Co-creating safe spaces: Study protocol for translational research on innovative alternatives to the emergency department for people experiencing emotional distress and/or suicidal crisis

Michelle Banfield; Scott J Fitzpatrick; Heather Lamb; Melanie Giugni; Alison L Calear; Erin Stewart; Maree Pavloudis; Lucy Ellen; Ginny Sargent; Helen Skeat; Bronwen Edwards; Benn Miller; Amelia Gulliver; Louise A Ellis; Vida Bliokas; Purity Goj; Melissa Lee; Kelly Stewart; Glenda Webb; Merkitta Main; Carrie Lumby; Kelly Wells; Carolyn McKay; Philip J Batterham; Alyssa R Morse; Fiona Shand; Stride Safe Space Team

doi:10.1371/journal.pone.0272483

Co-creating safe spaces: Study protocol for translational research on innovative alternatives to the emergency department for people experiencing emotional distress and/or suicidal crisis

PLoS One. 2022 Oct 3;17(10):e0272483. doi: 10.1371/journal.pone.0272483. eCollection 2022.

Authors

Michelle Banfield¹, Scott J Fitzpatrick¹, Heather Lamb¹, Melanie Giugni¹, Alison L Calear¹, Erin Stewart², Maree Pavloudis², Lucy Ellen³, Ginny Sargent⁴, Helen Skeat⁴, Bronwen Edwards⁵, Benn Miller⁶, Amelia Gulliver¹, Louise A Ellis⁷, Vida Bliokas⁸, Purity Goj⁹, Melissa Lee⁹, Kelly Stewart¹⁰, Glenda Webb⁶, Merkitta Main¹¹, Carrie Lumby¹², Kelly Wells¹³, Carolyn McKay¹⁴, Philip J Batterham¹, Alyssa R Morse¹, Fiona Shand¹⁴; Stride Safe Space Team

Affiliations

¹ Centre for Mental Health Research, The Australian National University, Australian Capital Territory, Australia.
² ACT Mental Health Consumer Network, Australian Capital Territory, Australia.
³ Centre for Social Research & Methods, The Australian National University, Australian Capital Territory, Australia.
⁴ Population Health Exchange, The Australian National University, Australian Capital Territory, Australia.
⁵ Roses in the Ocean, Brisbane, Australia.
⁶ Towards Zero Suicides Initiatives, South Western Sydney Local Health District, Sydney, Australia.
⁷ Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
⁸ School of Psychology, University of Wollongong, Wollongong, Australia.
⁹ ACT Health Directorate, Australian Capital Territory, Australia.
¹⁰ Sonder, Adelaide, Australia.
¹¹ South Western Sydney Local Health District, Sydney, Australia.
¹² Illawarra Shoalhaven Suicide Prevention Collaborative, Wollongong, Australia.
¹³ Adelaide Primary Health Network, Adelaide, Australia.
¹⁴ Black Dog Institute, University of New South Wales, Sydney, Australia.

Abstract

Introduction: Safe spaces are an alternative to emergency departments, which are often unable to provide optimum care for people experiencing emotional distress and/or suicidal crisis. At present, there are several different safe space models being trialled in Australia. However, research examining the effectiveness of safe space models, especially in community settings, is rare. In this paper, we present a protocol for a study in which we will investigate the implementation, effectiveness, and sustainability of safe space models as genuine alternatives for people who might usually present to the emergency department or choose not to access help due to past negative experiences.

Material and methods: We will use a mixed methods, co-designed study design, conducted according to the principles of community-based participatory research to obtain deep insights into the benefits of different safe space models, potential challenges, and facilitators of effective practice. We developed the study plan and evaluation framework using the RE-AIM framework, and this will be used to assess key outcomes related to reach, effectiveness, adoption, implementation, and maintenance. Data collection will comprise quantitative measures on access, use, satisfaction, (cost) effectiveness, distress, and suicidal ideation; and qualitative assessments of service implementation, experience, feasibility, acceptability, community awareness, and the fidelity of the models to service co-design. Data will be collected and analysed concurrently throughout the trial period of the initiatives.

Discussion: This study will enable an extensive investigation of safe spaces that will inform local delivery and provide a broader understanding of the key features of safe spaces as acceptable and effective alternatives to hospital-based care for people experiencing emotional distress and/or suicidal crisis. This study will also contribute to a growing body of research on the role and benefits of peer support and provide critical new knowledge on the successes and challenges of service co-design to inform future practice.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Emergency Service, Hospital
Humans
Psychological Distress*
Research Design
Suicidal Ideation*
Translational Research, Biomedical

Grants and funding

This project is funded by an Australian Government Department of Health National Suicide Prevention Research Fund Targeted Research Grant, managed by Suicide Prevention Australia. ARM is funded by an Australian Government Department of Health National Suicide Prevention Research Fund Post-Doctoral Fellowship, managed by Suicide Prevention Australia. PJB is supported by NHMRC Fellowship 1158707 and AC is supported by NHMRC Fellowship 1173146. The funders have no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.