Issue - meetings

Report and presentation attached.

The NELFT Associate Medical Director explained that Open Dialogue was a new model of mental health treatment for adults that looked at the local resources of a person’s family and community. This had been found to significantly improve outcomes and produce a considerable economic saving. Family therapy techniques of this kind had been recommended by the National Institute of Clinical Excellence for conditions such as bipolar disorder, depression and schizophrenia.

A recent CQC survey had shown that nearly half of patients had felt their family was not involved enough in their case or treatment. For Open Dialogue, all staff would be trained in family therapy related skills – a collaborative approach involving family members, not just the person concerned.

Following Open Dialogue treatment, 82% of patients had no recurrence of symptoms after 2 years and 74% had returned to work or study. There were also lower incidences of medication and hospitalisation amongst patients who had undergone the treatment.

The core principles of Open Dialogue focussed on the provision of immediate help and who could assist from the recipient’s social or family network. It was also aimed to have psychological continuity with the same clinician being seen throughout the pathway. There was also a tolerance of uncertainty that ensured Open Dialogue was a joint process, avoiding premature conclusions or decisions.

Open Dialogue was a more flexible system, allowing the discussion of different conditions etc. For those people without sufficient family members willing to participate, peer support workers could be introduced to support the Open Dialogue process. Open Dialogue would be provided by NELFT home treatment teams in Havering and Waltham Forest and around 200 people in the UK had now been trained in the technique. The NELFT training course had also now been accredited by the Association of Family Therapists. If funding was received, there would be a total of 8 Open dialogue trial teams across the UK. Outcomes from the service had been very positive so far and there had also been an increase in staff morale amongst those teams providing the service.

Challenges for Open Dialogue included the establishment of an operational policy for the model by which it was hoped to be able to measure key outcomes. Further information on the technique was available on Youtube and officers would provide details.

Once the full trial of Open Dialogue commenced, connections would be made with GPs, pharmacists and other stakeholders. It was emphasised that it was necessary to understand a person’s whole family or network in order to successfully resolve their problems. It was planned to offer the service initially for people who had fallen into crisis although there would not be any change to initial access to other mental health services.

The Committee noted the position and thanked Dr Razzaque for attending the meeting. It was agreed that the Committee would be kept updated with developments re Open Dialogue.