Open dialogue approach cuts psychiatric hospital admissions, study finds
New research shows mental health patients are less likely to be admitted to hospital under the open dialogue model.
The Full Story
A plain summary built from the channels that reported this story.
A new study led by University College London has found that mental health patients are three times less likely to be admitted to a psychiatric hospital if they are treated using the open dialogue approach, which closely involves family and friends in their care. The research, the first controlled trial of its kind, also found that patients spent 54% less time in hospital over two years and were half as likely to be referred to crisis services compared with those receiving standard treatment.
The open dialogue model originated in Finland in the 1980s and has been piloted by five NHS mental health trusts in England. It differs from conventional care by offering more frequent and longer sessions, adapting to what the patient prefers and needs. The same clinicians stay involved, and support is available within 24 hours of a crisis. Crucially, family and friends are treated as equal partners in every decision.
The study followed around 500 people on the programme. Researchers reported that while patients still had relapses, they were significantly less likely to end up in hospital and reported higher satisfaction with their care. One psychiatrist involved in the trial said, "We feel we have a moral imperative now to make this happen." He added that the approach could save the NHS money, noting that 80% of the mental health budget is spent on the 2% of people in hospital.
Personal accounts illustrate the impact. One patient, Nihad, had been struggling with his mental health for more than five years. His wife Farah said nobody was listening to him before, which frustrated him more. With open dialogue, she became part of the team supporting him, and the couple described the approach as a "miracle." Another patient, 23-year-old Sophie, said she did not see a future before the programme, but with her mother involved in sessions, she rebuilt herself. Her mother recalled receiving phone calls from train stations when Sophie was in crisis, and said the change has been massive.
However, some psychiatrists have questioned the findings, suggesting that additional funding and staffing for the pilots could explain the improvements. More research is now being carried out, including into the potential financial benefits for the NHS of adopting this approach more widely.
On screen
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Key Claims
Claims reported during this story's coverage, mapped by channel. Ordered by how many channels carried each claim.
| Claim | BBC One | Channel 4 |
|---|---|---|
| A study reported that open dialogue patients had lower psychiatric hospital admissions, less time in hospital, and fewer crisis service referrals. | ||
| Open Dialogue patients were three times less likely to be admitted to a psychiatric hospital than those receiving standard treatment. | ||
| Open Dialogue patients who were admitted spent 54% less time in hospital compared to those receiving standard treatment. | ||
| Referrals to crisis services were halved for Open Dialogue patients compared to standard treatment. |
Channel Perspectives
What each channel focused on, with key quotes.
BBC ONE West focused on the practical experience of open dialogue through the story of Nihad and his wife, highlighting how the approach adapts to patient needs and involves family as part of the team. The report also gave airtime to staff perspectives and noted the skepticism from some psychiatrists about funding and staffing.
- “If he was having treatment, as usual, as we put it, the appointments and contact with staff would be less frequent, would be of less duration, and the beauty of the open dialogue approach is that we try to adapt the frequency and duration to what the patient prefers and what they need.”
- “The odds of being admitted to hospital are three times lower if you are being treated with open dialogue than treatment as usual.”
- “Some psychiatrists question the findings, saying additional funding and staffing for the pilots could explain improvements for patients like Nihad.”
Channel 4 highlighted the collaborative and human side of open dialogue through the story of Sophie and her mother, and featured the trial's clinical lead arguing for a moral imperative to implement the approach. The report also stressed the potential cost savings for the NHS by reducing hospital admissions.
- “I feel like we have a moral imperative now to make this happen.”
- “When people are involved and they come in, yes, it can be stressful, but they want to be in that stress to help their loved one almost always.”
- “80% of mental health budget is spent on the 2% of people in the hospital.”
Broadcast Timeline
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