The Comprehensive Open-Dialogue Approach in Western Lapland: I. The incidence of non-affective psychosis and prodromal states

Jukka Aaltonen, Jaakko Seikkula and Klaus Lehtinen

Psychosis, 2011, vol. 3, issue 3, 179-191

Abstract: Mental health services in a health district in Finland with a population of 72,000 were developed into a comprehensive family- and network-centered entity by giving all the psychiatric personnel training in family therapy or psychodynamic individual therapy, and by arranging a system in which all psychiatric crises were treated in a family- and network-centered manner by multidisciplinary crisis teams, mostly in the patient’s home. The system is a modification of the Need-Adapted Approach called the Open-Dialogue Approach (ODA). The changes in the incidence of first-contact non-affective psychoses and prodromal states were studied in two cities of the District, considering the five-year periods before and after the system was fully established. The mean annual incidence of schizophrenia decreased, brief psychotic reactions increased, and the incidence of schizophreniform psychoses and prodromal states did not change. The number of new long-stay schizophrenic hospital patients fell to zero. It can be argued that the ODA has been helpful, at least in moving the commencement of treatment in a less chronic direction. It may have even increased social capital in the entire psychiatric catchment area, and promote mutual trust between the general population and the psychiatric services. Mental health services in a health district in Finland with a population of 72,000 were developed into a comprehensive family- and network-centered entity by giving all the psychiatric personnel training in family therapy or psychodynamic individual therapy, and by arranging a system in which all psychiatric crises were treated in a family- and network-centered manner by multidisciplinary crisis teams, mostly in the patient’s home. The system is a modification of the Need-Adapted Approach called the Open-Dialogue Approach (ODA). The changes in the incidence of first-contact non-affective psychoses and prodromal states were studied in two cities of the District, considering the five-year periods before and after the system was fully established. The mean annual incidence of schizophrenia decreased, brief psychotic reactions increased, and the incidence of schizophreniform psychoses and prodromal states did not change. The number of new long-stay schizophrenic hospital patients fell to zero. It can be argued that the ODA has been helpful, at least in moving the commencement of treatment in a less chronic direction. It may have even increased social capital in the entire psychiatric catchment area, and promote mutual trust between the general population and the psychiatric services.

Date: 2011
References: Add references at CitEc
Citations: View citations in EconPapers (3)

Downloads: (external link)
http://hdl.handle.net/10.1080/17522439.2011.601750 (text/html)
Access to full text is restricted to subscribers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:taf:rpsyxx:v:3:y:2011:i:3:p:179-191

Ordering information: This journal article can be ordered from
http://www.tandfonline.com/pricing/journal/RPSY20

DOI: 10.1080/17522439.2011.601750

Access Statistics for this article

Psychosis is currently edited by Dr John Read

More articles in Psychosis from Taylor & Francis Journals
Bibliographic data for series maintained by Chris Longhurst ().