Establish alternatives to hospital EDs for people experiencing severe and complex mental illness who are distressed
Action 11.5.1, 11.5.2 & 11.5.3:
Promote the use of a safety planning tool for people who experience high levels of distress
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Establish a network of safe spaces, initially in the Moreton Bay region
Secure further funding to design and establish Safe Space Initiatives in our region
The ‘Collaboration in Mind Safe Spaces Working Group’ was established in 2017 to work towards developing a network of safe space alternatives to hospital emergency departments, for people in psychological distress. The working group have developed a three-tier Safe Space model, inclusion and exclusion criteria for each tier, and identification of appropriate service types to deliver a Safe Space at each tier, across the region. Development of an evaluation framework was also agreed and created.
Members of the working group collaborated to successfully secure a LINK Innovations Grant from Metro North Hospital Health Service, to undertake a trial of two three-tier Safe Space sites in the region – one in Redcliffe, and one in Caboolture. Aftercare, Richmond Fellowship Queensland, Wesley Mission Queensland and Encircle partnered to develop and implement the trial sites during 2018/2019, with each site implementing a safety planning tool.
Key achievements of the trial include the significant impact the Safe Spaces had on decreasing distress levels for visitors, with 96% of visitors reporting that they found their visits to the Safe Space useful and over 72% reporting that they used tools and strategies to learn to self-manage distress levels. Also of note, was the collaborative nature of the project that enabled a community-based rather than a single service response, incorporating connection with Queensland Police and Ambulance services, enhanced communication between Metro North HHS and the community agencies involved in a person’s care, and expanded referral pathways.
Building on the learnings from this activity, the PHN, together with the Safe Spaces working group, submitted a funding proposal to the Commonwealth Department of Health for ongoing funding of Safe Spaces in the region. This proposal was successful, with a $10.5 M investment in new Safe Spaces for the region, as alternatives to hospital EDs to support people in distress. This funding is expected from 2021 onwards.
Whilst the Safe Spaces trial project was highly successful in delivering on key outcomes, and providing substantial groundwork for future expansion of the model, there were some key learnings gained from the evaluation of the trial that are useful to note for future implementation of the Safe Space model. These include:
- Limitations of a short time frame and small cohort of available data to deliver evidence based outcomes in areas such as reducing hospital admissions
- Limited accessibility of the sites across the region (only two sites)
- Limited capacity to implement the 2nd and 3rd tiers, electing to support a greater spread of community response
- Challenges to extension of opening hours and remaining open past the trial period.
Ongoing funding for three-tier Safe Spaces is essential for future development of the model. The trial of two sites was welcomed, but needing to close them down at the end of the trial has resulted in the already existing gap in safe spaces for people in the community, again widening.
Securing potential future funding for Safe Spaces resulted in the working group adapting the model to align with a suicide prevention approach, attracting interest from the Commonwealth Department of Health, to secure funding.
Future funded models need to be clear about the target audience for the safe spaces and what they set out to achieve if they are to demonstrate effectiveness.
Connection between the Suicide Prevention Strategic Partnership Group and the Collaboration in Mind Safe Spaces Working Group to progress key actions is critical to ensure consistency.
The Collaboration in Mind Safe Spaces Working Group are currently advocating to attempt to have the announced investment in Safe Spaces available sooner.
The Working Group are also looking at how the new Integrated Mental Health Service Hubs may become suitable three-tier Safe Spaces in the meantime.