Safe Spaces are non-clinical, peer-led services for those experiencing distress or suicidal crisis. Based on peer practice principles such as increased choice, mutuality and respect, safe spaces provide an alternative for those who choose not to attend the emergency department or other clinical services. Despite addressing an important gap in the broader health system, a number of challenges face these services with regard to their implementation and sustainability. In this presentation we report findings from the first national study of safe spaces in Australia. Drawing on the perspectives of service-users, peer workers, health professionals, community members, and those involved in service co-design, we discuss how patterns of service usage and satisfaction indicate a growing community need for this kind of service. These successes, however, are compromised by emergent issues such as divergent understandings of the scope of practice, the significant demands placed upon the peer workforce, and the need for their better integration within the broader health system. While safe spaces make a unique contribution to suicide prevention, greater attention is needed to the health systems in which they are being implemented in order to maximise the benefits offered by these models.

This paper will report on a new study to map the system of mental health providers across Victoria, led by the Victorian Collaborative Centre for Mental Health and Wellbeing (VCCMHW), in collaboration with a team of social network researchers.
The reform of the Victorian mental health system set out by the Royal Commission into Victoria’s Mental Health System entails a radical transformation of mental health service delivery, in terms of philosophy, accessibility and availability, integration and coordination, and governance (State of Victoria, 2021). As part of their responsibilities to undertake research and disseminate knowledge to deliver the best possible outcomes for people living with mental illness, VCCMHW seeks to understand Victoria’s mental health service system as an interconnected system of providers, as a means to better implement and evaluate the impact of reform processes.
The importance of understanding mental health service systems as networks has long been recognised (e.g., Morrissey, 1992; Morrissey et al, 1995). Such networks are important in service access and care coordination. This initiative aims to map referral pathways and collaboration between mental health services, and its intersection with allied sectors (e.g., housing, AOD). This will pinpoint bottlenecks and gaps, identify problematic referral paths, and suggest new collaborations.

We report a study on the features of effective workplace relationships for delivering integrated care in two integrated mental health and alcohol-and-other drug (AOD) services.

Mental health and AOD professionals in the services collaborate across practices to tailor care to consumer needs and overcome the limitations of siloed care models (Jones & Delany 2014). While formal organisational roles, procedures and policies are vital to effective integrated services, the importance of professionals’ informal workplace relationships to effective collaboration has been overlooked in research on integrated service delivery. Staff use relationships to access help and resources (Borgatti & Halgin, 2011), while relationships also influence attitudes and provide social and emotional support (Chambers et al. 2012). Social Network Analysis (SNA) is a framework that permits us to see beyond formal structures by mapping and analysing informal relationships as a network of interpersonal interactions.

Using SNA, we examine three relational aspects that support practice integration: advice-seeking, relational safety and workplace friendship. We describe how the nature of these relationships helps professionals solve complex problems and deliver better outcomes for consumers. We examine the interpersonal challenges of integrated care, and how service design can be used to support relationship-building across practices.

Feedback from consumers and carers is a vital part of continuous improvement for all mental health organisations. However, the processes for receiving and responding to feedback are often defensive and compliance-focused, failing to genuinely engage with and learn from the voices of consumers and carers.
In early 2023, Neami National introduced the Lived Experience Feedback Coordinator role into our quality team. This role oversees consumer and carer feedback across all our services, with a focus on centring and elevating these people’s voices in the organisation’s feedback processes. Combining the Lived Experience lens with an understanding of the organisation’s inner workings, the role can also bridge gaps in understanding between services and consumers when complaints arise.
In this presentation, we will explore how the Lived Experience Feedback Coordinator role has shaped and changed the way we respond to feedback as an organisation. We will also discuss the broader pieces of work we are doing to re-orient our feedback processes towards honest and collaborative conversations, collective accountability, and building stronger relationships with consumers and carers.