Imagining a Safe Space: Australian Community Views About What Makes Crisis Mental Health Services 'Safe' and 'Unsafe'

Mental health services have an interest in maintaining psychosocial safety for consumers, carers, and staff alike. While much discussion around safety in service delivery pertains to the likelihood of patients engaging in damaging behaviours, we take the position that community attitudes towards safety offer more expansive, relational, and spatial definitions of safety. In a survey consisting of a mix of open and closed questions of 279 Australians aged 16-87 years, participants were asked to comment on their experiences of safety and unsafety in emergency mental health service use, as well as what they consider to be a safe or unsafe service. Applying a thematic analysis to the data, findings showed that emergency departments are not safe or appropriate for mental health consumers. Participants had heterogenous but largely consistent ideas about what made a service safe. Elements of safety mentioned by participants included a therapeutic orientation to time; service predictability; sensory dimensions of safety; and feeling understood. For some participants, notions of safety and unsafety dictated not only their satisfaction with services but overall likelihood of service use, thereby emphasising the critical importance of community attitudes towards safety in service design and delivery.