Background Young people commonly use social media platforms to communicate about suicide. Although research indicates that this communication may be helpful, the potential for harm still exists. To facilitate safe communication about suicide on social media, we developed the #chatsafe guidelines, which we sought to implement via a national social media campaign in Australia. Population-wide suicide prevention campaigns have been shown to improve knowledge, awareness, and attitudes toward suicide. However, suicide prevention campaigns will be ineffective if they do not reach and resonate with their target audience. Co-designing suicide prevention campaigns with young people can increase the engagement and usefulness of these youth interventions. Objective This study aimed to document key elements of the co-design process; to evaluate young people’s experiences of the co-design process; and to capture young people’s recommendations for the #chatsafe suicide prevention social media campaign. Methods In total, 11 co-design workshops were conducted, with a total of 134 young people aged between 17 and 25 years. The workshops employed commonly used co-design strategies; however, modifications were made to create a safe and comfortable environment, given the population and complexity and sensitivity of the subject matter. Young people’s experiences of the workshops were evaluated through a short survey at the end of each workshop. Recommendations for the campaign strategy were captured through a thematic analysis of the postworkshop discussions with facilitators. Results The majority of young people reported that the workshops were both safe (116/131, 88.5%) and enjoyable (126/131, 96.2%). They reported feeling better equipped to communicate safely about suicide on the web and feeling better able to identify and support others who may be at risk of suicide. Key recommendations for the campaign strategy were that young people wanted to see bite-sized sections of the guidelines come to life via shareable content such as short videos, animations, photographs, and images. They wanted to feel visible in campaign materials and wanted all materials to be fully inclusive and linked to resources and support services. Conclusions This is the first study internationally to co-design a suicide prevention social media campaign in partnership with young people. The study demonstrates that it is feasible to safely engage young people in co-designing a suicide prevention intervention and that this process produces recommendations, which can usefully inform suicide prevention campaigns aimed at youth. The fact that young people felt better able to safely communicate about suicide on the web as a result of participation in the study augurs well for youth engagement with the national campaign, which was rolled out across Australia. If effective, the campaign has the potential to better prepare many young people to communicate safely about suicide on the web.

Health communication during a health crisis, such as the COVID-19 pandemic, is vital to reduce the impact on populations. To ensure the communication is effective, audience segmentation is required with specific resources that have been developed for each segment. In addition, the messages need to be clear, mutual trust between the communicator and the audience needs to be developed and maintained, and resources should focus on cultural values. [1][2][3] The evidence around effective crisis communication indicates that it needs to be timely, clear, concise and appropriate to the target audience. [1][2][3][4][5][6] Communication is particularly important for those at higher risk during the crisis, 3,[5][6][7][8][9][10][11] such as people who are immunocompromised, the elderly, and Aboriginal and Torres Strait Islander people. 7 2020 vol. 44 no. 4

Elder, Kungarakan tribal group and a member of the Iwaidja tribal group 26 Consultant to the Commonwealth Department of Health, Indigenous tobacco control advocate, Canberra, Australian Capital Territory, Australia Contributors All authors have contributed substantially to conception, drafting and finalisation of this fundamentally important open letter. Competing interests None declared. patient consent for publicatiopn Not required. provenance and peer review Not commissioned; externally peer reviewed.