Strengths and challenges for implementing non-clinical safe spaces for people experiencing emotional distress and/or suicidal crisis: A mixed-methods study from Australia

Background ‘Safe Spaces’ are novel interventions that provide non-clinical, peer-led services for people experiencing emotional distress and/or suicidal crisis. To date, little empirical research has examined these service models, particularly from the perspectives of peer workers working within these services and health services staff employed in local health systems in which safe spaces have been implemented. Methods We used a convergent mixed methods study design, collecting both quantitative and qualitative data from safe space staff (18 survey and 31 interview participants) and health services staff (49 survey and two interview participants). An exploratory unidirectional approach to data integration was taken whereby themes developed in the coding of qualitative data guided analysis of the quantitative data. Findings Peer workers described their work as multifaceted, challenging, and highly responsive to meeting diverse guests’ needs. Lived experience was expressed through ways of being and doing, yet a range of professional competencies, training, and support needs were identified as critical to this work. High demand and insufficient resourcing, along with negative perceptions of peer work, the risk of vicarious trauma and burnout, and low levels of integration within existing health systems resulted in clear challenges to the ongoing feasibility, effectiveness, and sustainability of safe spaces. Conclusion Safe spaces fill a critical gap in existing healthcare systems, offering after-hours crisis and preventative care and support. Greater resourcing and attention to the broader organisational and system-level barriers that impact their adoption and integration within local health systems is needed to maximise the service model’s effectiveness.