Centre for Mental Health Research, The Australian National University, Australian Capital Territory, Australia.
ACT Mental Health Consumer Network, Australian Capital Territory, Australia.
PLoS One. 2022 Oct 3;17(10):e0272483. doi: 10.1371/journal.pone.0272483. eCollection 2022.
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.
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.
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.
安全空间是急诊科的替代选择，急诊科通常无法为经历情绪困扰和/或自杀危机的人提供最佳护理。目前，澳大利亚正在试用几种不同的安全空间模式。然而，很少有研究检查安全空间模式的有效性，特别是在社区环境中。在本文中，我们提出了一项研究的方案，该研究将调查安全空间模式的实施、有效性和可持续性，这些模式是那些通常会去急诊室就诊的人或由于过去的负面经历而选择不寻求帮助的人的真正替代选择。
我们将使用混合方法、共同设计的研究设计，根据社区参与式研究的原则进行，以深入了解不同安全空间模式的益处、潜在挑战以及有效实践的促进因素。我们使用 RE-AIM 框架制定了研究计划和评估框架，该框架将用于评估与覆盖范围、效果、采用、实施和维护相关的关键结果。数据收集将包括对访问、使用、满意度、（成本）有效性、困扰和自杀意念的定量测量；以及对服务实施、经验、可行性、可接受性、社区意识和模型对服务共同设计的保真度的定性评估。在倡议的整个试验期间，将同时收集和分析数据。
这项研究将能够广泛调查安全空间，为当地提供信息，并更广泛地了解安全空间作为医院为经历情绪困扰和/或自杀危机的人提供的护理的可接受和有效替代方案的关键特征。这项研究还将有助于增加关于同伴支持作用和益处的研究，并提供关于服务共同设计的成功和挑战的关键新知识，为未来的实践提供信息。
