Forum on 'Open Dialogue' crisis care
Consumers, carers and clinicians had the opportunity to hear how one US organisation has implemented the ‘Open Dialogue’ model of psychiatric care at an information session hosted by the Mental Health Commission of NSW on 5 November.
The Commission invited Dr Christopher Gordon and Brenda Miele Soares from non-profit organisation Advocates to share how they adapted Open Dialogue for use in Massachusetts, and the model’s benefits and limitations.
Open Dialogue is a system of care for people experiencing a mental health crisis, originating in Tornio, 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.
Dr Gordon and Ms Miele Soares explained they have utilised the principles of Open Dialogue since 2009 in two of Advocates’ programs, including an outpatient service for people aged 14-35 years called The Collaborative Pathway.
Key learnings from this implementation that Dr Gordon and Ms Miele Soares shared included that the approach could be provided safely in a US context; individuals and families generally liked the approach; it aided fruitful discussions regarding the use of medications; and the approach’s emphasis on taking time before making diagnoses or proposing solutions allowed space for natural resolutions to crises to occur.
Dr Gordon and Ms Miele Soares cautioned that Open Dialogue was “not magic” and did not work for all consumers or families that took part in Advocates’ programs.
“Psychosis does not usually ‘melt’, ‘dissolve’, or ‘evaporate’ with dialogue,” Dr Gordon said.
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.”
Download Dr Gordon and Ms Miele Soares' presentation or watch the video.