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Serenity Integrated Mentoring (SIM) is a new program being introduced in London aimed at improving coping mechanisms and reducing emergency service use in High Intensity Service Users (HISUs). In this feasibility study, Anokhina et al. an evaluation of SIM effectiveness was assessed using demographic data. Three SIM boroughs (Greenwich, Camden and Islington) were compared with a non-SIM borough (Enfield) on emergency service use and costs in the 12 months prior to SIM and 9 months after. Qualitative interviews were conducted with SIM practitioners and service users. They found hat service users did attend A&E less, and were being arrested less, but this was true for both SIM and non-SIM participants. The economic analysis also showed that, at this stage, we cannot see any cost savings to service use yet. These results are something we expected because of the small scale of the study. However, we found that the quality of the data that is recorded by emergency services would allow us to carry out a full-scale study which would give us clearer answers

StopSIM is a coalition of mental health service users and allies who have grave concerns about the rapid, widespread rollout of the High Intensity Network’s ‘Serenity Integrated Mentoring’ (SIM) intervention across NHS England. The intervention is designed for people who have not committed a crime, but are in contact with mental health services, are frequently at high risk of suicide and self harm and are deemed “high intensity users” of emergency services. Key intervention components include a co-ordinated withholding of potentially life saving treatment by multiple agencies (A&E, mental health, ambulance and police services) and, using SIM’s own words, the “coercive” approach of a police officer as an interventionist.  

For some time now I've been looking to find out more about mental health services in Trieste, Italy. Then I met Vincenzo Passante Spaccapietra, co-host of the Place of Safety? podcast series. This has enabled me to learn more about the closure of the mental institutions in Trieste, Italy, and the work of Franco Basaglia.  I was keen to find out what really took place, what this really means in practice and how we can adopt this model in the UK. We were delighted to have become involved and to have recorded a couple of podcasts. I recommend this resource to everyone interested in safe, compassionate, patient led mental health care.

The INQUEST handbook is a free and trusted guide for bereaved families and friends affected by a sudden death that involves an inquest, available in print and online.  It has been developed and shaped by the many families they work with, and helps prepare bereaved people for the inquest process in England and Wales.

Angie Middleton, Patient Safety Lead for Mental Health (London Region), presents on the Mental Health Suicide Report and discusses London's incident reporting. She highlights that we need to understand whether the extent to which the increase in reported incidents is as a result of more consistent reporting, or an actual increase in actual incidents or as a result of an increase in the number of patients accessing secondary mental health services. She asks whether there is a way of collectively getting timely, consistent and accurate data for multiagency use, and how we can collectively reduce suicides by 10% by 2020/21.

Samantha Gould was 16 years old when she died by suicide due to an overdose of prescribed medication on 2 September 2018. She had borderline personality disorder that meant she was at risk of deliberate self-harm and suicide. In this report, the Coroner highlights concerns about a systemic weakness in the way in which Child and Adolescent Mental Health Services and primary care communicate with local pharmacies concerning 16-18 year old patients who are at risk of deliberate overdose. In spite of a safety plan agreed with Sam’s consultant psychiatrist whereby Sam’s parents would be responsible for her medication, Sam was able to pick up older prescriptions on 1 September 2018 without challenge, and it was those medications that were fatal in the combined amounts ingested by Sam.