In November BEING attended a forum on Open Dialogue. The forum was hosted by the Mental Health Commission of NSW. Dr Christopher Gordon and Brenda Miele Soares shared their experience of Open Dialogue and lessons they have learned. They use Open Dialogue in their not-for-profit organisation called Advocates in the United States.
Open Dialogue is a system of care for people experiencing mental health crisis. It originated in Tornio, Finland which achieves the world’s best documented results for first episode psychosis. It focuses on working with the individual and their family in their homes if possible, and creating a dialogue where everyone is heard.
Other key features include:
• Came from a social network perspective
• There is always more than one clinician
• All decisions are made in front of the person and their network
• Emphasis is on stories, rather than symptoms
• People are seen quickly
At Advocates, Open Dialogue is used in two programs. The first is called The Collaborative Pathway and is for people in acute psychiatric crisis. The second is in the Community Based Flexible Supports (CBFS) program and is for people with longstanding conditions. Dr Gordon and Ms Miele Soares learnings from these two programs includes: people and their families generally liked the process; it decreases isolation, creates creativity and engagement, and promotes shared decision making.
The Mental Health Commission of NSW paper Perspectives on Mental Illness and Medication note Open Dialogue as good practice. Dr Gordon and Ms Miele Soares found Open Dialogue aids in discussions about the use of medication. This is particularly important, since for 70 percent of the families in The Collaborative Pathway, whether or not to take medication was a main concern. To read more about The Collaborative Pathway program, please visit Advocates website here.
Dr Gordon and Ms Miele Soares noted that Open Dialogue did not always work for all families and that psychosis does not magically disappear with Open Dialogue. However, when a person feels heard, respected and safe, problems that are worsened by stress can often start to fade.