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Standing in Solidarity with the #stopSIM Coalition |
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A response from NHSE was recieved to this open letter on 13th May 2023
click here to read online or download the pdf. |
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An open letter to NHS England and all those involved in SIM and similar schemes
| stopSIM allies open letter pdf version |
Dear NHS England,
Re: A Professional challenge to NHS England - An open letter in solidarity with the #StopSIM Coalition
We have come together, as a group of mental health, social care and academic professionals, to write this open letter to express our concern, dissent and disappointment in relation to NHS England's response to Serenity Integrated Mentoring (SIM) and similar harmful approaches that are in common practice across our mental health crisis care systems.
We stand in solidarity with the #Stop SIM Coalition, and all who have had their mental distress criminalised both prior to, and throughout SIM, and call on NHS England to publish the joint Stop SIM policy that has been coproduced between NHSE and the Coalition, and which NHSE has now drawn back from in favour of an NHSE position on SIM and similar programmes.
The StopSIM coalition has provided time, investment, and commitment to working with NHSE over a 15-month period to develop policy and guidance that would support human rights and ensure that people who are in mental health crisis receive the treatment and support they both need and are entitled to. We believe that to discard this work in this way, with no discussion with those involved or affected by these inhumane practices, undermines the investment and trust that had been extended by both individuals and the coalition to the statutory organisations involved in these practices. Whilst the sentiment of the NHSE position statement is consistent with the aim to stop the implementation of SIM and related practice, we believe that the failure to publish the policy, without consulting or informing the Stop SIM Coalition as the key partner, has instead resulted in further disempowerment, disillusionment and ultimately harm to patient-provider working relationships and the representation and rights of those with lived experience of our mental health systems as a whole.
The collaboration that took place which led to a coproduced policy had the potential to be revolutionary in terms of its demonstration of true co-production with those who have lived, and living experience, of mental health services. However, the decision not to publish, and to fail to communicate with key partners in relation to the change in position, is, in our view, neither accountable nor acceptable.
Serenity Integrated Mentoring and similar schemes - sometimes described as HIN (High Intensity Network) or similar, include the involvement of police and the criminal justice system in the delivery of non-emergency mental health care and the use of criminal sanctions in response to acute mental distress. This approach is in direct conflict with development elsewhere in the sector and the requirements of both the Mental Health Act and Human Rights Act, and commitments made in the UN Convention on the rights of disabled persons.
The use of such tools as behavioural contracts which are used in these schemes, and in direct contradiction to NICE guidelines, include the threat of sanctions such as Criminal Behaviour Orders, arrest and imprisonment if they are not upheld. The Business Case for Commissioning SIM (UCL, 2019[i]) across NHS Trusts in England advocates sharing private medical records with police officers to develop “SIM Response Plans” that give health professionals “the confidence” to withhold clinical care from people under SIM who present to emergency services in crisis. Criminalisation of mental distress and withholding of medical care puts NHS Trusts in breach of both the Mental Health Act[ii] Code of Practice (para 22.2 People who are subject to criminal proceedings have the same rights as everyone else) and ultimately at risk of breaching positive obligations to uphold the human rights of those within their jurisdiction.
SIM materials, from conference presentations made public during the initial scrutiny in 2021, demonstrated derogatory attitudes from staff towards patients, such as comments that the scheme is helpful because staff no longer "dislike patients". Since the concerns were raised however, many of these documents and reports have been removed from the internet and are no longer available via their original sources. We believe this constitutes a lack of transparency by our public sector and call for organisations to apply their duty of candour in relation to whether these types of schemes are/have been in use in their areas and any potential harm that has arisen as a result.
It was through the commitment of the Stop SIM coalition that the nature of these schemes became public knowledge, with statements calling for inquiry into these practices subsequently made by mental health charities, and the major professional associations whose members are involved in delivering mental health services. The harm associated with the co-delivery of mental healthcare and policing was not initially identified by professionals involved, by the professional networks who incubated the first schemes, or by NHS England or the professional organisations who gave awards to the early schemes for ‘innovation’. This should cause us all to pause for thought about why those who were involved or aware of such schemes did not speak out.
