SummaryPeer-supported open dialogue is a variant of the ‘open dialogue’ approach that is currently practised in Finland and is being trialled in several countries around the world. The core principle of the approach is the provision of care at the social network level, by staff who have been trained in family, systems and related approaches. These staff include peer workers, who will help to enhance the democratic nature of the meetings around which care is centred, as well as enabling such meetings to occur where networks are fragmented or lacking. Certain organisational and practice features and underlying themes are key to the approach. Crucially, open dialogue is also a system of service provision. Staff trained in peer-supported open dialogue from six National Health Service (NHS) trusts will launch pilot teams in 2016, as part of an intended national multicentre randomised controlled trial.

The course was widely reported as a positive experience, with substantial changes in attitudes and approaches to clinical work arising thus. Across the four superordinate themes, participant responses described a highly experiential course, experienced as an emotional journey which enabled them to embody the principles of POD, as well as use them at work.

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Open Dialogue is a model of mental health services that originated in Finland and has since, been taken up in trial teams worldwide. As this is a relatively unknown approach in the UK, it is important to tentatively explore perspectives of NHS staff and service-users. Sixty-one Open Dialogue conference attendees, both staff and service-users, were recruited for this study. A feedback questionnaire was administered to determine the extent to which they believed the key tenets of Open Dialogue were important to service user care, and the extent to which they existed within current NHS services. Analysis of data demonstrated a strong consensus on the importance of the key principles of Open Dialogue for mental health care and also moderate disagreement that these principles exist within current NHS service provision. The Open Dialogue principles may offer a useful framework in order to develop services in a clinically meaningful way.

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