© 2016, © Emerald Group Publishing Limited.Purpose: The purpose of this paper is to stimulate discussion within mental health and psychiatric nursing as to how the open dialogue approach can contribute to their work. The paper is mainly theoretical, though relates to practical examples of open dialogue in mental health care research and practice to illustrate the actual potential in practice. Design/methodology/approach: First the authors raise issue with the narrow lens of psychiatric diagnosis and question its usefulness against a contemporary backdrop of personalised care and recovery orientated practice. Open dialogue as a way of being and as a process are explored as they relate to people interaction and contribute to therapeutic interaction, organisational and community development. The authors reflect on how open dialogue can be and is practiced in different ways and at different levels. Findings: The authors consider open dialogue as a suitable approach for working with people who have mental health and/or psychiatric problems. The approach is also recommended for working in larger circumstances as families and social network, on organisational and community levels in different ways. Open dialogue should be considered not as a method or technique but as a process of interaction which can be applied to different conditions and circumstances. Originality/value: Within mental health discourse open dialogue is increasingly evident and filtering into the broader discussion on increasing effectiveness of mental health interventions. Perfectly suited to mental health and psychiatric nursing as a way of being with service user, this reflection on open dialogue offers further thoughts on how as a process it has already filtered into nursing practice and how as nurses we can easily accommodate it within the therapeutic approach.