Safe spaces as an alternative ​to the emergency department for suicidal distress: ​exploring guests' experiences​

Australians experiencing suicidal crises are routinely directed to emergency departments (ED), despite EDs being perceived as inappropriate and under-resourced to adequately address mental health and suicidal crises. To address this significant gap in care, non-clinical "safe spaces" have emerged as an alternative, but research on their effectiveness in Australia remains limited. This study evaluates guest satisfaction, perceived helpfulness of services, and factors associated with distress reduction in safe spaces.

This study analysed routine care data from Stride, an Australian safe space provider, for N = 906 first-time guests at three locations (Blacktown, Wollongong, and Belconnen). Guest characteristics, service factors, and perceived helpfulness were assessed. Regression models examined predictors of distress reduction and visit helpfulness.

Guests reported significant distress reduction on exit (p <.001, 95% CI: 27.94-30.57). Greater reductions were associated with longer stays (p <.001), "coffee and chats" with a peer worker (p <.001), use of sensory modulation tools (p =.007), and outgoing referrals (p =.003), while bringing a support person (p <.001) was associated with smaller distress decreases. Follow-up data (n = 486, 53.6%), showed most guests found their visit helpful (97.9%, n = 476) and preferred safe spaces over EDs for future distress (81.3%, n = 395).

Findings suggest safe spaces effectively reduce distress and are a preferred alternative to EDs. This highlights their potential as a community-based, non-clinical option for individuals in suicidal crisis.