Oldman Erin, Banfield Michelle, Lamb Heather, Stewart Erin, Oni Helen Tosin, Miller Benn, Giugni Mel, Morse Alyssa R, Fitzpatrick Scott J
Roses in the Ocean, Brisbane, Australia.
Centre for Mental Health Research, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.
Health Expect. 2025 Aug;28(4):e70379. doi: 10.1111/hex.70379.
The past decade has seen an increase in non-clinical 'safe spaces' for those experiencing suicidal crisis or distress. Integrating service user perspectives through co-design is increasingly recognised as essential for the design of these services to meet user needs. Operationalising genuine co-design practices involving diverse stakeholders in local contexts remains underdeveloped, and research remains limited.
Drawing on co-design participants' experiences, this study evaluates how co-design processes influenced the design and implementation of safe space models in Australia.
A mixed-methods design was used to analyse survey, interview and documentary data for six safe space co-design projects. Thematic synthesis and triangulation were applied to develop overarching themes.
Key partners, steering committee members and lived experience representatives involved in the co-design and implementation of the six sites participated in surveys and interviews.
Power imbalances between health services staff and lived experience representatives were key barriers to genuine engagement, alongside tokenistic co-design, or 'faux-design'. Despite these challenges, all participants reflected positively on their involvement.
Effective co-design requires trust, transparency, power sharing, sufficient resourcing and sustained lived experience engagement throughout the project life cycle. Health service providers must assess their capacity for authentic engagement before attempting co-design. Future co-design initiatives should focus on ensuring that lived experience input is not lost during implementation. Future research should explore how to support and sustain this engagement throughout all project phases.
People with lived experience of emotional distress and/or suicidal crisis, including academic researchers, health, community service and peer workers, carers, and advocates were involved in this study. All authors identify as people with lived experience, from both academic and non-research backgrounds.
在过去十年中，为经历自杀危机或困扰的人设立的非临床“安全空间”有所增加。通过共同设计融入服务使用者的观点，越来越被认为对于设计这些满足使用者需求的服务至关重要。在当地环境中让不同利益相关者参与真正的共同设计实践的实施仍不发达，相关研究也很有限。
本研究借鉴共同设计参与者的经验，评估共同设计过程如何影响澳大利亚安全空间模式的设计和实施。
采用混合方法设计，分析六个安全空间共同设计项目的调查、访谈和文献数据。应用主题综合和三角验证法来确定总体主题。
参与六个场所共同设计和实施的关键合作伙伴、指导委员会成员以及有实际经验的代表参与了调查和访谈。
卫生服务人员与有实际经验的代表之间的权力不平衡是真正参与的关键障碍，同时存在象征性的共同设计或“假设计”。尽管存在这些挑战，但所有参与者都对自己的参与给予了积极评价。
有效的共同设计需要信任、透明度、权力共享、充足的资源以及在项目生命周期中持续有实际经验的参与。卫生服务提供者在尝试共同设计之前必须评估其真正参与的能力。未来的共同设计倡议应侧重于确保在实施过程中不会丢失有实际经验者的意见。未来的研究应探索如何在所有项目阶段支持并维持这种参与。
有情绪困扰和/或自杀危机实际经验的人，包括学术研究人员、卫生、社区服务和同伴工作者、护理人员及倡导者参与了本研究。所有作者均表明自己有实际经验，来自学术和非研究背景。
