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NELFT NHS Foundation Trust provides a range of community health and mental health services across the north east London Boroughs of Barking & Dagenham, Havering, Redbridge, Waltham Forest, Essex and Kent and Medway.
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Open Dialogue ─ a different approach to mental healthcare
The 28th International Meeting on Dialogical and Reflective Approaches to Psychosis and other Challenging Mental States (IMDRAP) was jointly held by SOAS and UCL in London earlier this month.
Open Dialogue practitioners from around the world took part to hear about the latest research updates from the ODDESSI and APOD studies, as well as discussions on a variety of issues related to dialogical teaching, practice and philosophy.
Among them Professor Russell Razzaque, Clinical Director and Head of Research & Development at NELFT, presented an introduction to Open Dialogue, focusing on the core open dialogue principles:
· The provision of immediate help: first meeting arranged within 24 hours of contact made in a crisis.
· A social network perspective: patients, their families, carers & other members of the social network are always invited to the meetings.
· Psychological continuity: The same team is responsible for treatment – engaging in network meetings – for the entirety of the treatment process, whether that be a month or a decade.
· Dialogism: promoting dialogue is primary and, indeed, the focus of treatment.
This different approach to mental healthcare has had global uptake including in Finland, Denmark, Sweden, Germany, and the US. NHS trusts have trained over 700 clinicians from the UK and abroad since 2013, with NELFT the first to provide accredited training.
The emphasis on building deep and authentic therapeutic relationships betweenstaff and patients, compared totreatment as usual show positive outcomes.
74% of patients who received dialogical care showed no relapse after two years and had returned to work or study compared with 7% of those who had the usual treatments. In a subsequent five year follow up, 86% had returned to work or full-time study.
ODDESSI (Open Dialogue: Development and Evaluation of a Social Network Intervention for Severe Mental Illness) a large-scale programme of research into crisis and continuing mental health care within the NHS was also discussed on the day. The programme directed by Professor Stephen Pilling (UCL), funded by the National Institute of Health Research (NIHR) and managed by NELFT, includes Open Dialogue and research teams in five NHS Trust research sites across the country.
Users of service of the NELFT Dialogue First and Waltham Forest Peer Supported Open Dialogue spoke about how talking about traumatic experiences together with their close network of family and friends creates the trust, acceptance and understanding that leads to healing and long-term stability.
Teams working in these services explained how different they are as they hold the people seeking help as experts in their own life, while at the same time having a positive impact on staff wellbeing and retention.
To access the presentations and find out more about Open Dialogue 28TH INTERNATIONAL MEETING ON DIALOGICAL AND REFLECTIVE APPROACHES TO PSYCHOSIS AND OTHER CHALLENGING MENTAL STATES (IMDRAP)