On 10th March a letter from Tim Kendall, NHS England’s national clinical director for mental health, was released setting out NHSE’s position on SIM and similar schemes. We cannot disagree with the points raised in this letter, which clearly sets out elements of this model which need to be eliminated from practice and addresses the underpinning attitudes of professionals that at best lack compassion and at worst demonstrate active dislike of patients.
However, we were shocked to read responses from the Stop SIM Coalition, stating that the release of the letter was not approved by them. The Stop SIM Coalition had been promised that the joint policy they spent 15 months’ co-designing would be released to the public, so that patients were able to educate and protect themselves and to guarantee accountability if individual Trusts continue with SIM or SIM-like schemes.
The Stop SIM Coalition’s response can be read in full here.
We believe that it is essential that the NHS response to concerns relating to SIM and similar approaches, and to the decision not to publish the policy is transparent. This was recognised in the early statements from professional associations in response to the negative publicity about the schemes[iii]While the letter from Tim Kendall specifies that the SIM approach is not endorsed by NHSE, there is a long history of similar statements and directives being made without prompting change in systems and culture. NICE guidance on self-harm dating back to 2004 and 2011 indicates that patients must be treated with respect and dignity and that discriminatory responses are inappropriate. Despite this, in 2023, it remains necessary for NHS England to release a position statement informing employees that discriminatory practices and attitudes to patients who self-harm and/or are suicidal are unacceptable.
The Stop SIM Coalition’s work highlighting the way in which a narrow, poorly evidenced understanding of dependency and the impact of trauma has been used to stigmatise patients within these schemes has been invaluable. The response of NHSE is disappointing and will cause significant damage, with some lived experience campaigners saying they are no longer able or willing to participate in involvement work.
While NHS England and some NHS Trusts have publicly distanced themselves from SIM and similar models, the signatories to this letter are aware of continued use of criminal sanctions and oppressive attitudes towards people in crisis seeking help from emergency and mental health services, as evidenced by both anecdotal and review evidence (e.g. safeguarding adults reviews, DHRs, NCISH, Coroner findings etc.).
Without a robust policy in place and public accountability, crucial system change will be impossible. We understand that the CQC requires policy documentation in order to consider the recommendations within Tim Kendall’s letter during its inspections.
In summary, we are asking that:
We ask that other academics, professionals and students who may read this letter support service users by writing to their local Trust to seek assurance about how these practices will be phased out.
The signatories to this letter are listed below, and unless an organisation is also listed each signatory has provided their own view rather than that of their organisation.
We await your response.
Yours Sincerely
Re: A Professional challenge to NHS England - An open letter in solidarity with the #StopSIM Coalition
We have come together, as a group of mental health, social care and academic professionals, to write this open letter to express our concern, dissent and disappointment in relation to NHS England's response to Serenity Integrated Mentoring (SIM) and similar harmful approaches that are in common practice across our mental health crisis care systems.
We stand in solidarity with the #Stop SIM Coalition, and all who have had their mental distress criminalised both prior to, and throughout SIM, and call on NHS England to publish the joint Stop SIM policy that has been coproduced between NHSE and the Coalition, and which NHSE has now drawn back from in favour of an NHSE position on SIM and similar programmes.
The StopSIM coalition has provided time, investment, and commitment to working with NHSE over a 15-month period to develop policy and guidance that would support human rights and ensure that people who are in mental health crisis receive the treatment and support they both need and are entitled to. We believe that to discard this work in this way, with no discussion with those involved or affected by these inhumane practices, undermines the investment and trust that had been extended by both individuals and the coalition to the statutory organisations involved in these practices. Whilst the sentiment of the NHSE position statement is consistent with the aim to stop the implementation of SIM and related practice, we believe that the failure to publish the policy, without consulting or informing the Stop SIM Coalition as the key partner, has instead resulted in further disempowerment, disillusionment and ultimately harm to patient-provider working relationships and the representation and rights of those with lived experience of our mental health systems as a whole.
