Conference „Healthy society as a matter of concern of the Open Dialogue Approach”, Wieliczka, Poland, 27-28.11.2014
On the 27-28th of November 2014 in Wieliczka took place conference „Healthy society as a matter of concern of the Open Dialogue Approach”. The event brought together practitioners, researchers, local authorities, beneficients of mental health care system and their families. The conference was predicted to give a place for the public debate about the possibilities of better adjustment of the system of mental health care in Poland to the needs of the patients and their relatives. Our special guests were one of the founders of the approach – prof. Jaakko Seikkula from Jyvaskyla University in Finland, and dr Werner Schuetze – psychiatrist, propagator and practicioner in ODA in Germany. Lectures and workshop attracted over 250 participants.
The space of the conference was heavy in its emphasis on the need to implement need-adapted treatment. Voices of both proffessionals and beneficients of the mental health-care system gave testimonies of inadequacy of the system and of a failoure in introducing National Programme of the Mental Health Care to the common practice. Basic principles of Open Dialogue Approach are in line with the model of community mental health service and exemplify a „good practice”, which efficacy is backed up with longitudinal studies in Finland, Norway and Germany. Presented research material evidences high efficacy of such a multidimensional approach to treatment based on social environment of the patient. Results show that Open Dialogue Approach shapes the system of care in a way that narrows down frequency and lenght of in-patient treatment, supports the patient in his social roles, restrain the doses of medication and foster the sense of control and responsibility in the healing proccess. These results not only indicate financial profits, but can also raise standards of Polish psychiatry. Open Dialogue derives its strenght and efficacy out of resources which are not commonly recognized and involved in a consistent model:
- Immediate help (24 hours)
- Need-adapted treatment
- Flexibility and mobility
- Interventions in acute crisis
- Hospitalization only in necessity
- Basing on patient’s resources in the healing proccess
- Cooperation between institutions
- Restraining from stigmatization
Promising results were revealed in researches on first-epizode schizophrenia patients benefited from ODA:
- Shorter hospitalization, 14 days per person/2 yeas – compared to 117 days per person in classical treatment
- Neuroleptics used in 33% of patients – compared to 100%
- Relapses in 24% of patients – compared to 71%
- Return to full-time job – 81% of patients – compared to 43%
It is very unusual, that conference is a place of sharing ideas for both researchers, practitioners and local authorities and beneficients of menal health care system. The event in Wieliczka provided many different perspectives united in the common need of change. Support and endorsement to the idea of Open Dialogue of local authorities and a declaration of providing trial projects in Wieliczka and Trzebnica districts are strong arguments for the central government to support long-range plans of modernization of the system.
Invited guests emphasised the neccessity of trainings and courses for staff members both in hospitals and the institutions in the field of social service. Inspiration for such practises comes from Finland, where the level of education among the personel in hospitals adopting ODA is the highest in Europe. Another challenge for polish psychiatry is a need to improve systems of information which are essential in monitoring and verifying the effecicacy of treatment. These points, as well as most of postulates fostered in Finnish model of psychiatry, go in line with the main goals of National Programme of the Mental Health Care.
The most important points of the conference were stories, opinions and needs expressed clearly by the beneficients of polish mental health care system. Most of them had common core: the need of better cooperation between institutions, common avability of variety of forms comunity services, emphasis on social reintegration and a prevention against stigmatization.
Polish practitioners from Wroclaw convinced the audience that implementing ODA to the hospital is not a difficult task. They emphasised, that benefits which offer ODA – for example better cooperation and atmosphere among the staff members, hope for more effective treatment for the patients with psychosis, better commitment of the family – are beyond the contribution to the training proccess. Any fundamental reorganization in functioning of the ward wasn’t necessary. Futhermore, applying already described and tried practice pushed the ward a step closer to the ideal model portrayed in National Programme of Mental Health Care.
Nowadays, profound part of the experts from around the world and Europe is consentaneous that classical, mainly pharmacological models of treatment are insufficient. Today, the eyes of all leading psychiatry centres are aimed at Finland, Tornio and the team of prof. Jaakko Seikkula. In their experiences lie the slutions of the main and most severe problems of psychiatry. In Wieliczka there was a chance to discuss these solutions and draw on inspiration from the roots.
The conference was followed by the one day workshop (28.11.2014) which was quided by prof Jaakko Seikkula, prof Bogdan de Barbaro and dr Werner Schuetze.