What is Open Dialogue?
Open Dialogue is both a way of structuring mental health services to be more responsive to people’s needs, and a philosophical approach to being with people in distress, being in dialogue with the person’s social network. Open Dialogue originated in Finland in the 1980s and has been spreading around the world, partly because the results have been impressive, including much lower rates of medication use, hospitalisation and chronicity.
In practice, Open Dialogue is structured around ‘network meetings’—bringing together whoever might have a useful perspective on what is happening, usually with at least two Open Dialogue practitioners (more if there is a lot of worry). In practice, this often means family members, but it can include whoever the person feels would be useful, for example a neighbour, case worker, teacher, or friend. The idea is that there are lots of different perspectives (polyphony) and it can be extremely helpful to talk together, to listen to all of these different perspectives. Any decisions are made in network meetings—nothing is said or decided about people behind their backs (that’s the “open” part).
Is Open Dialogue available in Australia?
Open Dialogue has really taken off in Europe and the United States, with trials by both the National Health Service (NHS) in England and the public mental health system in New York. Many services and independent practitioners around the world are taking up the ideas and adapting them to their own context. It has really been incredible to see how both mainstream and alternative services have been inspired! In Australia, many people have expressed an interest in Open Dialogue, but we are challenged by the distance from qualified trainers, who are currently concentrated in Europe.
A few different solutions to this training problem have emerged. Some services have undertaken whatever training has come to Australia (between two and four days) and then done their best to honour the spirit and principles of Open Dialogue. Another approach has been taken by a group of public mental health services in NSW, in collaboration with Sydney University, who have come together to bring trainers from Finland, and work towards a sustainable foundation for growing Open Dialogue in Australia.
Yet another development has been in regional QLD, where a Primary Health Network has collaborated with an area mental health service, a community-managed and a peer-operated service, to bring trainers from Open Dialogue UK for a one-year foundation training (and, excitingly, half the trainees have lived experience roles!). Some keen individuals have decided to go to Europe to learn—one Australian is training in Finland to be an Open Dialogue trainer, another is undertaking the one-year foundation training in London, and another is undertaking the three-year training in London (that’s me!)
So, the short answer is yes—Open Dialogue has come to Australia.
Is it widely available to everyone in distress who would like to try this approach? No, and that will take a while!
If you are interested in keeping up-to-date with developments, check out the Open Dialogue website www.opendialogue.org.au. And if you are in Melbourne and interested in working with an independent Open Dialogue trainee practitioner (two years into the training), who also draws on Intentional Peer Support training, then I’d love to hear from you! I am offering low-cost consultations while I am in my final year of training. I receive supervision from my colleagues and trainers in London. You can contact me either through the website or by email email@example.com.