Healing Happens in Relationships
An Open Letter to the Prime Minister – Andy Burnham
Dear Prime Minister,
There are moments in life that change the way you understand the world.
For my family, one of those moments came when someone finally stopped trying to fix us and started listening to us.
Ten years ago, we were an ordinary family. We had no experience of serious mental ill health and never imagined that we would spend years navigating mental health services, repeated hospital admissions and the heartache of watching our eldest daughter continue to struggle with an eating disorder.
Like many families, when my daughter became seriously ill, we encountered dedicated and compassionate professionals who cared deeply. Yet despite their commitment, we often found ourselves moving between services, rebuilding relationships and retelling our story. Every transition meant starting again. Every new team meant rebuilding trust.
Over time, I came to understand something that I wish I had known at the beginning: mental distress is never experienced by one person alone. It ripples through families, relationships and communities. We all carry it.
Years later, our family was introduced to Open Dialogue.
It did not offer a miracle cure. Instead, it offered something we had been searching for all along: continuity, trust and the opportunity to make sense of our experiences together.
For the first time in years, my daughter told me that she truly felt listened to.
For the first time, I felt heard too.
That experience changed not only how I understood my family’s journey, but what I believe is possible for the future of mental health care.
Two years ago, I co-founded Open Dialogue in Schools and Communities (ODiSC), an international network of people with lived experience, clinicians, researchers and service leaders working together to sustain and develop Open Dialogue across education and community settings. I also serve as Chair of the Mental Health – Time for Action Foundation, where I continue to advocate for mental health care that is compassionate, relational and genuinely person-centred.
Alongside supporting implementation within mental health services, we are exploring how the principles of Open Dialogue can be embedded in schools and communities, building on pioneering work already underway in Australia and elsewhere.
Our ambition is to create environments where young people, families and professionals can come together in dialogue early – fostering connection, understanding and support before difficulties escalate into crisis.
That work feels particularly important now.
The publication of the ODDESSI study in The Lancet marks an important milestone in the UK’s exploration of Open Dialogue. It represents years of collaboration between researchers, NHS services, clinicians, people with lived experience and families seeking to understand what a relational, network-based approach to mental health care can offer.
The findings are encouraging.
They suggest that people receiving Open Dialogue were significantly less likely to experience hospital admission and crisis-service referral, while reporting improvements in patient-defined recovery, quality of life and their experience of care compared with standard care.
For those of us who have lived this reality, these findings are more than statistics.
They speak to a possibility we have experienced ourselves.
And they invite us to ask a much bigger question:
What kind of mental health system do we want to build?
My family’s experience has taught me that continuity matters.
Families matter.
Being listened to matters.
And the quality of the relationships between professionals, individuals and those who love them matters every bit as much as the treatments we provide.
Mental health care should be organised around relationships, not simply around episodes of care.
That means asking different questions.
How do we create services that people can trust?
How do we ensure families are partners rather than bystanders?
How do we build continuity into systems that too often feel fragmented?
How do we create space for genuine dialogue when people are at their most vulnerable?
And how do we listen to young people themselves about the kind of care they want and need?
These are not simply questions for clinicians or researchers. They are questions about the kind of society we want to be.
Prime Minister, you have spent much of your public life arguing for public services that are closer to people and more responsive to the communities they serve. Now, from your position at the heart of government, you have an opportunity to help bring that principle into mental health care.
Open Dialogue offers a way forward to achieve this.
It is not simply another intervention to add to an already complex system. It is a different way of being with people – walking alongside them, working with as opposed to doing to.
It places relationships, continuity, dialogue and shared decision-making at the heart of care, creating the conditions in which healing can take place. I strongly believe that being heard is the first and most crucial step towards healing, and healing happens in relationships.
I invite you to meet with myself and my daughters and hear for yourself the power and beauty of the Open Dialogue approach.
They know what it is like to be young and struggling with mental distress, to be labelled as a NEET, hopeless and fearful in a fragmented system not designed to offer the kindness and support needed. They can tell you what it feels like when people sit together, listen to one another, stay alongside you and make space for your voice and the voices of the people who love you.
My youngest daughter can tell you. After six months of Open Dialogue, she went from being out of work, isolated and depressed to beginning university and, at last, truly thriving. Her remarkable experience was also featured in the Financial Times in its article, “‘Friends and family’ therapy offers new approach to mental health in UK.” Read her story in the Financial Times and The Observer.
They can tell you what it meant to be listened to rather than simply assessed.
They can tell you what it meant for their family to be included rather than standing outside the system, trying desperately to understand what was happening.
And they can tell you what difference relationships, continuity and genuine dialogue made.
After everything my family has experienced, I have come to believe that the future of mental health care will not be shaped by evidence alone, important though evidence is.
It will also be shaped by the values we choose to build our services around.
If we choose continuity over fragmentation, relationships over transactions, and dialogue over distance, then perhaps families like mine will find hope much sooner than we did.
Prime Minister, you now have an opportunity to help lead that change across our mental health services and what a better place to start than meeting with my family members who have lived and living experience of the system as it is and as it could be if we placed relationships humanity and genuine dialogue at its heart.
Because sometimes the most powerful thing we can offer another human being is not an answer.
It is the experience of being truly heard.
Yours sincerely,
Rachel Bannister
Parent and lived experience advocate
Chair Mental Health – Time for Action Foundation,
Co-founder ODiSC
Mental Health - Time for Action Foundation 