Open Futures Network

IntroductionOpen Futures Logo

Western Lapland in Finland have converted their traditional mental health service from one that had very poor outcomes for people with a diagnosis of schizophrenia to one which gets the best in the Western World for first episode psychosis. The Open Dialogue Approach is now the psychiatric system in Western Lapland, Finland. The Open Dialogue Approach has a strong evidence base having been researched widely (Lehtinen, 2000), (Seikkula, 2006), (Aaltonen, J. et al, 2011) and (Seikkula, J. et al, 2011) . These studies have shown amazingly good long-term outcomes for patients who experience psychotic symptoms with over eighty percent of first-episode psychotic patients in Western Lapland either employed or back at school at the end of study periods of 2 or 5 years. Also only about one third of the patients are ever treated with antipsychotic medications and only 20% take antipsychotic medications on a continual basis.

The Open Futures Network is a local Nottingham initiative, which seeks to promote mental health, resilience and wellbeing through exploring the Open Dialogue Approach in the field of mental health and also wider society. Open Dialogue offers huge potential for improvements in service development and delivery and for more humane and compassionate relationships in society at large.


This newly formed network brings together service-user and carer led groups, health care professionals, academics, community artists and activists within collaborative and dynamic partnerships, which themselves model the Open Dialogue principles and approach. The aims of the network are as follows:

  • Manage power- share leadership, promote equity and learn new roles.
  • Manage and celebrate difference- cultural/ religious/ family differences.
  • Manage polyphony- work with different voices- explore tensions/ benefits.
  • Manage uncertainty- examine risks v opportunity. Compare diagnostic v divergent pathways.
  • Manage dialogue- create spaces for mutual dialogue to take place. Celebrate storytelling – hearing and listening. Develop physical and psychological spaces for dialogue.


The network is service user led, bringing together local groups and local services, artists, activists, healthcare professionals and academics within collaborative and dynamic partnerships for well-being.

Open Futures illustration

Membership remains open.


Network Leads:
Caroline Fox, caroline[at]makingwaves[dot]org
Julie Gosling, julie[at]makingwaves[dot]org

Clinical Lead:
Steven Coles, steven[dot]coles[at]nhs[dot]net


Lehtinen, V. (2000): Two-Year Outcome in First Episode Psychosis Treated According to an Integrated Model. Is Immediate Neuroleptisation Always Needed? European Psychiatry 15, 312-320.

Seikkula, J. (2006): Five-Year Experience of First-Episode Nonaffective Psychosis in Open-Dialogue Approach. Psychotherapy Research 16, 214-228.

Aaltonen, J., Seikkula, J., Alakare, B. (2011): The Comprehensive Open-Dialogue Approach in Western Lapland: I. The incidence of non-affective psychosis and prodromal states, Psychosis: Psychological, Social and Integrative Approaches, 3:3, 179-191.

Seikkula, J., Alakare, B., Aaltonen, J. (2011): The Comprehensive Open-Dialogue Approach in Western Lapland: II. Long-term stability of acute psychosis outcomes in advanced community care, Psychosis: Psychological, Social and Integrative Approaches, 3:3, 192-204.