth mental health programme

Kehoe,

Whitehead,

de Boer

et al. 2024

“…13 The facilitation of co-design processes and the need to be wholly open to new ideas, perspectives and methods can be challenging for those already established in their models of operation and understanding of how things should operate. 17 This can be a particular challenge when different parties use different communication strategies and key terms, resulting in barriers to effective collaboration and understanding. 8,10,12 When the co-design process works well, however, there are major benefits which include the creation of a more responsive service, increased involvement of consumers and carers, and a more democratic and inclusive approach.…”

Section: Co-design Challenges and Benefitsmentioning

confidence: 99%

“…To address the underutilisation of consumer expertise, there has been a global push to include consumer input in the design, implementation and evaluation of suicide interventions, 4 while taking into account the particular vulnerabilities of this cohort, with the aim of making suicide‐prevention services less stigmatising, more accessible, and more tailored to the specific needs of those requiring support, 17 thereby encouraging help‐seeking and improving programme effectiveness. From the limited research into the use of co‐design for the development of suicide prevention programmes, it has been found that outcomes tend to be positive, especially in cases where the roles of external stakeholders are more collaborative rather than merely consultative or advisory 4 .…”

Section: Introductionmentioning

confidence: 99%

A qualitative evaluation of a co‐design process involving young people at risk of suicide

Kehoe,

Whitehead,

de Boer

et al. 2024

BackgroundCo‐design is becoming common practice in the development of mental health services, however, little is known about the experience of such practices, particularly when young people are involved.ObjectiveThe aim of this study was to conduct a process evaluation of the co‐design which was undertaken for the development of an intervention for youth and adolescents at risk of suicide. This paper briefly outlines the co‐design process undertaken during a COVID‐19 lockdown and then focuses on a qualitative evaluation of the experience of taking part in a co‐design process.Setting and ParticipantsThe evaluation involved young consumers of a public youth mental health service, their carers/parents and service delivery staff who had taken part in the co‐design process.MethodThis study used follow‐up semistructured interviews with the co‐design participants to explore their experience of the co‐design process. Inductive thematic analysis was used to draw out common themes from the qualitative data.ResultsIt was found that despite the practical efforts of the project team to minimise known issues in co‐design, challenges centred around perceptions regarding power imbalance, the need for extensive consultation and time constraints still arose.DiscussionDespite these challenges, the study found that the co‐design provided a human‐centred, accessible and rewarding process for young people, parents and staff members, leaving them with the feeling that they had made a worthwhile contribution to the design of the new service, as well as contributing to changing practice in service design.ConclusionWith sensitivity and adaptation to usual practice, it is possible to include young people with suicidal ideation, their parents/carers and professional staff in a safe and effective co‐design process.Patient and Public ContributionThe authors would like to thank and acknowledge the young people with a lived experience and their carers who participated in the co‐design process and research evaluation component of this study. We also wish to thank the clinical staff, peer workers and family peer workers who participated in this research.

Evaluating the role and effectiveness of co‐produced community‐based mental health interventions that aim to reduce suicide among adults: A systematic review

Hanlon

McIlroy

Poole

et al. 2022

Self Cite

Background: Suicide is a major public health risk requiring targeted suicide prevention interventions. The principles of co-production are compatible with tailoring suicide prevention interventions to meet an individual's needs. Aims: This review aimed to evaluate the role and effectiveness of co-produced community-based suicide prevention interventions among adults. Methods: Four electronic databases (PsycInfo, CINAHL, MEDLINE and web of science) were systematically searched. A narrative synthesis was conducted. Results: From 590 papers identified through searches, 14 fulfilled the inclusion criteria. Most included studies elicited the views and perspectives of stakeholders in a process of co-design/co-creation of community-based suicide prevention interventions. Conclusion: Stakeholder involvement in the creation of community-based suicide prevention interventions may improve engagement and give voice to those experiencing suicidal crisis. However, there is limited evaluation extending beyond the design of these interventions. Further research is needed to evaluate the longterm outcomes of co-produced community-based suicide prevention interventions.Patient and Public Involvement: This paper is a systematic review and did not directly involve patients and/or the public. However, the findings incorporate the views and perspectives of stakeholders as reported within the studies included in this review, and the findings may inform the future involvement of stakeholders in the design, development and delivery of community-based suicide prevention interventions for adults.