The collaboration that took place which led to a coproduced policy had the potential to be revolutionary in terms of its demonstration of true co-production with those who have lived, and living experience, of mental health services. However, the decision not to publish, and to fail to communicate with key partners in relation to the change in position, is, in our view, neither accountable nor acceptable.
Serenity Integrated Mentoring and similar schemes - sometimes described as HIN (High Intensity Network) or similar, include the involvement of police and the criminal justice system in the delivery of non-emergency mental health care and the use of criminal sanctions in response to acute mental distress. This approach is in direct conflict with development elsewhere in the sector and the requirements of both the Mental Health Act and Human Rights Act, and commitments made in the UN Convention on the rights of disabled persons.
The use of such tools as behavioural contracts which are used in these schemes, and in direct contradiction to NICE guidelines, include the threat of sanctions such as Criminal Behaviour Orders, arrest and imprisonment if they are not upheld. The Business Case for Commissioning SIM (UCL, 2019[i]) across NHS Trusts in England advocates sharing private medical records with police officers to develop “SIM Response Plans” that give health professionals “the confidence” to withhold clinical care from people under SIM who present to emergency services in crisis. Criminalisation of mental distress and withholding of medical care puts NHS Trusts in breach of both the Mental Health Act[ii] Code of Practice (para 22.2 People who are subject to criminal proceedings have the same rights as everyone else) and ultimately at risk of breaching positive obligations to uphold the human rights of those within their jurisdiction.
SIM materials, from conference presentations made public during the initial scrutiny in 2021, demonstrated derogatory attitudes from staff towards patients, such as comments that the scheme is helpful because staff no longer "dislike patients". Since the concerns were raised however, many of these documents and reports have been removed from the internet and are no longer available via their original sources. We believe this constitutes a lack of transparency by our public sector and call for organisations to apply their duty of candour in relation to whether these types of schemes are/have been in use in their areas and any potential harm that has arisen as a result.
It was through the commitment of the Stop SIM coalition that the nature of these schemes became public knowledge, with statements calling for inquiry into these practices subsequently made by mental health charities, and the major professional associations whose members are involved in delivering mental health services. The harm associated with the co-delivery of mental healthcare and policing was not initially identified by professionals involved, by the professional networks who incubated the first schemes, or by NHS England or the professional organisations who gave awards to the early schemes for ‘innovation’. This should cause us all to pause for thought about why those who were involved or aware of such schemes did not speak out.
On 10th March a letter from Tim Kendall, NHS England’s national clinical director for mental health, was released setting out NHSE’s position on SIM and similar schemes. We cannot disagree with the points raised in this letter, which clearly sets out elements of this model which need to be eliminated from practice and addresses the underpinning attitudes of professionals that at best lack compassion and at worst demonstrate active dislike of patients.
However, we were shocked to read responses from the Stop SIM Coalition, stating that the release of the letter was not approved by them. The Stop SIM Coalition had been promised that the joint policy they spent 15 months’ co-designing would be released to the public, so that patients were able to educate and protect themselves and to guarantee accountability if individual Trusts continue with SIM or SIM-like schemes.
The Stop SIM Coalition’s response can be read in full here.
We believe that it is essential that the NHS response to concerns relating to SIM and similar approaches, and to the decision not to publish the policy is transparent. This was recognised in the early statements from professional associations in response to the negative publicity about the schemes[iii]While the letter from Tim Kendall specifies that the SIM approach is not endorsed by NHSE, there is a long history of similar statements and directives being made without prompting change in systems and culture. NICE guidance on self-harm dating back to 2004 and 2011 indicates that patients must be treated with respect and dignity and that discriminatory responses are inappropriate. Despite this, in 2023, it remains necessary for NHS England to release a position statement informing employees that discriminatory practices and attitudes to patients who self-harm and/or are suicidal are unacceptable.
