Open dialogue therapy cuts psychiatric hospital admissions, study
New research shows involving a patient's family and close friends in mental health treatment cuts psychiatric hospital admissions by three times.
Stock photo for illustration only, not from the actual event
- Open dialogue approach involves patients' families and friends in therapy
- Study reveals patients are three times less likely to be admitted to hospital
- Patients reported higher recovery ratings and improved quality of life
- The method was originally developed in Finland during the 1980s
Involving a patient's family and friends as part of a fresh approach to mental health treatment makes it three times less likely that they will be admitted to a psychiatric hospital, new research has revealed. Patients also rated their overall recovery and quality of life significantly higher compared to those who underwent traditional treatment methods.
This marks the first major study focusing on Open Dialogue, a methodology for delivering treatment and organizing mental health services centered around patient priorities, seeing the same consistent clinicians, and involving their inner social circle. However, the trial across five NHS trust areas also found that the method did not prevent patients from experiencing relapses, prompting some critics to argue that further research into its long-term effectiveness is still required.
One beneficiary of this approach is Dr Nihad Fathi, who felt his life spiraling out of control as the Covid-19 pandemic took hold in 2020. By the following summer, work-related pressures left him feeling anxious, depressed, worthless, and burdened by the sensation that he was letting his clients down.
Stock photo for illustration only, not from the actual event
During regular sessions, Nihad and his wife Farah sit in a circle inside their east London home alongside two clinicians: consultant psychiatrist Dr Bill Travers and community psychiatric nurse David Adebayo. Having worked with Nihad for five years, their employer—the North East London NHS Foundation Trust—has been utilizing Open Dialogue with selected community patients since 2019.
Open Dialogue was initially devised in Finland during the 1980s and is presently utilized across more than 20 countries worldwide, although formal research into its effectiveness has remained relatively scarce. The sessions facilitate a free-flowing conversation regarding the patient's feelings, desired assistance, and potential methods to achieve it, while also giving their network an opportunity to share observations and personal feelings.
"It enables you to reach a much firmer and deeper understanding of the underlying reasons for the problems and indeed to seek solutions that come very much from the person and their family."
Dr Bill Travers
Led by University College London, the study involved 500 patients who approached mental health services during acute crises, splitting them into two groups where one received Open Dialogue and the other received usual care. Researchers observed no significant difference in relapse rates between the groups; however, among Open Dialogue patients who did require hospitalization, their average length of stay was cut in half compared to the control group.
The Open Dialogue model highlights a paradigm shift from traditional, clinician-centric psychiatric care toward collaborative, network-oriented support systems. By empowering families and maintaining consistency in clinical staff, the approach helps demystify mental healthcare and establishes a secure environment for patients. While resource-intensive elements pose administrative and staffing challenges for standard healthcare frameworks, the demonstrated improvements in patient wellbeing signal a promising direction for future mental health service reforms.
Dr Russell Razzaque, a consultant psychiatrist and clinical lead for the trial, stated that these findings could hold significant implications for how the NHS manages psychiatric care moving forward. Conversely, consultant psychiatrist Dr Sameer Jauhar expressed caution, suggesting that the observed benefits might stem from the extra resources poured into the trial rather than the therapy model itself, indicating that the question remains unresolved.
Source: BBC Health
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