The clinic, located in the Bathurst Health Service grounds, is an inpatient facility for people undergoing significant mental stress.

People who stay at the clinic are quite vulnerable and a former patient, who the Western Advocate is not naming, says they shouldn't be able to leave the facility without permission, as has previously been the case.

She is so concerned that despite encouragement from her doctors and psychologist, she has refused to return to the clinic due to safety concerns.

"Before you could leave, but you had to ask and be assessed, now I can walk in and out without telling anyone or being assessed, which is just not safe," she said.

Most patients, she said, would only step outside of the facility to get some fresh air, smoke a cigarette or go to the hospital cafe for a drink.

However, some may attempt to leave with the intention of harming themselves.

The former patient admitted that she had tried to "escape" the facility before, but the staff's assessment process picked up on her poor frame of mind and ensured that she didn't leave.

"With the open door, you might as well be at home. It's the same thing," she said.

The Western NSW Local Health District's (WNSWLHD) executive director for Mental Health, Drug and Alcohol, Jason Crisp, said the decision to switch to an open-door policy occurred approximately 12 months ago.

He said it is "in line with providing the least restrictive environment as is required by the NSW Mental Health Act 2007".

"Panorama Clinic is a voluntary unit. People who choose to seek support from the service are free to come and go as they please," he said.

"If a more restrictive environment is necessary, treatment options are available in Orange. The clinical team is able to make that decision at a local level and helps the patient get the help and treatment they need."

The former patient said the Panorama Clinic, location-wise, was her first choice over Orange because staying in Bathurst meant her family could visit her daily, as they have done during previous stays at the clinic.

A local psychologist, who also won't be named, said that open-door policies can work in mental health facilities but only if there is appropriate staffing, infrastructure and procedural supports in place.

He referred to several studies that supported this.

"Retention rates within the service are able to improved with the use of collaborative care strategies which involve active participation from the client/patient - which can include an 'open door' policy, however it really does require additional resourcing so that 'at risk' patients are identified well and supported to remain within the unit," he said.

"It fits more within the charter of rights for mental health services to have an open door but this does not mean it can be implemented safely without some systems and processes."

He said other countries have supported open-door policies with weekly staff training, additional staffing numbers, moving the door out of sight to negate impulsive exiting, and putting in place a risk management process to chat with people on the way out.

There may also be a small locked-door area that can be used on a temporary basis for high-risk patients.

The WNSWLHD has not stated if any other measures have been put in place at the Panorama Clinic to support the open-door policy.