We Did the Work

The co-design non-negotiables behind Hear/SAY: BHT Impact Creators' Collective.

From the start of BHT Impact, we knew that youth and family voices wouldn't just inform our work, they would shape it. Caring for youth and adolescent populations is fundamentally different from caring for adults. Yet, behavioral health organizations still design, deliver, and evaluate services without truly including the people they aim to serve. The result is youth who feel disconnected, families who struggle to navigate systems, and innovations that fail to meet real needs. We designed Hear/SAY because we believe the perspectives of youth and caregivers have the power to change that.

It hasn't been an easy task. For the past six months, we have been building and learning what it truly takes to create a writers program where youth and caregivers can contribute directly to our articles, briefs, and educational resources.

Hear/SAY is purposely open to youth and young adults ages 13–26 and to caregivers of young people. This has been one of the most meaningful and rewarding processes to have at BHT Impact, and we’re sharing how we put our co-design values into practice. 

In legal terms, hearsay is an out-of-court testimony offered to prove the truth of whatever it asserts. It is typically dismissed, not because it lacks truth, but because the person who said it isn't in the room directly to be heard. We borrowed that idea intentionally. The voices of youth and families are set aside in behavioral health, not because their experiences lack truth, but because they are rarely given a seat at the table to speak for themselves. Hear/SAY exists to ensure they are in the room.

Non-Negotiable #1: Lived Experience and Expertise are Expertise. 

What it means:

We believe that the expertise that comes from navigating systems is hard-earned, specialized, and irreplaceable. We value that at the same level as any credential.

How we designed for it: 

We designed a path of Hear/SAY to be a cohort-based structure, allowing participants to develop a flagship content collection and evaluate our yearly strategies, ensuring that lived expertise is leading and guiding our work.

Non-Negotiable #2: Radical Accessibility

What it means:

Accessibility to us means multiple ways in, multiple ways to contribute, and content that can reach a range of people and experiences.

How we designed for it:

We built diverse pathways for engagement in Hear/SAY so that contributors can engage at different levels based on their capacity, comfort, and availability. We open participation at age 13 and, in return, our content is accessible to 13-year-olds, removing barriers to knowledge, care, and entry.

Non-Negotiable #3: Authentic Narratives Need Safety and Ownership

What it means:

Creating spaces for people to share their lived expertise should not be taken lightly. Vulnerability to us means an automatic obligation to keep contributors safe and to respect their authority over their narrative.

How we designed for it:

Consent and safety are baked into every aspect of Hear/SAY. Contributors will always own their stories, have the opportunity to change their minds at any point, and choose how they are credited and visible. We built in content checkpoints from application to publication, along with trauma-informed policies, to ensure a supportive environment that prioritizes contributor well-being, with clear procedures for sensitive disclosures, parental consent, and off-boarding so contributors are protected at every stage.

Non-Negotiable #4: We Invest in Each Other.

What it means: 

We believe in mutual growth. As BHT Impact grows from the insights of youth and family, our contributors should also reach new heights in their personal and professional journeys. Youth and caregiver engagement is a two-way relationship. 

How we designed for it: 

We started with fair compensation and grew from there to ensure

Hear/SAY can be a capacity-building engine. We structured professional development and mentorship opportunities from the full BHT team, along with our national thought-leadership platform. We hope that the contributors' participation enhances their personal and professional portfolios by creating a vehicle for it. Additionally, when a piece is published, contributors can collaborate with our storytelling and marketing expert on messaging ideas to share and amplify their work. We want to see youth and families win, and that requires showing up as cheerleaders and investing meaningfully in the people we work with. 

Non-Negotiable #5: Innovation = Interconnectivity

What it means: 

We see the big picture! And we wanted every aspect of Hear/SAY down to the everyday logistics to connect back to it. A young person's experience, a caregiver's perspective, and systemic challenges are all a part of the same story. Bringing those angles together is how the most important insights in behavioral health aren't isolated.

How we designed it:

Hear/SAY was designed not just as a content pipeline but as an ecosystem. Each contributor's piece will be organized around shared themes and lived-experience perspectives, and will connect to systemic analysis. The connection is visible from day one through content mapping, so contributors understand not just what they're creating but also why it matters and how it lives. 

Non-Negotiable #6: Continuous Quality Improvement

What it means:

To us, co-design means remaining present, staying curious, and remaining committed when feedback challenges everything you’ve built. We see launching our engagement and co-design process as just the first step toward evolving to serve youth and families better as they navigate behavioral health systems.

How we designed for it:

We incorporate regular feedback loops in different mediums with contributors to evaluate what’s working, what isn’t, and what we should do differently in our processes. Between cohorts, after publications, and before and after milestones, we built in deliberate communication evaluations to assess what we were building and to adjust before moving forward. Every person's experience informs how we grow and strengthen our organization and pathways. 

** We're going deeper. We’ll be pulling back the curtain to share a closer look at the areas of Hear/SAY that taught us the most. In the resources ahead, we’ll get into details on how we operationalized privacy, safety, legal, and continuous quality improvement (CQI), the steps we took to build each one, the challenges we ran into, and how we worked through them. 

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Hear/SAY applications open April 27th, 2026. Follow us on LinkedIn to stay connected and receive updates on this and all of our other work.

BHT Impact is a fiscally sponsored project of Moore Impact, a 501(c)3 public charity.