Open Dialogue approach – a carer’s perspective on why it could be transformative

Maggie Clark writes about the experiences of her and her daughter with navigating mental health services in Scotland.

I feel my daughter, Emma, would be in a very different place now, had the Open Dialogue Approach been available to her when she first accessed mental health services four years ago, as a 15 year old.

In those four years she has had 11 different psychiatrists. All with differing views but all agreeing medication and continually changing medication was the way forward. Only one of them didn’t think it needed to be long term and really engaged with both of us.  All of them had differing views on the benefit of psychology.  We had one family therapy session but that didn’t seem to achieve anything and wasn’t followed up.

Don’t get me started on trying to pigeon hole not just Emma but us, as a family.

Emma just wanted to get better but the system often meant the time to work with her with the right support at the right time was missed on lots of occasions by all the team. The system is broken and not coping.

As a mum and carer it can be hard to fight her corner at times, what do I know? I’m sure that’s what they think, they are “the experts”. Well, no they are not, we are the experts, so they need to listen more to us, and more importantly, they should listen to Emma! Really listen to what she is telling them, about her her condition impacts on her life! Her relationships! Her family! Feel her pain! Feel our pain and help us as we try to support her in every possible way.

Transition didn’t go well either.  Emma was left in a void for weeks despite just having been discharged from hospital. By the time she was seen she was in crisis again and needed admission.

This continual crisis cycle over the past  four  years is heart breaking and for Emma it makes her feel that no one can help her. There is a real lack of crisis support, often it was just me.

As carers, we are not given any training on how we could help to support our loved one in a crisis. All I can do is give her sedation to let both of us get some  rest. It’s what I have  to do.

Where is the prevention and support?  Oh and no shared records so continually telling her story its no wonder she finds it hard to engage now. Dealing with mental health services can often feel like an uphill battle and sometimes like being on a merry go round!

There are real stars out there, one community psychiatric nurse (adult), a psychologist and a psychiatrist (CAMHS) but they are few and far between.  Most of the staff try their best in a model that is all about the service rather than the person, carers or family. It’s the wrong way round!

To me the Open Dialogue approach with its better support, accessible, person centred, family and asset based approach should be the norm and not something that is aspired to. It’s a no brainer!

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