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 seven principles of Open Dialogue.
The treatment model originated in Finland in the 1980s and has led to results around recovery, return to employment and reduced medication.
There were impressive findings from Finland which indicate a 78% reduction in bed days, a two thirds reduction in use of anti-psychotics and more than a third 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 are taking part in a national RCT trial, which began in late 2017. For more details visit our research pages.
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 and it involves paid support workers with lived experience becoming part of the network meetings.
The team will receive referrals from Single Point of Access (SPoA) for new episodes of care sought by adults in specific GP practices in the Canterbury and Coastal area. Because we are in the pilot/research stage of the service, we will currently only be able to work with service users from Canterbury and Coastal areas.
Key aspects of the approach include:
- 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 wellbeing for clients and families, increased user satisfaction and high staff satisfaction.
Peer support
The service consists of a multi-disciplinary team of Open Dialogue-trained clinicians who have undergone one year of Peer Supported Open Dialogue training. 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.
Connected
Click here to read about the Open Dialogue service in the Winter 2018 issue of Connected