Open Dialogue UK was formed in 2012 in order to support the development of the Open Dialogue approach in the NHS in the UK.

Nick Putman, a psychotherapist based in the UK, had a long standing interest in working with people diagnosed with ‘psychosis’, experiencing extreme states, or hearing voices. Having worked and lived in various therapeutic communities and trained as a psychotherapist with The Philadephia Association in London, who have a long history working therapeutically with people having such experiences, he became interested in the possibility of developing a more therapeutic, psychosocial, and family-based approach to ‘psychosis’ within the NHS. In his experience there was not enough of such work taking place in the NHS, where the treatment for people diagnosed with ‘psychosis’ was primarily based on medication and often hospitalisation, with any family work typically focused on psycho-education.

Research conducted by John Read and others has highlighted the prevalance of trauma in the histories of people who have ‘psychotic’ experiences later in life, and Nick became convinced that the approach taken by the NHS and most public mental health services internationally needed to be developed in order to offer more therapeutic work that could include family/social network members. He travelled the world, meeting many inspiring people working in a variety of community projects, largely outside the public mental health care system, and became further convinced of the need for change.

Given that most people diagnosed with ‘psychosis’ are in need of public mental health care at the time of crisis, Nick continued to look for a model that could be taken up by the NHS, and on travelling twice to Western Lapland in 2012, spending a month in total studying the Open Dialogue model developed there and participating in network meetings, it became very clear that this was the model he had been looking for – he felt very much at home and was energised by what he found.  And so he formed Open Dialogue UK and began working hard to create opportunities to develop the approach both in the UK and internationally.

The Open Dialogue approach is both a philosophical/theoretical approach to people experiencing a mental health crisis and their families/networks, and a system of care, developed in Western Lapland in Finland over the last 40 years. In the 1980s psychiatric services in Western Lapland were in a poor state, in fact they had one of the worst incidences of the diagnosis of schizophrenia’ in Europe. Now they have the best documented outcomes in the Western World. For example, around 75% of those experiencing psychosis have returned to work or study within 2 years and only around 20% are still taking antipsychotic medication at 2 year follow-up.

Remarkably, Open Dialogue is not an alternative to standard psychiatric services, it is the psychiatric service in Western Lapland. This has afforded a unique opportunity to develop a comprehensive approach with well-integrated inpatient and outpatient services. Working with families and social networks, as much as possible in their own homes, Open Dialogue teams work to help those involved in a crisis situation to be together and to engage in dialogue. It has been their experience that if the family/team can bear the extreme emotion in a crisis situation, and tolerate the uncertainty, in time shared meaning usually emerges and healing/recovery is possible. Open Dialogue has drawn on a number of theoretical models, including systemic family therapy, dialogical theory and social constructionism.

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