What is Castlemaine Safe Space?

CaSS is unique from any other service, as we honour our guest’s autonomy by not calling external services for intervention, without the consent from our guest. For many people experiencing a suicidal crisis, emergency departments are the most immediately accessed or only form of support. However, busy emergency departments are not ideal locations for people who are in psychological/emotional distress.  

Everyone is welcome to attend the space, during our opening hours. No referral or appointments are necessary. In the future we hope to connect guests with a wide range of other community based services such as housing, relationship counselling or financial assistance, to help address the causes of their distress. Everyone who attends Safe Space is treated with respect, kindness, and compassion.

CaSS is one of 4 Pop-Up Safe Spaces being piloted across Australia, co-designed by Roses in the Ocean. In 2021 the ELM Network received funding to set up a Safe Space in Castlemaine. Then in early 2022 the Castlemaine Safe Space Working Group was formed, to lead and drive the development of this community designed, led and managed Safe Space in Castlemaine. 

This project has been made possible by ELM, (Every Life Matters) who received an initial grant from the Foundation for Rural and Regional Renewal and funding support from Mt Alexander Shire Council, Roses in the Ocean and Central Victorian Primary Care Partnership.

History of Safe Spaces

The Safe Haven concept was initially based on the UK mental health charity Mind’s 2011 independent inquiry into acute and crisis mental health services. This research found that people wanted a safe place to go in times of crisis, to be treated in a caring and respectful way, with a reduction in the medical emphasis of usual acute care. The report also acknowledged the benefits of peer support. 

Safe Haven Café - St Vincent’s Hospital, Melbourne, Victoria

One in nine patients who presented to the St Vincent’s Hospital Emergency Department (ED) from 2015 to 2017 cited mental health as their primary reason for attending.
 
Modelled on the Aldershot Safe Haven Café, the Safe Haven Café at St Vincent’s Hospital was established in 2018 as a non-clinical, therapeutic alternative for those needing assistance but not emergency care. It offers respite and peer support to help build resilience and capacity for people to self-manage their mental health in the community.

A review of the service conducted by PwC reported: 

•     Improved consumer experience of care and sense of social connectedness in the local community

•     Reduced mental health presentations to the hospital’s ED, freeing up capacity and potentially reducing treatment delays for other ED patients

•     Café visitors said they felt ‘welcome’, ‘safe’, ‘comfortable’ and ‘relaxed’. They also reported gaining a sense of hope, feeling valued, heard, and seen, and that the café helped them connect with people. This improved their confidence in settings outside of the café, enabling them to make other positive changes in their lives.

Safe Spaces and Lived Experience

Advocates for safe spaces recognise that lived experience is a unique form of expertise and that the practical insights of people who have ‘walked the walk’ should guide the design and delivery of these supports.  There is an emerging evidence base for their therapeutic value in promoting hope, sharing their wisdom, when appropriate and truly being able to empathise. 

Lead organisation for the crucial role of lived experience, Roses in the Ocean, say that once enabled with training and support, those with lived experience can be a part of supporting others. Their experience can help in reducing stigmatising attitudes and contribute to healthy and sustainable communities.

The Design of Castlemaine Safe Space

Castlemaine Safe Space was co-designed with Roses in the Ocean. Roses in the Ocean have been part of the co-design of nearly 30 Safe Spaces across Australia. Their Co-design process in Castlemaine involved asking members of our community with lived experience of suicidality and emotional distress what emotions and feelings were experienced by a person seeking help through ED and other suicide prevention supports (and those who chose not to), and explored the reasons why they felt that way and what needs they had at each stage, including finding a service, arrival & initial assessment, waiting, treatment and on leaving (see Appendix 1). From there, it was established what our community wanted and needed in terms of a more suitable approach. The results of this process were then circulated throughout the community with more than 30 responses.

 Our Working Group was then established from interested community members who were tasked with implementing the wants and needs expressed by our community.

The Safe Space and the Importance of Self-determination

One of the main principles of a Safe Space is: 

Promoting autonomy, self-determination and choice and control for guests, in particular for those that have had poor experiences with voluntary and involuntary hospitalisation who would therefore not seek help of any kind in the future with clinical services. 

The Safe Space concept relies on offering:

·      an alternative to emergency departments and other emergency clinical services.

·      a place to fill the gap between what is on offer now and what is more palatable for our guests.

·      an alternative in terms of agency and personal choice of guests concerning treatment options.

As a community, we are responsible to be honest, transparent and present with one another, but cannot be responsible for one another’s choices or actions. Both experience and research have shown that when the system takes responsibility for or over an individual, through force and/or coercion, the typical result is often more trauma, isolation and disconnection. Trauma, isolation, disconnection have been linked to increases in suicide rates.

We honour that suicidal thoughts are valid responses to painful experiences in peoples’ lives. With that pain often comes a lack of choice related to autonomy, resources, housing, relationships and community, healthcare, income, work, exposure to violence and so on. We prioritise consent and self- determination, and recognise and respect the many ways that people live with, sit with, cope with, or move through these experiences.