By Daniel Mackler

In the far north of Finland, a stone's throw from the Arctic Circle, a group of innovative family therapists converted the area's traditional mental health system, which once boasted some of Europe's poorest outcomes for schizophrenia, into one that now gets the best statistical results in the world for first-break psychosis. They call their approach Open Dialogue. Their principles, though radical in this day and age of multi-drug cocktails and involuntary hospitalizations, are surprisingly simple. They meet clients in crisis immediately and often daily until the crises are resolved. They avoid hospitalization and its consequential stigma, preferring to meet in the homes of those seeking their services. And, perhaps most controversially, they avoid the use of anti-psychotic medication wherever possible. They also work in groups, because they view psychosis as a problem involving relationships. They include in the treatment process the families and social networks of those seeking their help, and their clinicians work in teams, not as isolated, sole practitioners. Additionally, their whole approach values of the voice of everyone in the process, most especially the person directly in crisis. And finally, they provide their services, which operate within the context of Finnish socialized medicine, for free. Open Dialogue weaves together interviews with psychiatrists, psychologists, nurses, and journalists to create both a powerful vision of medication-free recovery and a hard-hitting critique of traditional psychiatry.