ABSTRACT
Background
Interest in co-design for suicide prevention is growing, yet few studies have evaluated feasibility, acceptability and impact, particularly for culturally and linguistically diverse populations. This study assessed a co-design process used to develop a digital suicide prevention intervention with international students in Australia.
Design
We conducted a mixed-methods pre–post evaluation across 10 student and three stakeholder workshops. Participants were 27 international students (57.7% with lived experience of suicidal thoughts and behaviours) from 18 countries and 21 sector stakeholders (education, well-being and student services). Surveys assessed feasibility, acceptability, safety, satisfaction, perceived benefits and confidence in co-design skills. Quantitative data were analysed using descriptive statistics and paired t-tests; open-ended responses were thematically summarised.
Results
Workshops were feasible, with high ratings for accessibility, support and safety. International students reported high acceptability and satisfaction, with significant increases in co-design confidence (e.g., collaborating, adapting, participating and influencing outcomes) and perceived benefits (greater mental-health literacy, empowerment, social connection and belonging). Stakeholders reported moderate to high acceptability and valued cross-sector learning and system insights; confidence ratings showed no measurable change. Safety ratings were high for both groups.
Conclusions
Co-design was feasible, acceptable and safe, and associated with benefits for participants. Findings support co-design as a practical, capacity-building approach for developing culturally responsive digital suicide-prevention initiatives for culturally and linguistically diverse populations.
Patient or Public Contribution
An expert advisory group of international students with lived experience of suicide provided ongoing guidance. International students and sector stakeholders co-designed the intervention and contributed to planning, design, implementation and review.