WASHINGTON (dpa-AFX) - A new way of supporting people during a mental health crisis could reduce hospital admissions and improve their experience of care, according to a study led by a researcher at University College London (UCL).
The study, published in The Lancet Psychiatry, is the first randomized controlled trial to test Open Dialogue, an approach that changes both how mental health care is delivered and how services are organized.
Open Dialogue focuses on the person and their support network. It brings together the patient, mental health professionals, and people close to them-such as family members, caregivers or friends-to discuss the person's needs and plan their care during and after a mental health crisis.
A key part of Open Dialogue is holding regular meetings with the patient, people in their support network and two trained practitioners. The same practitioners continue to support the patient after the crisis. The meetings aim to help everyone better understand the person's mental health problems, support their independence and strengthen their relationships.
The ODDESSI trial involved 494 people who sought help from mental health services in England during a crisis. Participants were either offered Open Dialogue or received the usual treatment.
The study found that people who received Open Dialogue were more than three times as likely to avoid being admitted to a psychiatric hospital compared with those receiving usual care. They were also less likely to need crisis services again during the two-year study.
The researchers said these results suggest that Open Dialogue could potentially help reduce NHS costs. People who received Open Dialogue also reported better recovery, improved quality of life and greater satisfaction with their care.
However, the study had some limitations. The version of Open Dialogue used in the trial did not include family-based treatments that are commonly used in Finland. It also did not involve family members and friends in meetings as often as planned. More research is needed to understand how the approach works and how it can be improved for use in the UK.
'Our results are encouraging, as we found that Open Dialogue can reduce hospital bed usage and improve people's satisfaction with their treatment and experience with mental health services. But we did not find any difference in time to relapse, an important measure of mental health treatment efficacy,' concluded lead author Professor Steve Pilling.
'There is more work to be done to fully establish Open Dialogue's clinical effectiveness, refine its methods and better understand the mechanisms underpinning its effectiveness.'
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