Open Dialogue Therapy Cuts Psychiatric Hospital Admissions
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- Open Dialogue therapy made patients three times less likely to be admitted to psychiatric hospital, a UCL-led trial of 500 patients in crisis across five NHS trusts found.
- Open Dialogue patients who were admitted spent on average half as long in hospital, and rated their recovery and wellbeing more highly than those receiving treatment as usual.
- The trial found no significant difference in relapse rates between the Open Dialogue group and the control group, even as hospital use fell sharply.
- Open Dialogue, which originated in 1980s Finland and is now used in more than 20 countries, organises care around 'network meetings' where the same two clinicians meet with the patient and their chosen family, friends or neighbours.
- Consultant psychiatrist Dr Sameer Jauhar argued the benefits may reflect the extra resources invested in the approach rather than its distinctive elements, and called for further research.
- Dr Russell Razzaque, the trial's clinical lead, said the approach could substantially cut NHS costs by reducing reliance on the most expensive part of the system: inpatient psychiatric beds.
Why it matters: For an NHS where inpatient psychiatric beds are the most expensive part of the mental health system, even a partial shift to Open Dialogue could free substantial resources for community services — but the unresolved question of whether the family-inclusive model itself drives outcomes, or whether well-staffed community care alone would match it, will determine whether the approach scales beyond the five pilot trusts.
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