Open approach to mental healthcare

http://www.theguardian.com/society/2015/mar/12/open-dialogue-approach-mental-healthcare

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Last week, a report by the all-party parliamentary group on mental health said people with mental health problems receive substandard care (Report, theguardian.com, 4 March). In response, the president of the Royal College of Psychiatrists, Professor Simon Wessely, asked to see “good words translated into good deeds”. The good news is that some of these good deeds are already happening – but at the frontline. On NHS Change Day on Wednesday nearly 500 people attended the first national conference, in London, on peer-supported “open dialogue”. They heard firsthand reports of the profound changes this approach is bringing to patients and families.

In Finland, studies show that open dialogue has allowed over 70% of those presenting with acute psychosis to be discharged from services – almost symptom-free – within two years, yet with far less hospitalisation or high-dose medication. In the UK, far fewer achieve these outcomes.

Open dialogue fully involves the patient and their social network, from the very beginning; with a flattened hierarchy, a shared agenda and the aim of “being with”, rather than “doing to”.

A group of dedicated mental health professionals are now introducing open dialogue to the UK. Clinicians and local peer volunteers from four NHS mental health trusts have commenced training, and a trial to compare it to current practice starts in 2016. Dr Lauren Gavaghan ST5 psychiatrist, LondonDr Tom Stockmann ST4 psychiatrist, LondonDr Russell Razzaque Consultant psychiatrist and associate medical director, London Dr Lucy Kilmartin ST4 psychiatrist, LondonVal Jackson Family therapist and peer-open dialogue trainer, LeedsKatie Mottram Author and peer-open dialogue administratorLondonYasmin Ishaq Service manager, Kent and Medway early intervention in psychosis serviceAnnie Jeffrey Carer lead, Kent and MedwayJane Hetherington Senior highly specialist psychological practitioner EIP, Kent and MedwayDr Anna Cheetham Consultant psychiatrist, recovery and assertive outreach, NottinghamshireCatherine Thorley Family and systemic psychotherapist, LondonLauren Markham STR worker, LondonStuart D’Amiral Specialist care coordinator/occupational therapist, North EssexSara Betteridge Chartered psychologist and chaplain/spiritual care adviser, LondonMirabai Swingler Spiritual care lead/chaplaincy team lead, LondonDr Rosarii Harte Deputy medical director, Kent and MedwayDr Beth Coleman Clinical psychologist, Kent and MedwayYasmin Phillips Community mental health nurse, NELFTCorrine Hendy Peer support worker, NottinghamshireEmma Dunton Specialist care coordinator/occupational therapist, Medway early intervention service, KMPTJulie Lynn Community mental health nurse and non-medical prescriber, North EssexAngela Duffy Community mental health nurse, early intervention team, Kent and MedwayAustin Somervell North-east Essex early intervention in psychosis teamKevin Blakey Psychologist, Nottinghamshire healthcare NHS foundation trust