The Stop SIM Coalition’s work highlighting the way in which a narrow, poorly evidenced understanding of dependency and the impact of trauma has been used to stigmatise patients within these schemes has been invaluable. The response of NHSE is disappointing and will cause significant damage, with some lived experience campaigners saying they are no longer able or willing to participate in involvement work.
While NHS England and some NHS Trusts have publicly distanced themselves from SIM and similar models, the signatories to this letter are aware of continued use of criminal sanctions and oppressive attitudes towards people in crisis seeking help from emergency and mental health services, as evidenced by both anecdotal and review evidence (e.g. safeguarding adults reviews, DHRs, NCISH, Coroner findings etc.).
Without a robust policy in place and public accountability, crucial system change will be impossible. We understand that the CQC requires policy documentation in order to consider the recommendations within Tim Kendall’s letter during its inspections.
In summary, we are asking that:
- NHSE demonstrates leadership and commitment to co-production by immediate publication of the joint policy.
- The framework for monitoring of the requirements on Trusts outlined in Tim Kendall’s letter is made transparent to the public, with information about how to raise concerns where such practices and schemes continue.
We ask that other academics, professionals and students who may read this letter support service users by writing to their local Trust to seek assurance about how these practices will be phased out.
The signatories to this letter are listed below, and unless an organisation is also listed each signatory has provided their own view rather than that of their organisation.
We await your response.
Yours Sincerely
Signatories:
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Fiona Daniels, Children's Social Worker.
Lizzie Furber, Principal Social Worker / AMHP. Daisy Long, Director, Former Social Worker, Visiting Fellow. Dr Charley Baker, Associate Professor of Mental Health. Christian Kerr, Lecturer, Independent Social Worker. Chloe Whittall, Director & Social Worker. Dr William Murcott, Senior Lecturer Mental Health Nursing. Dr Neil Scott Gordon, Psychotherapist. Lesley Dougan, Psychotherapist. Dr Sally Morgan, Clinical Psychologist. Kerry Daynes, Consultant Forensic Psychologist. Dr Anna Rebowska, Consultant Child & Adolescent Psychiatrist Elaine Brown, Social Worker / Mental Health Practitioner. Dr Claire Blackwell, Specialty Doctor in Gastroenterology. Claire Townsend, Social Worker, AMHP Kerry Sildatke, Trainee Clinical Psychologist. Dr Cate Bailey, Consultant Liaison Psychiatrist. Mel Ball, Head of Lived Experience Workforce. Andy Bell, Interim Chief Executive, Centre for Mental Health. Helen Pritchard, Social Worker. Sam Hartley, Clinical Psychologist. Dr Jill Hemmington, Senior Lecturer, AMHP Course Lead, AMHP, University of Central Lancashire. Hel Spandler, Professor of Mental Health. Chris Young, Lived Experience National Advisor, NCCMH. Dr Lynsey McAlpine, Psychiatrist. Caroline Bald, Social Work Lecturer. Cat Papastavrou Brooks, Research Associate (Mental Health) Stefano Belli, Trainee Clinical Psychologist. Dr Kirsten Barnicot, Lecturer in Mental Health Services Research. Dr China Mills, Senior Lecturer