Open Dialogue Approach to Mental Health Services

We appologise for including so much text – but we understand that sometimes people feel a little nervous to go to links – so have included most of what we hope is important below (from an article written in the Independent by Celia Dodd 6th December 2015)  more

“The Open Dialogue approach was first developed in Finland in the 1980s, which at the time had one of the worst incidences of schizophrenia in Europe. There are now well-established services in Berlin and New York, where state investment in four respite centres that practise Open Dialogue has been doubled to $100m (£66m). Services are also springing up in Italy, Poland and Scandinavia.

What’s most impressive about Open Dialogue is its success with even the most intractable mental illnesses, where current systems of care too often fail, or offer only short-term respite. Results over the past 30 years from Finland sound impressive: 74 per cent of patients experiencing psychosis are back at work within two years, compared with just 9 per cent in the UK. Crucially, relapse rates are far lower than here: after an average of two years’ treatment, most patients don’t need to come back – ever.

Here, a mental-health diagnosis can feel like a life sentence.

Open Dialogue’s key principles are: people are seen within 24 hours of becoming unwell; and all meetings with the psychiatric team are held at home, or wherever the patient finds most helpful. Significant others in the patient’s life – family members, or trained peer-support workers – are engaged in meetings from the word go. What service users appreciate most is that they always see the same people.

One family’s comments: “The number of times I went to meetings with my son to see a team of people we’d never seen before. How are you supposed to start talking to someone you don’t know? My son just felt that he wasn’t listened to.

What also sets Open Dialogue apart from standard treatment is that discussion about patients takes place in front of them, in what are called “reflections” between members of the team; this adds to their sense of control.

But whereas the mainstay of standard treatment is usually medication, the mainstay of Open Dialogue is talking. But there’s something else which encourages patients to open up: mindfulness. Every member of the team, from psychiatrists to support workers, practises it. Dr Razzaque explains: “This is not about teaching service users mindfulness. This is about clinicians practising mindfulness themselves. 

The writer of the above article describes this treatment as radical – we think it sounds like common sense – treating people at a vulnerable time in their lives – with respect.”

Open Dialogue is currently being piloted in four NHS trusts. It could revolutionise mental-health care in the UK.

Open Dialogue UK is a good starting point to find out whats happening here in the UK and which just recently (February 2nd 2016) had a Conference promoting openness and democracy in mental health services and also offering Foundation Training for NHS teams, peers and independent practitioners (deadline for applying – 26th April)

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