As we hurtle through February, and the Christmas break becomes a fading distant memory, this is the time of the year when I do a little bit of looking back – and lots of looking forward.  In a world that is throwing so many challenges, threats and fears at us, it feels important to me to hang on to hope.

And at the start of 2026 I am seeing glimmers of hope.

Our continued work

I am so proud of the work that teams across Platfform do. In really challenging circumstances  people show up every day and give their best – whether that’s out in communities supporting people, in our central support teams making sure the organisational cogs are rolling, in training rooms and classrooms, or working alongside sector colleagues on big ambitious transformation programmes, the work that gets done always astounds me and it gives me hope.

New Mental Health and Wellbeing Strategy

Last year in Wales we have seen the launch of a new 10 year Mental Health and Wellbeing Strategy – its ambition to create an ‘open access’ mental health system here, so that everyone needing help gets to speak to someone on the day they need to, and gets at least some of the help they need – gives me hope. The national leadership that we are experiencing in Wales and the overwhelmingly positive response of people working across the mental health system gives me hope.

Open Dialogue

And the fact that an approach to supporting people experiencing crisis called Open Dialogue is being considered as part of what we offer in Wales – is giving me hope.

I think the world needs a little more dialogue right now – but before I get overexcited with the potential for Open Dialogue to be the solution for international peace – let’s just focus on the role it could play in transforming people’s experience of the mental health system.

I first heard about Open Dialogue eight or nine years ago through being part of Compassionate Mental Health gatherings. Thank you for that opportunity!

Open Dialogue originated in Finland as a response to people experiencing first episode psychosis and in very basic terms involves wrapping a circle of support – family, friends and professionals around a person experiencing crisis, listening deeply to everyone – as equals and working together with the person at the centre, in moving forward. It requires ‘the experts’ to step out of the expert role and see themselves and their contribution as no more or less helpful and valuable than the person in crisis, their family and their friends. And options for moving forward are agreed together.  The conversation essentially becomes a treatment. The trial had amazing results https://www.hopendialogue.net/the-project/

It sounds so obvious when you hear about it, and it is. It’s sounds so simple, but it’s not. Our current hierarchical, expert driven mental health systems are all too often the antithesis of this approach. Moving the system that we have now towards an Open Dialogue approach is a massive shift.

The ODDESSI trial

When I was first learning about Open Dialogue, a big NHS England trial was beginning, the ODDESSI trial. Whilst there are pockets within our NHS that are working hard to establish Open Dialogue, not least in Wales in ABUHB and C&VUHB, ODDESSI is the largest and most robust clinical trial in the UK.  The results are imminent, and whilst we don’t know what they are yet, there has been quite a bit of interest and coverage in both trade and general media which makes me think there is some positive news coming. Another reason to hold onto hope.

If the evaluation confirms that Open Dialogue approach is successful, then the results come at a great time for Wales as the NHS works hard to transform to an ‘open access’, person-led, trauma informed system in which Open Dialogue fits perfectly.  And for Platfform the results, I hope, will further strengthen our calls for evidence-based system change and redesign.

Support that is easy to access, compassionate and close to home

Over the past few years, we’ve developed multiple projects in the community that seek to do this. Platfform’s Cwtch Project in Swansea delivered in partnership with Neath Port Talbot Council has tested a new approach for wider service-redesign across the Health Board and highlighted the importance of flexible, community-based, open access support which dealt with challenges of depression and addiction together.

Our young people’s Hangout model is now operating from two bases in Cardiff and Barry, funded by Cardiff and Vale Health Board, with a similar model operating in Swansea Bay funded via the Welsh Government Sustainable Social Services Grant. Young people can come along without referral to access connection, support and boost their wellbeing. These ‘Hangouts’ have been designed by children and young people with clinical oversight and support.  They offer a real alternative to those in distress or at risk of it, in a therapeutic but not pathological way. We have seen reductions in waiting lists for Children and Adolescent Mental Health Services (CAMHS) support as a result and we have been able to work with young people on CAMHS waiting lists to avoid escalation and crisis.

Platfform also delivers services that act as a therapeutic alternative to hospital, including the Seibiant Sanctuary. It’s a calm and quiet place where you can talk to our team about what’s happening. You can stop, breathe, and start to think about next steps. These are open when other services are closed, and being based in the community and open access, we know makes a real difference to people’s lives, outcomes as well as the wider challenges the NHS is facing.

Now, let’s make it happen!

We’ve learnt so much from these services in recent years and how they align with a more Open Access approach. As well as awaiting the findings from the ODDESSI pilot, we look forward to sharing our own insights to help transform the NHS and mental health services.

2026 could well be a year of change in Wales, and we hope it can be the year we look back on in the future, when real change in delivering better mental health services started.

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