in Public Health. Dale Whetter, Trainee Clinical Psychologist. Jonathan Oliver, Clinical Psychologist. Tulane Chiarletti, Social Worker. Kayleigh Mulqueen, Trainee Clinical Psychologist. Alastair Morgan, Senior Lecturer in Mental Health. Dr Michael Larkin, Reader in Psychology. Rebecca Milton, PhD Student, Medical Humanities. Dr Cath Malone , Clinical Psychologist. Ruth Jones, Psychoanalytic Psychotherapist. Bruce McClure, Social Worker. Rhiannon Osbourne, Final Year Medical Student, Health Inequalities Researcher. Beauty Dhlamini, Health Organiser, Global Health Writer. Laura-Jane Smith, Respiratory Consultant. Nick Burke, Social Work Practitioner Academic. Courtney Sommer, Executive Director, Making Space Collective CIC. Veronica Heney, Director of Research, Making Space Collective CIC. Grace Hornett, Assistant Psychologist Francesca Lepori, Peer Support & Lived Experience Practice Lead. Lauren Waples, Trainee Clinical Psychologist. Dr Bethan M Edwards, Research Associate, Occupational Therapist. Ben Eder, GP Trainee. Mike Steel, Independent Advocate. Emily Carrington, Occupational Therapy Support Worker (Mental Health). Domna Salonen, Occupational Therapist / Mental health researcher. Mark Bemelmans, Research Student. Kane Barnacle, Independent Social Worker / Consultant Advocate / Human Rights Specialist. Rosemary Hedges, Retired Clinical Psychologist. Dr Kim Jackson-Blott, Principal Clinical Psychologist. Charlotte Huggett, Trainee Clinical Psychologist. Hannah-Phoebe Bowen, Counsellor. Neil Chadborn, Senior Research Fellow. Joseph Sykes, Quality Lead & Registered Mental Health Nurse. Fiona Hackett, Mental Health and Wellbeing Practitioner. Stephen Lancashire, Convener. Dr Sarah Davidson, Clinical Psychologist. Martin Blanchard, Retired Academic/Consultant Psychiatrist. Dr Rachel H Tribe, Clinical Psychologist. Gareth Bell, Senior Lecturer in Mental Health Nursing Practice. Poppy Secker, Registered Mental Health Nurse. Laura Tovell, Psychiatric Liaison Nurse. Keir Harding, Occupational Therapist. Rikke Albert, Consultant Nurse, Mental Health. Claire Hayward, Occupational Therapist. Sara Vali, Counsellor. Domna Salonen, Occupational Therapist / Mental Health Researcher. Karen Persaud, Carer. Gemma Woolliscroft, Social Worker. Rebekah Pierre, Social Worker. Zoe Fyfwe, Counsellor. Dr Rebekah Moore, Principal Clinical Psychologist. Mike Ince, AMHP, BIA. VJ Appleton, Company Director. Paul McAllister, Mental Health Social Worker. Jane Fisher, Mental Health Lecturer, Psychiatric Survivor. Jane Cannon, Lived Experience Carer. Dr Gopinath Ranjith, Consultant Psychiatrist. Dr Amanda Taylor-Beswick, Social Work Academic. Dr Satbinder Kaur Bhogal, Clinical Psychologist. Katy Hawkins, Lived Experience Practice & Peer Support Lead. Dr Robert Embry, Speciality Doctor in Mental Health. Dr Gemma Angel, Lecturer. Alan Mathew, Occupational Therapist, Lecturer. Dr Kavian Kulasabanathan, GP Trainee, Researcher. Dr Richard Thwaites, Clinical Psychologist. Rachel Luny, Nurse. Rosie Buckland, Independent Social Worker. Dr Micol Ascoli, Consultant Psychiatrist. Dr Sam Porter, Consultant Psychiatrist. Victoria Biggs, Lecturer/Research Fellow, now Medical Student. Dr Samei Huda, Consultant Psychiatrist. Sophie Ramshaw, Mental Health Support Worker. Dr James Smith, Accident & Emergency Doctor. Abbie Kennedy, Liaison Psychiatry Nurse, Prof