The ODDESSI trial was the largest RCT ever into a new model of mental healthcare in the UK. Beginning in 2017 It followed 6 Open Dialogue teams over 5 years, comparing them to treatment as usual within adult mental health services. It delivered an in-depth evaluation of both quantitative and qualitative elements encompassing a wide range of topics, including patterns of hospital usage, prescription of medication, and levels of satisfaction among both carers and service users. The webinar will present the results and give an opportunity to consider the implications for family therapy.  

From Revolving Door to Empowerment

Many individuals seeking support from mental health services frequently encounter a system that prioritises swift diagnosis and prescription of medication. In many cases, there is little to no effort made to engage the person’s broader social network. This approach can result in a recurring cycle of admissions to mental health care, with some individuals remaining involved with services for many years. It is not uncommon for people to report that no one has ever enquired about the significant events or circumstances in their lives that may have contributed to their current situation.
Open Dialogue offers a different approach to mental health care. The focus is on the inclusion of family members and friends from the earliest possible stage, especially during times of crisis, creating a safe enough space to hear their stories. There is an intentional avoidance of rushing towards diagnosis, hospitalisation or medication, except in situations where immediate intervention is necessary to save a life. The emphasis is on collaboration and consistency, with two or three practitioners working alongside the same social network throughout the duration of the problem, thereby fostering strong relationships.

Implementing Open Dialogue requires staff to develop greater listening skills and to become comfortable with uncertainty, rather than feeling compelled to offer immediate solutions. This approach helps to avoid the disempowerment that can occur when service users are not listened to or involved in their own care. Although Open Dialogue has its origins in family therapy and represents a systemic approach it that depends on the collaboration of mental health practitioners across teams. 

Peer-Supported Open Dialogue Training

Since its inception in 2014 Peer-supported Open Dialogue (POD) has offered Foundation training accredited by the Association for Family Therapy (AFT). This programme is designed for a broad spectrum of practitioners within the mental health field including psychiatrists, psychologists, family therapists, nurses and others as well as individuals with lived experience.  Over 400 trainees have successfully completed the training. Some continue their systemic training to MSc level. 

The Scope and Impact of the ODDESSI Research

Russell will outline the principal outcomes of the research, providing insight into the significant findings that have emerged. In addition, Rachel—a carer and campaigner for change with first-hand experience of both traditional treatment and Open Dialogue—will share her perspective of the real-world impact of these approaches. The findings from the ODDESSI trial are expected to influence the future direction of service provision within mental health care. To further explore the relevance of these results, Val, a family therapist, will facilitate a discussion with attendees, focusing on the potential implications for the field of family therapy. 

About the Speakers:

Russell Razzaque

Russell Razzaque is a London based psychiatrist with twenty years' experience in adult mental health. He is currently a consultant, clinical director and head of research at North East London NHS Foundation Trust. Russell's special interests and particular fields of research are mindfulness and Open Dialogue and over the last 11 years he has been coordinating the national NHS Open Dialogue training and the clinical lead for the national multi-centre trial on Open Dialogue – ODDESSI – across several Trusts in England. He also published the book, "Dialogical Psychiatry".

Val Jackson

Val Jackson trained as an Occupational Therapist working in NHS mental health services in the UK and overseas. She qualified as a family therapist in 2001 working in the Leeds Early Intervention in Psychosis Service where she led an Open Dialogue trial. Open Dialogue just made sense to her and she has campaigned widely for its introduction in the UK ever since. She completed the 3 year OD trainer course in the UK and she has been a co-facilitator and tutor on the Peer-supported Open Dialogue, Systemic practice and Relationship skills course (POD) since its inception in 2014, helping to train NHS staff involved in the ODDESSI trial. Val took the lead in the AFT accreditation process for the POD course at Foundation level.

Rachel Bannister 

Rachel Bannister is co-founder and Chair of the charity Mental Health - Time for Action Foundation which campaigns for fully funded, holistic and compassionate mental health care services. Rachel is a passionate advocate of Peer Supported Open Dialogue (POD) and completed a PGCert in 2024. She works as a POD practitioner for NELFT. Rachel is a former patient rep on the RCPsych General Adult Faculty and Addictions Faculty She has also worked as carer rep for the Trent Division Executive, RCPsych Council and is currently a carer rep for the Quality Eating Disorders Network (QED) and patient rep for the Addictions faculty. Rachel has spoken candidly about her experience caring for a daughter with mental ill health and the struggle to access safe and effective care on many media platforms including a Channel 4 documentary, BBC Woman’s Hour, BBC Radio 4 today and PM. Rachel had also written about her own personal struggles with depression and addiction to prescription benzodiazepines in the British Medical Journal.

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