Dr Chris Salway
Chris Salway is a Consultant Psychiatrist, and visiting psychiatrist at a residential drug and alcohol rehabilitation unit. He is currently undertaking NHS Peer Open Dialogue training to help develop a Peer Open Dialogue project in South Somerset.
Former GP, Chris Salway, became a psychiatrist in 2000, and has been working for Somerset Partnership NHS Foundation trust for 16 years. For the past seven years he’s worked as a consultant general adult psychiatrist. He’s also the visiting psychiatrist at a residential drug and alcohol rehabilitation unit in Weston-Super-Mare.
He says: “The history of psychiatry is one of understanding and treating mental health problems from a perspective exploring social, psychological and biological factors. In recent decades biological psychiatry has come to the dominance.
I had bought in to this biological approach and in my daily psychiatric NHS practice I was becoming cynical and depressed.
Since being exposed to ideas of the Open Dialogue, which in many ways are not new ideas, it has re-awakened my passion for my going in to psychiatry in the first place.
I am currently doing the NHS Peer Open Dialogue training and hoping to help develop a Peer Open Dialogue project in South Somerset, within my current consultant post with Somerset Partnership NHS foundation trust.”
About Open Dialogue
The Open Dialogue approach is both a philosophical/theoretical approach to people experiencing a mental health crisis and their families/networks, and a system of care, developed in Western Lapland in Finland over the last 25-30 years.
In the 1980s psychiatric services in Western Lapland were in a poor state, in fact they had one of the worst incidences of the diagnosis of schizophrenia’ in Europe. Now they have the best documented outcomes in the Western World. For example, around 75% of those experiencing psychosis have returned to work or study within 2 years and only around 20% are still taking antipsychotic medication at 2 year follow-up.
Remarkably, Open Dialogue is not an alternative to standard psychiatric services, it is the psychiatric service in Western Lapland. This has afforded a unique opportunity to develop a comprehensive approach with well-integrated inpatient and outpatient services. Working with families and social networks, as much as possible in their own homes, Open Dialogue teams work to help those involved in a crisis situation to be together and to engage in dialogue.
It has been their experience that if the family/team can bear the extreme emotion in a crisis situation, and tolerate the uncertainty, in time shared meaning usually emerges and healing/recovery is possible. Open Dialogue has drawn on a number of theoretical models, including systemic family therapy, dialogical theory and social constructionism.
The North East London NHS Foundation Trust (NELFT) is leading on a national multi-centre Open Dialogue pilot that seeks to transform the model of health care provided to patients with major mental health problems in the UK. Tom Stockmann, Chris Salway and Joanne Tudball are involved with the project to look at the pioneering potential of Open Dialogue .