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The lack of adoption of eMental Health technologies by people with severe mental illness (SMI) might be explained by a mismatch between technology design and users’ skills, context and preferences. Co-design can optimize this fit, but populations labelled as ‘vulnerable’ are often excluded or misrepresented. The goal of this study is to gain insight into best-practices for co-design with people with SMI. A qualitative, multi-method approach was used, consisting of a systematic scoping review of 21 included studies, 25 co-design expert surveys and six participant interviews. The results delivered 23 best-practices divided into four overarching aspects of co-design, namely: (1) activities to carry out before the start of a co-design study; (2) fruitful collaboration of the co-design team; (3) bespoke approach within co-design to accommodate the skills and abilities of SMI participants; and (4) mitigation of challenges surrounding power balance. The best-practices may help researchers and designers offer the SMI population a more specialized approach for co-design, which can cause the innovative output of eMH projects to be more effective and better adopted. Throughout the co-design process, more attention should be paid to the personal and clinical benefits of participation for the participants themselves.

design for health

Best-practices for co-design processes involving people with severe mental illness for eMental health interventions: a qualitative multi-method approach