The NSW Mental Health Commission hosted a forum on ‘Open Dialogue’ crisis care. Dr Christopher Gordon and Brenda Miele Soares from the US non-profit organisation Advocates spoke about the results of the evaluation, conducted in partnership with the Boston University Center for Psychiatric Rehabilitation, of the use of an Open Dialogue approach to psychiatric crisis care.
Advocates provides a broad range of services for people facing life challenges such as addiction, aging, autism, brain injury, intellectual disabilities, and mental health challenges. Their services include 24hr. Psychiatric Emergency Services provided to individuals of all ages in 30 Boston communities, regardless of ability to pay. They have utilised the principles of Open Dialogue since 2009.
Open Dialogue is a system of care for people experiencing a mental health crisis, originating in Finland. It emphasises working with an individual, their family and network, in their own homes where possible, to help them to be together and engage in dialogue during a crisis situation. Distinguishing features include involving more than one clinician in care and making decisions in front of individuals and their network. Antipsychotic medications are used sparingly, at low doses if possible and for shorter periods of time if possible than is typical in traditional Psychiatry.
The evaluation found that the Open Dialogue approach resulted in positive outcomes for the majority of participants in terms of functioning, social engagement in work or study, reduced hospitalisations and adverse events and reduced dependence on antipsychotic medication. These results are shown to be consistent with results from Finland which are also include in the presentation. NSW Mental Health Commissioner John Feneley said the principles of Open Dialogue resonated with the Strategic Plan for mental health reform in NSW. “By placing the consumer and their families at the centre of coordinated community care delivery, as this program does, it is the intent of the reform agenda in NSW that we will have a more responsive, person centre approach to mental health service delivery.”
Mental Health Commission of NSW Webpage describing the Forum on Open Dialogue: http://nswmentalhealthcommission.com.au/news/our-news/forum-on-open-dialogue-crisis-care
Utube video of presentation on Open Dialogue
Radio National has also broadcast a program on Open Dialogue which can be accessed at: http://www.abc.net.au/radionational/programs/allinthemind/open-dialogue/7174084 (This programme includes interviews with Jaakko Seikkula (co-developer of the Open Dialogue approach), Flick Grey (Australian consumer academic training in Open Dialogue) and Anna Arabskyj (family member who has personal experience as a member of Open Dialogue social network meetings).)