How can teams grow in development of “Open Dialogue’ as a response to crisis for people with psychiatric problems?

The care landscape in Flanders, specially within mental health care is very fragmented and the route to care is difficult for clients with for example psychotic experiences. The last years there is an increasing focus on socialization of care and community care. This means that there is an increased demand on the formal and especially the informal network of the client. Because of the fragmentation of mental health care their rises a risk or difficulty in the cooperation within the network of clients. As a result the informal network is still insufficiently listened to. There is a great risk that the focus of care is primarily on the client's clinical recovery and that strengths and other relevant factors in the network remain underexposed and are not timely addressed. It is the conviction of the researchers that Open Dialogue can be a possible answer to help highlight these strengths and other relevant factors in the network with as result a more recovery-oriented care. Open Dialogue is a system of mental health care, first developed in Finland, which has two essential ingredients: a therapeutic and philosophical approach to being with people in a time of crisis/need, and a way of organizing mental health services that maximizes the possibility of being able to respond to people in such a way and in a timely manner. It usually starts with arranging a ‘network meeting’ in the community. Within the 2-year research project (September 2021 – September 2023) researchers, in close cooperation with the field and clients, prepared and analyzed the steps for initial development of the "Open Dialogue" principles to the context of teams within mental health services. The participatory action research involves 3 outpatient and 2 residential teams within Mental Health services in the region of Limburg, Flanders. Six co-creation sessions have taken place in which the principles of "Open Dialogue" are worked on together with at least 2 ambassadors per team. Learning from each other was central. Through focus groups and interviews with the ambassadors information was collected. The research-goal was to identify supporting and impeding factors that lead to sustainable development of Open Dialogue in Flanders region using the Consolidated Framework of Implementation Research, CFIR. The results of the process are ready and can be reported. This includes insight in levers and obstacles that teams can encounter in the development of Open Dialogue. Outgoing the results and the description of context factors teams can look at their own context and can filter out steps that can be taken to improve their recovery-oriented care for their clients and their informal network. An additional result of the research is situated in the analysis of the context factors through using the Consolidated Framework of Implementation Research, CFIR. This framework showed not always easy in use to describe these specific contexts and this participatory research. Even the revised version proved to be a challenge in using within this research.