Finland’s Open Dialogue is a Revolution in Psychiatry

revolution psychiatry

A revolution in psychiatry is underway thanks to a new approach to mental health care.

Open Dialogue, pioneered in Finland, offers a different way of looking at mental health problems. It sees a symptom of mental health as an indication that there has been a break down in relationships and communication. The person at the centre of concern, for they are not called a patient, is simply the person in a social network who is expressing this break down.

Treatment involves the whole family and social network. All healthcare staff are trained in family therapy and related psychological skills. Their focus is not to diagnose and treat with medication, though that is discussed by everyone and agreed upon unanimously. It is to make sure that everyone’s voice is heard.

Open Dialogue has been taken up in countries around the world, including much of the rest of Scandinavia, Germany and several States in America. Results from trials are striking. For example, 72 per cent of those with first episode psychosis treated via an Open Dialogue approach returned to work or study within two years, despite significantly lower rates of medication and hospitalisation.

Dr. Razzaque is responsible for introducing this new approach into the NHS. Green Lane Films Director Emma Goude has been filming the training and watching psychiatric professionals ‘unlearning’ this new way. They talk of having to ‘sit on their hands’ and hold back from being the ‘expert’ with all the answers. Instead they’re learning to be with their own distress instead of rushing in to ‘fix’ the distress of someone else. And they’re finding that this has a therapeutic value in itself. The revolution in psychiatry must first begin within each member of a mental health team.

Dr. Russell Razzaque, author of the book ‘Breaking Down is Waking Up‘ commissioned Green Lane Films to film the first National Conference on Peer Supported Open Dialogue that took place in 2015.  These videos show some highlights.


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