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Draft NHSE plans seek to ‘eradicate’ police role in SIM care model


A draft NHSE statement suggests mental trusts could be asked to eradicate features of the ‘serenity integrated mentoring’ (SIM) care model from clinical practice, following a whirlwind of concerns in 2021 and an investigation by national clinical director Tim Kendall.

A core feature of SIM is to place a police officer within a healthcare team charged with supporting patients who frequently attend emergency services in crisis, and creating crisis plans.

The draft position statement produced by NHSE, which the regulator said is not its final version and is subject to changes, says SIM should not be used.

It also proposes the eradication of the following practices from any equivalent care model:

  • Police involvement in delivery of therapeutic interventions in planned, non-emergency, community mental healthcare;
  • The use of coercion, sanctions (criminal or otherwise), withholding care and otherwise punitive approaches; and
  • Discriminatory practices and attitudes towards patients who express self-harm behaviours, suicidality and/or those who are deemed “high intensity users”.

The statement, which is the first indication of NHSE’s position on the SIM model but not its final stance, also suggests Professor Kendall will be seeking assurance from trust medical directors that SIM or similar models, and the above three features of concern, are no longer used. A full policy and public statement on the model is expected by the spring.

The StopSIM coalition, whose campaigning prompted the NHSE review, said: “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".

Further reading on the hub:

The High Intensity Network (HIN) approach and SIM model for mental health care and 'high intensity users' – views and discussion

StopSIM: Mental health is not a crime


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This is mostly good news for patients & users of services. I believe that the urgent need for this change is an example of what happens when care services are driven by managerialism. By that I mean the unrelenting drive to fit everything into boxes and set up 'one size fits all services', often without any meaningful & thorough consultation with users of services. There are as many approaches to care for people with mental health problems and mental illness as there are people. Discrimination, sanctions, and punitive measures have no place.

I do have concerns about the eradication of 'Police involvement in delivery of therapeutic interventions in planned, non-emergency, community mental healthcare'. This seems an unfair and unnecessary provision, driven by 'managerialism and the need to' box everything off.'

As a mental health nurse, it's my experience that police support can be extremely helpful for patients/users of services in many situations, especially in early intervention, e.g., preventing escalation and in tackling discrimination and harassment of people with mental illness. This is backed up by the views of the people (users of services) I have worked with. To stop this is unfair to those police officers who are skilled at helping people in crisis and in preventing problems before the arise. I'd be interested in the views of users of services and the police on this. 

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Edited by Steve Turner
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