Peer-supported Open Dialogue (POD) in NHS mental health services Kent and Medway NHS and Social Care Partnership Trust

Current mental health treatment models often see high hospital admissions and use of psychiatric medication. Adult mental health care is predominantly individualised treatment and often means patients seeing a number of different clinicians and services. 

Open Dialogue is a novel approach to mental health care that originated in Finland in the 1980s. It involves people and their family or social networks being seen within the first 24 hours of crisis, and seeing the same clinicians throughout their care; so that hasty treatment decisions are avoided and all discussions are held in their presence. This approach can lead to reduced relapse rates, lower medication use and increased chances of employment.

Kent and Medway NHS and Social Care Partnership Trust has developed Peer-supported Open Dialogue (POD), an adaptation of the original approach, with the involvement of peer support workers. 

More than 90 patients and their networks have been seen so far, and there have been encouraging initial results, particularly around patient satisfaction, mental and social wellbeing, support for carers, and reduced hospital admissions. On the Community Mental Health Survey, the POD service is rated higher than both the local NHS Trust services and the national average.

A key challenge was gaining agreement to staff the service from within existing resources, without clear UK outcome evidence or national benchmarks. However, Board and executive level commitment, and staff dedication helped bring the service to fruition. 

Funding from the Trust has been secured to support the POD service for an additional year, and there are plans to spread the innovation to other sites across Kent.

Contact information

For more information about this project, please contact Dr James Osborne, Consultant Psychologist, Lead Psychologist for East Kent, Community and Recovery Services.