CompletedInterventional

Is Open Dialogue more clinically effective and cost-effective than standard care for people who present to services in mental health crisis?

When someone experiences a severe mental health crisis, getting the right support is essential. This UK trial investigates whether a care method called 'Open Dialogue' works better than standard NHS crisis services. Open Dialogue brings together the person in crisis and their trusted network of family or friends. Together with mental health professionals, the group makes shared decisions about medications, talking therapies, and practical help. Researchers are comparing this approach against standard NHS care across several trusts. The goal is to see if Open Dialogue helps people stay well, reduces hospital admissions, and improves quality of life. Taking part involves completing short interviews with a researcher over two years. The treatment you receive is based on your GP surgery, and your standard NHS care is never affected by whether you join the research interviews.

At a glance

Status

Completed

Sponsor

North East London NHS Foundation Trust

Enrolment target

644

Start

03 Jun 2019

Estimated completion

30 Jun 2020

Severe mental illness

What is this study about?

Going through a mental health crisis can feel frightening and overwhelming for both the person involved and those close to them. In standard NHS care, a crisis team usually assesses the person and recommends medication, talking therapies, or a stay in hospital. While this helps many people, researchers are always looking for better ways to support long-term recovery in the community.

This study explores an approach called 'Open Dialogue'. Originally developed in Finland, Open Dialogue involves the person in crisis, their family, friends, and mental health staff meeting together as a team. Instead of doctors making decisions in private, all treatment choices—such as medication and therapy—are discussed openly in group conversations. This ensures the person and their loved ones have a strong voice in their own care.

Early research suggests that Open Dialogue may help people recover faster and spend less time in hospital. However, the NHS needs high-quality evidence before deciding whether to offer this approach widely. By comparing Open Dialogue directly with standard care, this study will show whether it delivers better results and good value for money for the NHS.

Key takeaways

Compares a family-focused care method (Open Dialogue) with standard NHS crisis care.
Open to adults aged 18 and over who have recently experienced a mental health crisis.
Involves answering research questions at the start, and at 3, 6, 12, and 24 months.
Your treatment group is decided by your GP practice, ensuring everyone receives active care.
Participation in research interviews is completely voluntary and can be stopped at any time.

Who may be eligible?

This trial is open to adults aged 18 and older who have recently experienced a mental health crisis. This usually means being admitted to a psychiatric hospital ward or being supported by an NHS mental health crisis team. To take part, you must be registered with a GP practice taking part in the trial and speak enough English to complete the research questions.

The study is not suitable for everyone. People cannot join if they have already received Open Dialogue therapy in the past, or if they have a diagnosis of dementia, a learning disability, or a brain injury. It is also not suitable for individuals whose main difficulty is drug or alcohol addiction, those under the care of forensic (criminal justice) mental health services, or people without a permanent home.

Doctors and researchers will also make sure that taking part is completely safe for you and the research team before inviting you to join.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you aged 18 or older?
Have you recently needed support from an NHS mental health crisis team or hospital?
Is your GP surgery taking part in this clinical trial?
Can you comfortably understand and speak English for the interviews?
Have you never received Open Dialogue care before?

Answer every question to see your result.

What does participation involve?

Taking part in the study lasts for two years. Because of how the study is designed, the type of care you receive—either Open Dialogue or standard NHS care—depends on which GP surgery you belong to. You do not get to pick the group, but you will always receive full NHS care.

If you agree to take part in the research, you will meet with a researcher for an interview lasting about 45 minutes. You will answer questions about your health, your feelings, and your social circle. The researcher will meet with you again at 3, 6, 12, and 24 months to see how you are doing over time.

At the end of the two years, researchers will also review your medical records to see if you have needed hospital care or experienced a relapse. A small number of carers and participants may also be asked if they would like to join an extra discussion to give feedback on their experiences.

Potential risks and benefits

Taking part may not directly improve your health, but many people find it rewarding to share their views and help improve NHS services for others. There are no major physical risks involved. However, talking about mental health crises can sometimes feel upsetting. If an interview becomes difficult, the researcher will pause or stop straight away and offer you details of support services. You are free to leave the study at any time, and doing so will never affect your medical care or the support you receive from the NHS.

Locations (5)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

North East London NHS Foundation Trust
City only
Rainham, England
Kent And Medway NHS and Social Care Partnership Trust
City only
Maidstone, England
Barnet, Enfield and Haringey Mental Health NHS Trust
City only
London, England
Camden and Islington NHS Foundation Trust
City only
London, England
Devon Partnership NHS Trust
City only
Exeter, England

Common questions

Will taking part change my medication or treatment?

Your clinical team will still make all treatment decisions with you. Whether you receive Open Dialogue or standard care depends on your GP surgery's group, not whether you agree to do the research interviews.

Can my family or friends be involved?

Yes. Open Dialogue actively encourages involving family members, partners, or friends in meetings. Some carers may also be invited to complete short research surveys if they wish.

Do I have to pay to take part?

No, taking part in NHS research is completely free, and all regular care remains covered by the NHS.

What happens if I change my mind?

You can step down from the research at any time without giving a reason. Your doctors and nurses will continue caring for you as normal.

How was it decided which treatment I get?

The trial uses a system where whole GP surgeries are randomly assigned to provide either Open Dialogue or usual care. This ensures researchers can fairly compare both approaches.

How to find out more

Katherine Clarke

k.clarke@ucl.ac.uk +44 (0)2031083260 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.