Open Dialogue is a mental health treatment model that originated in Finland in the 1980s and has led to results around recovery, return to employment and reduced medication.
We are delighted to have developed our own Peer Supported Open Dialogue team who are based in our Canterbury office. This is an adaptation of the original approach. It involves paid support workers with lived experience becoming part of the network meetings.
The team will receive urgent referrals from Single Point of Access (SPoA) for new episodes of care sought by adults in the Canterbury and Coastal area.
Key aspects of the approach including:
- ensuring an immediate response at the point of crisis;
- the same care professionals being involved throughout the care;
- family inclusive network meetings;
- all clinical discussions being undertaken in the presence of the family
- all decisions being co-created by the client, their support system and the clinicians to strengthen recovery.
Anticipated outcomes include reduced hospital admissions and lengths of stay, increased well being for clients and families, increased user satisfaction and high staff satisfaction.
We are also taking part in a national pilot project. For more details visit our research pages.
Set up of the service and the difference to the existing model
Set up and principles
What is Open Dialogue?
Open Dialogue is a community-based and integrated way of engaging with families, or a person’s social network, from the very start of seeking help (within 24 hours of crisis). It is based on the 7 principles of Open Dialogue.
How do you know it works?
There were impressive findings from Finland which indicate 78% reduction in bed days, 2/3 reduction in use of anti-psychotics and over a 1/3 reduction in relapse rates for a psychosis population. Feedback from individuals and families in Kent who have received it so far have been extremely positive. However, it is acknowledged that the model has not been researched in an NHS secondary care population and so there will be a KMPT Research study to evaluate the team and we will be taking part in a National RCT trial set to begin late 2017.
How are referrals made to Open Dialogue?
Referrals will be received from Single Point of Access (SPoA).
What are the referral criteria for Open Dialogue?
We will be accepting new referrals for individuals in crisis who meet the criteria for secondary mental health services, irrespective of diagnosis (if there is one).
What is the catchment area of Open Dialogue?
At this stage it will only be Canterbury and Coastal areas.
Can individuals and their families/networks be re-referred to Open Dialogue following discharge?
Only people presenting as a new episode of care in crisis will be referred to Open Dialogue. A new episode will indicated by having had a period of six months or longer since discharge from secondary care services. Individuals and families/networks that have previously been open to the Open Dialogue service can self-refer back in to the service at any time.
What are the working hours of the service?
The service will initially be running Monday-Friday 8am-8pm, with the view of this extending to weekend provision from Spring time. Initially referrals will be taken between 9am and 5pm Monday to Friday.
What is the care coordinators caseload in Open Dialogue?
Care coordinated caseloads will be 20 in order to be flexible with responding to crisis.
Which service line does the Open Dialogue team sit under?
The team will report to both community and acute service lines governance meetings.
Who will be working in Open Dialogue service?
A multi-disciplinary team of Open Dialogue trained clinicians who have undergone one year of Peer Supported Open Dialogue training.
What is the peer element in Peer Supported Open Dialogue service?
Every individual and family/network will have the opportunity to have access to a Peer Support Worker employed by KMPT and trained in Open Dialogue. Peer Support Workers have lived experience of mental health issues, and experience of having engaged with community mental health services.
Is Open Dialogue anti-medication?
Open Dialogue is strongly rooted in psychosocial models of thinking, but is not anti-medication. There is primarily an emphasis on meaning making and shared understanding of experience, rather than on symptomology.
Individuals will be able to gain access to Psychiatry input via the network meeting or within CMHT outpatient settings – the decision regarding this intervention will be a shared one, generated within network meetings.
Yasmin Ishaq, Service lead: 01227 812044 - Yasmin.firstname.lastname@example.org
Dr. James Osborne, Clinical lead: 07769 711694 - James.Osborne@kmpt.nhs.uk
Or come and speak to us – we are positioned upstairs in the Eastern and Coastal Area Offices, St. Martins hospital - adjacent to SPoA.
Online resource: https://www.kmpt.nhs.uk/research-and-innovation/open-dialogue.html