Design and evaluation of a youth co-designed trauma-informed public health resource for use in public sector settings in England

Background: Trauma-informed approaches (TIAs) are increasingly implemented across public-sector settings to improve support for young people affected by adverse childhood experiences (ACEs). However, practitioners often report difficulties translating broad trauma-informed principles into everyday practice, and young people are rarely involved in developing resources intended to support implementation. Aim: To co-design, implement and undertake a preliminary evaluation of a youth-led trauma-informed resource for professionals working with young people in public-sector settings in England. Methods: The study formed part of the UKRI-funded Attune programme and employed Accelerated Experience-Based Co-Design (AEBCD). Eighteen adolescents with lived experience of ACEs and 16 professionals from nine public-sector settings participated in three regional co-design workshops. Findings from a prior arts-based lived experience study informed the workshops. Participants collaboratively developed Validating Voices, a low-cost resource designed to increase validating interactions between professionals and young people. The resource was subsequently introduced into nine organisations and evaluated using staff surveys and semi-structured interviews. Results: Co-design participants identified professional invalidation of young peoples experiences, identities, needs and emotions as an under-recognised contributor to mental health. The resulting resource combined discussion cards, creative activities, role-play and organisational reflection exercises to promote validating practices. Five organisations implemented the resource and reported it to be feasible. Flexible local adaptation was common, while more participatory role-play elements proved harder to implement consistently. Staff observed increased opportunities for disclosure, reflection, peer connection and professional curiosity about young peoples experiences. Staff reported listening differently to young people and, in some settings, implementing changes in response to young people's recommendations. Conclusions: Youth-led co-design identified validation as a practical and meaningful mechanism for operationalising trauma-informed principles in everyday professional practice. With refinements, Validating Voices shows promise as a resource to support more relational, collaborative and trauma-informed responses to young people in public sector settings.