The Council of Europe has recently released the Compendium report: “Good practices in the Council of Europe to promote Voluntary Measures in Mental Health Services”. The reported practices may directly aim to reduce, prevent, or even eliminate coercive practices in mental health settings, and others will indirectly result in similar outcomes by advancing the general aim to promote voluntary mental health care and support.
Open Dialogue is featured in the table of practices both as “Open Dialogue in a High Security Psychiatric Ward” (Norway) and both as “Open Dialogues Model” (Finland and internationally). The first practice, which is listed as a hospital-based initiative, refers to the Department of Specialised Psychiatry at Akershus University Hospital, a high-security psychiatric ward in Oslo, which has undertaken a program based on OD. Early reports suggested success in helping to end the use of any coercive measures for individuals who had previously been subjected to high amounts of coercion in other closed psychiatric institutions.
The Open Dialogue Model is discussed more extensively under the “Community-Based Initiatives” section of the compendium. The paragraph mentions the definition of the European Network of National Human Rights Institutions and Mental Health Europe (2020, p.17):
“Service providers aim to facilitate regular ‘network meetings’ between the person and his/her choice of an immediate network of friends, carers or family, and members of the healthcare team. A strong emphasis is placed on transparency in treatment planning, and decision-making processes aim to respect a person’s will and preferences, safeguarded from undue influence. Such support enables the person to retain their legal capacity and to make the final decision on, for example, his/her treatment, after exchanges and reflection within the group.”
The compendium also reported that introducing Open Dialogue into the care systems led to the establishment of a culture of dialogic communication among staff, service users, family members, and other members of a person’s social network. Moreover, community-based multidisciplinary treatment teams were organised to provide primarily outpatient services. Both these changes are in full accordance with the recommendations made by the WHO in its Comprehensive Action Plan on Mental Health 2013-2020.
Click here to learn more about the compendium and to download the full version in PDF format.