What is the Open Dialogue approach in mental health?

Open Dialogue is a collaborative way of supporting someone through a mental health crisis, focusing on the whole family and support network instead of just the individual.

It brings everyone together to find the best way forward, with open conversations and shared decision-making at its heart. 

Open Dialogue began in Finland – now trialed by the NHS – and is built on the belief that recovery is more likely when everyone involved is heard and included.

What are the main features of Open Dialogue? 

• Immediate response: Support teams are available within 24 hours of a crisis, so help comes quickly when it’s needed most. 
• Social network: Care involves the person’s family, friends, and anyone important to them, recognising that mental health affects everyone around us. 
• Network meetings: All treatment happens in meetings with the person and their network. Clinicians, the individual, and their loved ones talk openly and make decisions together. 
• Transparency: Nothing is discussed behind closed doors. Every conversation and decision happens with everyone present, building trust and understanding. 
• Flexibility: Support adapts to the person’s needs, whether that means meeting at home, online, or somewhere else that feels comfortable. 
• Continuity: The same clinical team stays with the person throughout their care, providing consistency and reassurance. 
• Tolerance of uncertainty: Open Dialogue recognises that answers aren’t always immediate. It’s okay not to have everything figured out straight away.

What are the goals and benefits of Open Dialogue? 

Open Dialogue aims to: 

• Prevent a crisis from escalating
• Reduce the risk of a relapse 
• Build stronger support systems
• Encourages shared understanding of the issue
• Create less hierarchy in care
• Empower people and their networks to use their own resources for recover