Few mental health services operate out of business hours in central Melbourne, meaning people experiencing mental health issues often have to rely on emergency departments (ED) for support. St Vincent’s Hospital identified a need to provide people with an alternative, non‑clinical service, and opened the Safe Haven Café. Based on a successful UK model of the same name, the service provides a safe place for consumers to seek support in the community.
Fran Timmins, Safe Haven Café Project Manager, said that consumers often find ED a ‘cold and clinical place’ and the busy environment can be intimidating. At Safe Haven Café, relationships between staff and consumers are built to make consumers feel equal. This helps them build trust in the service, express themselves, and feel like they have a sense of control. Ms Timmins noted this is in contrast to the power imbalance that consumers can feel in a clinical setting.
We try really hard in our clinical spaces to make people feel welcome but everything we do in our clinical spaces puts us on an unequal footing with the people that come to us and that power position never shifts. The really interesting thing about the café is how that power doesn’t exist so that people engage with you on a level that we don’t normally have engagement with.
Staff at the café include clinicians, peer support workers and volunteers. A clinician described her role as ‘more like that of a peer worker; sitting with people, having one‑on‑one conversations or as a group’ and supporting other staff who work in the café.
The Safe Haven Café was designed by people with lived experience. Michael, a peer worker, said:
We didn’t come in with the assumption of this is what people need, we asked the people what they would like and it is just much more of an equalising environment.
In an evaluation of the Safe Haven Café, consumers said the café builds a sense of social connectedness and provides an improved consumer experience. It also found the café is a cost‑effective alternative to ED and that it reduced ED presentations.
Sue, a consumer at Safe Haven Café, spoke of the effect attending the café had on her life more broadly:
I definitely don’t get as lonely as when I started coming here. To the point that I actually might not even come here as regularly as I used to come … I actually quite enjoy … leading my own life a bit more. If Safe Haven hadn’t been here, it’s quite possible I would have been presenting to emergency.
The Safe Haven Café is open 20 hours per week. Since it opened in April 2018, there have been more than 1,500 visits, with 80 per cent of consumers visiting more than once.
One way consumers hear about the café is through the lived experience peer worker in St Vincent’s ED, who introduces consumers to the café as an alternative support setting. 50 per cent of those visiting the café for the first time come across from ED with the peer support worker.
With the success of Safe Haven Café, Ms Timmins would like to see the model expanded to other hospitals and evolve into the ‘Safehaven plus’ model that exists in the UK
It would be good to see the UK model where clinical and non‑clinical services are fully integrated and can accept people directly from emergency services as well as direct referral rights to acute teams and inpatient units.
Consumers would also like to see the model expanded, with increased café opening hours. A consumer from one of the Commission’s focus groups said:
I really like the Safe Haven Café. I definitely prefer it over calling a helpline and definitely over going to emergency. I think having more of them is important. I like the idea of a drop‑in centre because you don’t plan your crisis. It’s not like, ‘okay, I’m having my crisis at two o’clock on Thursday.’
During Melbourne’s stage four lockdown, St Vincent’s Mental Health partnered with the hospital’s telehealth team to make sure consumers still received the support they need, remotely. Ms Timmins noted that this is important at a time of increased isolation.
We deal with a lot of people who are socially isolated at the best of times, and being in lockdown would isolate them even further and deprive them of perhaps the only contact they have.
As part of its remote service, the café has provided mobile phones to people who might need help most, to ensure they can reach out if they want to.
Source: Safe Haven Café Customer Experience Review, October 2019; Better Care Victoria, A Safe Haven Cafe for Mental Health Consumers, [accessed 4 November 2020]; RCVMHS Meeting with Safe Haven Café, 31 March 2020; RCVMHS, Consumer Human Centred Design Focus Group—Crisis Response: Record of Proceedings, 2020; St Vincent’s Hospital, Safe Haven Café provides virtual mental health support during lockdown, [accessed 31 July 2020].
Photo credit: St Vincent’s Hospital Melbourne