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At night, the red ‘emergency’ sign of the emergency department at St Vincent’s Hospital Fitzroy acts as a beacon for homeless or socially isolated who are feeling distressed or in need of comfort. To lift pressure placed on staff at the emergency department, St Vincent’s Hospital Fitzroy recently launched the Safe Haven Café for people seeking mental health support.
At the launch of Safe Haven Cafe. From left: Angela Nolan, CEO St Vincent's Hospital Melbourne; Emmy-Lou Hamley, specialist mental health clinician and Safe Haven Café project manager; Fran Timmins, Director of nursing mental health services, SVHM.
Emmy-Lou Hamley is a specialist mental health clinician at St Vincent’s and project manager of Safe Haven Café. ‘Emergency departments are for people in pretty dire situations,’ she says. ‘We realised there was a group of people who needed somewhere else as an alternative to the emergency department. If someone isn’t in acute distress, where can they go to talk to somebody?’
Safe Haven Café is designed to meet such a need. It's a weekend drop-in service, giving potential mental health patients another option instead of the ED. The café was not designed to replace clinical mental health interventions, but to allow people to explore what options may be available to support them, and identify relevant local services.
Instead of bearded baristas, the café is staffed by a mental health clinician and peer support workers like Michael, who has a lived experience with mental health. Each night, he sits with people in the emergency department. ‘Doctors or nurses or members of the alert team will point me towards people who are lonely or might benefit from some company,’ Michael says. And if they fit a specific set of criteria, he directs them over.
On weekdays, the Safe Haven Café is a staff lounge and art gallery at St Vincent’s hospital. But at nights over the weekend, a hot drinks station is set up in a corner with snacks, books line the windows and tables are stacked with board games. From inside, you can still see the red ‘emergency’ sign over the door to the emergency department 70 meters away.
Funding came through the Victorian Labor Government’s Better Care Victoria Innovation Fund, designed to support projects that improve the efficiency of Victoria’s health system. The Safe Haven Café model began in the UK in 2014 and proved popular—quickly spreading to multiple locations—owing to its relaxed and supportive environment. In its four years of operation in the UK, it’s been shown to reduce social isolation for vulnerable people and to help them to maintain their mental health.
To meet the often complex needs of its users, the café went through a lengthy planning process.
The Safe Haven project team began by collaborating with the intended users of the service to map out the ideal mental health experience at Safe Haven. ‘This was a full co-design process,’ says Hamley. ‘We didn’t want this to be just another drop-in centre. Consumers spoke about their desire for a safe, relaxed, and non-judgemental atmosphere.’
Throughout that process, the project team conducted numerous surveys and found patients presenting to emergency often just wanted someone to talk to. ‘Our challenge was to put that person at the front of the patient’s experience instead of the end,’ Hamley says. ‘We try as soon as possible to get Michael involved so they have someone they can talk to.’
Michael believes the café is already been successful, recalling situations when he’s noticed people feeling marginalised who didn’t need to be presenting to the ED, and asked them to the café for a free coffee, snacks and a chat. ‘Then the next time they come to the café instead of the ED. There’s been multiple people like that so far.’
Since opening, they’ve seen a steady uptake in café patrons.
To Emmy-Lou, this symbolises a shift in focus in patient needs and how they are best addressed. ‘A year ago, people with mental health issues might sit in an emergency department for 8 to 10 hours. Now people who walk into the ED are still processed in triage, but those who are not acutely unwell are offered the option of going to Safe Haven for a cup of tea and a chat.’
And so far, feedback has been positive. ‘Of the people who have come over here, they’ve all walked out feeling safe, with a plan for the night, and even visibly different in their appearance,’ says Hamley. Most importantly perhaps, across early feedback survey results, ‘people have responded by saying they feel understood.’