A systematic review of the facilitators and barriers for the implementation of co-designed youth suicide and self-harm interventions

Background: Co-designed interventions targeting youth suicide and self-harm are starting to emerge, however, few studies discuss the barriers and facilitators for implementing such interventions. Objective: The aim of this systematic review was to synthesise the literature regarding barriers and facilitators for the implementation of co-designed interventions for suicidal and self-harming young people. Method: A systematic literature review was conducted in October 2024. From the 980 initial papers, a final sample of eight papers met eligibility criteria and were included in the review. Thematic analysis was used to identify barriers and facilitators to implementation in the included studies. Results: A total of three barriers were identified (implementation of the intervention was burdensome for some professionals; inconsistent teams, communication and support negatively impacted implementation; and mismatch between co-design expectations and implementation reality) and three facilitators were identified (consistent, clear communication and effective team structures; incorporation of co-design processes promoted implementation success; and flexible delivery approaches). Conclusion: Co-design is increasingly being used to develop tailored interventions to address suicide and selfharm in young people, but evaluation of the implementation of these interventions remains limited. This study has identified a range of factors such as clear communication, training, support, adaptability, and flexibility which may act as facilitators or, when absent, barriers for the implementation of co-designed interventions. Awareness of these factors may improve intervention implementation in the future.