The UK Peer-Supported

Open Dialogue


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The 2017 National Peer-supported Open Dialogue conference will be held in London on March 22nd. 
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Peer-supported Open Dialogue: an introduction

Many people – service users, carers, and staff of all disciplines – have a strong sense that we can do better in the services we provide for people with mental health difficulties, and there is a need to move towards a more holistic and collaborative approach to mental health care.

In a part of Finland, one such approach has been operating now for almost 20 years with very promising results - Open Dialogue. There, over 80% of people given a diagnosis of psychosis are reported as being symptom-free and back in employment or education within 5 years, with low use of medication and hospitalisation. This compares to recovery rates of between 20% and 40% in conventional services in 'developed' countries. 

What is distinctive about this approach is that a crisis response is offered within 24 hours and that this takes the form of a series of ‘network meetings’ – in which the person, their family and friends, and members of the professional team all come together to make sense of what is going on and work out how best to help the person through their crisis. It is a less hierarchical approach, where everyone is seen as a partner in the process from day one.

Initially, network meetings take place frequently (perhaps daily) and then become more spaced out once the immediate crisis is over. The same professional team stays involved until there is no longer any need for specialist mental health services – so responsibility for people’s care is not transferred between crisis, in-patient, recovery and community mental health teams during their ‘patient journey’. 

In some more recent applications of the Open Dialogue approach, such as the ‘Parachute’ service in New York,
peer support has been made integral to service delivery – which may be of particular value where people may have become disconnected from much active contact with family and friends. This is now being replicated in the UK as part of a trial.

The UK Peer-supported Open Dialogue (POD) project is a multi-centre study into the development and adaptation of Open Dialogue in the NHS. The project brings together 6 Trusts from around the country and starts with a one year training, which was launched in October 2014. It combines peer support with Open Dialogue and the planned trial aims to demonstrate the efficacy of Peer-supported Open Dialogue over treatment as usual in mental health services over the next 4 or 5 years.

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