Visiting the hospital emergency department (ED) in a suicidal crisis poses a significant risk for recurrent suicidal crises, ongoing emotional distress, and later death by suicide. Despite this, research consistently shows that many young people who seek help in the emergency department for a suicidal crisis do not receive the necessary care for effective recovery upon returning to their communities. Young people and service providers desperately want an alternative to ED but none currently exist for young people in Western Australia (WA). Options such as Safe Haven Cafés, which offer temporary practical and emotional support in a non-clinical environment provide potentially effective solutions.
We co-designed a Youth Safe Haven Café to guide the development of an alternative care model for young people experiencing a suicidal crisis, as an alternative to emergency departments in the Peel region. This region was selected as a pilot location because it has one of the highest rates of youth suicide in WA. Consultations were conducted with sixty-five participants from the region, including 33 young people with lived experience of suicide, 15 parents/caregivers, and 17 stakeholders supporting at-risk youth. Participants took part in an interview or focus group to share their opinions on various themes, including concept validation, physical design, staffing, operations, continuity of care, challenges and safety, measures of success and language. A combination of deductive and inductive thematic analysis was conducted using the pre-existing themes described above.
Participants unanimously agreed that a Youth Safe Haven Café is a valuable and essential service. They particularly noted its benefits as a safer alternative to the ED and as a place young people could receive the supportive care they need. The service needs to be socially and culturally appropriate, and distinct from clinical settings such as hospitals. Participants hoped it would provide options to alleviate distress and wanted to be supported by staff with lived experience of suicide. Staff characteristics include being relatable, good listeners, empathetic, non-judgmental, and caring.
This model of care can be easily adapted to other locations and may offer a new and highly effective approach to assisting young people in suicidal crisis. The co-design process revealed strong support from the Peel community for peer-led initiatives like the Youth Safe Haven Café, which is crucial for the successful implementation of such services.