The widely-criticised serenity integrated model, in which a police officer is part of a team responding to emergency mental health call-outs, is likely to be dropped
“Unless and until the full policy is freely available to service users and the public, service users are not equipped to protect themselves against the dangers of SIM and similar approaches. We hope that mental health trusts, commissioners and individual professionals will engage productively with the policy once it is available in its entirety.” StopSIM coalition
A draft document from NHS England recommends that mental health trusts stop including input from police officers in a widely-used care model.
The serenity integrated mentoring (SIM) care model is designed to support mental health patients who frequently present in crisis to emergency services. It involves placing a police officer within a health care team, so that when a patient experiences a crisis, the police officer is part of the team attending the patient.
The model, which was developed by Paul Jennings, formerly of Hampshire Police, has proved controversial, however. Campaigners believe that it criminalises people experiencing mental distress, and that the role of police officers goes beyond crisis support into planning ongoing mental health care. Pressure to investigate SIM, which has been used by 23 NHS trusts in England, has come from both patient groups and clinicians.
The campaign group STOPSIM has expressed concern that the model can lead to withholding healthcare from people, breaching human rights legislation; that having police involved in health care decisions is coercive and criminalises mental health crises; and that the programme has not had a robust and clinically-led evaluation. In 2021, Tim Kendall, NHS England’s national clinical director for mental health, wrote to mental health trusts asking them to review their use of the model.
NHSE’s draft document, which is not final, states that the SIM model should not be used. It also states that there should no longer be police involvement in the delivery of therapeutic interventions in planned community health care; that there should be no use of coercion or sanctions, or withholding of care; and that there should be no discriminatory practices used against patients who express self-harm behaviours or suicidality or against those regarded as “high-intensity” users.
The document suggests that Kendall will seek assurance from trust medical directors that they are adhering to these recommendations. NHSE is expected to publish a full statement on the SIM model in the spring.
The StopSIM coalition has been involved in drawing up the final policy for NHS. It told HSJ: “Unless and until the full policy is freely available to service users and the public, service users are not equipped to protect themselves against the dangers of SIM and similar approaches. We hope that mental health trusts, commissioners and individual professionals will engage productively with the policy once it is available in its entirety.”
This story about NHS England’s decision to end police involvement the care of people experiencing mental health crises follows an announcement last week by Bedfordshire Police that they would bill the NHS for hours spent by police officers in attending mental health callouts. Such callouts can take between a fifth and a third of police time and it is clear that both the police and NHS England no longer feel that this level of police involvement is appropriate. It is time for the NHS to rethink how it responds to emergency mental health callouts in a way that is sensitive to the needs of patients in acute mental health distress.