2013 June Lancaster Award UWE Health and Life Sciences

Rowan’s experience in Finland

On November 6th, Rowan Llewellyn-Williams presented a report on his experience with his Gane Trust Travel Scholarship to fellow students at the University of the West of England, and Gane Trustees, Cleo Witt and Peter Metcalfe:

“In 2013  I spent 25 days with a community-based mental health team in Finland based at Keropudas hospital, at Tornio in Western Lapland.   I worked within the outpatient treatment team and for a day on the adult inpatient unit, and spent a few days with the child and adolescent team based at nearby Kemi.

My interest was in the contemporary treatment of psychosis, particularly the use of psycho-social approaches:  Finnish Western Lapland has produced remarkable results through its Open Dialogue. This is a flexible and adaptive approach, focusing on the social and psychotherapeutic milieu rather than pharmacology alone.   It places a network of people around the client, and postpones prescribing psychiatric medication so that patients are still able to communicate about their mental situation.  It emphasizes the importance of engaging an individual’s family and social network and has been found to improve outcomes for acute psychosis.

I knew very little of the language, which early on restricted me from taking a full part in the treatment meetings, though I later came to realise that I could still participate actively, by focusing on the non-verbal part of the activity, observing and listening, and gradually learning key words and phrases.  I learnt how Open Dialogue allowed the client to guide the course of the discussion with the therapist contributing or asking for more information when necessary:  rarely did I hear an extensive preliminary discussion among the practitioners as would have been the case in England.

Some principles of Open Dialogue are already used by many UK practitioners in their work, such as striving to maintain a curious attitude to people’s lives rather than being an overly prescriptive professional. I have learned much from working with nurses who actively listen to people who are in their care, acknowledging that the person is the expert in their own experience. My trip to Finland showed me how this egalitarian approach to working as equals could be encouraged. In the Finnish language, the practice of supporting families through a mental health crisis can be called “walking together”. This phrase nicely conveys that they seek to work at the pace of the person who is most in need, adapting to developments as they occur.