“No co-design process can ever truly cater to every single person”: Perspectives of young people in Australia on co-design for the prevention of mental health challenges

Young people's mental health has become a critical global issue. Co-design with young people to deliver and adapt mental health services and programmes has become increasingly widespread. However, there remains relatively little guidance on undertaking co-design for universal prevention strategies to address mental ill-health among young people. This study aimed to explore the concept of co-design in universal mental health prevention (UMHP) efforts with young people and generate recommendations to support co-design practice in mental health prevention research. Eight participatory co-design workshops were completed online with 21 young people (aged 16–24 years old) in Australia. Reflexive thematic analysis was used to generate key themes from the young people's perspectives and contributions. Four main themes were generated to synthesise how co-design could be undertaken with young people in UMHP efforts: (1) Participation; (2) Inclusion; (3) Synergy; and (4) Process. Subthemes included examining power dynamics critically, exploring relationships between different stakeholders as well as the mechanics of co-design practices. Young people emphasised the need for diversity of both youth and non-youth individuals, accessible methods of recruitment and participation, and upholding young people's lived experience knowledge, as essential factors in UMHP co-design practice. This study offers new insights into young people's perspectives on how the principles of co-design may be adapted to UMHP research.