Nurse Advocate. Liz Bradford, Independent Advocate. Dr Emma Lambert, Consultant Psychiatrist. Nicola McMullen-Klein, Occupational Therapist. Vanessa Griffin, Clinical Psychologist. Robert Chapman, Senior Lecturer in Education. Adam Vance, Mental Health Nurse. Karen Scorer, Occupational Therapist. Beth Wright, CBT Therapist, Mental Health Nurse. Mia Mostoufi, Trainee Clinical Psychologist. Stephanie Allan, Research Assistant. Damien Milton, Senior Lecturer in Intellectual & Developmental Disabilities. Jon Hyslop, Executive Director. Dr Sara Finlayson, Consultant Clinical Psychologist. Katie Sydney, Trainee Clinical Psychologist. Emily Green, Healthcare Assistant (Acute Mental Health). David W Jones, Senior Lecturer in Psychology. Dr Ruth Ann Harpur, Clinical Psychologist. Dr Annie Hickox, Consultant Clinical Psychologist. Emmeline Joyce, Trainee Clinical Psychologist. Dr Lorraine Haye, Clinical Psychologist. Catherine O'Neill, Clinical Psychologist. Dr Radhika Mukherjee, Psychiatrist. Gargie Ahmad, PhD Student, Social Epidemiology. Dr Elizabeth Turner, Clinical Psychologist. John Baker, Professor. Sandra Simpson, Social Worker. Grace Evans, Assistant Psychologist, PWP. Louise Buxton, Mental Health Nurse. Cara, Mental Health Nurse. Nineb Nersy, Trainee Clinical Psychologist. Dr Matt Charles, Consultant Clinical Psychologist. Isla Skinner, Head of Patient & Carer Experience & Involvement. Dr Abdullah Mia, Consultant Clinical Psychologist. Beth Pink, Registered Mental Health Nurse. Christine Ward, Apprentice Occupational Therapist. Dr Julie Waine, Consultant Child & Adolescent Psychiatrist. Molly Rhinehart, Trainee Clinical Psychologist. Steven Pryjmachuk, Professor, Mental Health Nursing. Dr Emma Limon, Clinical Psychologist. Dr Harriet Fletcher, Consultant Psychiatrist. Amy Hird, Speech & Language Therapist. Morganna Dalby, Psychological Wellbeing Practitioner. Kirsty Brook, Lecturer, Mental Health Nurse. Elliot Taylor-Hawkins, Social Worker. Sophie Ellis, Psychologist, Criminologist. Dr Angela Byrne, Clinical Psychologist. David Hingley, Counsellor, Former Mental Health Nurse. Ruth Hawley, Senior Lecturer. Dr Mikaela D'Arcy-Smith, FY1 Doctor. Nisha Gharu, Senior Peer Support Worker, Mental Health. Charlotte Cox, Clinical Psychologist. Alison Faulkner, Survivor Researcher. Julien le Juene d'Allegeershecque, Teaching Fellow. Dr Harriet Fletcher, Consultant Psychiatrist. Dr Sabina Dosani, Consultant Child & Adolescent Psychiatrist. Emma Craigie, Mental Health Law (LLM) graduate, Survivor. Katy Stepanian, Lived Experience Professional. Andre Tomlin, Chief Elf. Alice Golding, Mental Health Social Worker. Haydyn Williams, Anonymous Occupation. Anna Moran, Autism Practitioner/Occupational Therapist. John Watson, Mental Health Practitioner, Mental Health and Well-being Team, University of Hull. Jill Rapoport, Retired GP. Kathleen Mackay, Retired GP and Public Health Consultant. James Kiely, Trainee Clinical Psychologist. Dr Clare Connelly, GPST2 Dr Mike Tomson, Medical educator and Retired GP. Pam Wortley, Retired GP. Natasha Astill, Consultant sexual health and HIV. Peter Wemyss-Gorman, Retired Consultant in Anaesthesia and Pain Medicine. Amanda C de C Williams, Professor of Clinical Health Psychology. Matthew Lumley, Consultant Haematologist. Joe Lewis, Lived Experience Senior Project Worker. Ken Checinski, Consultant Psychiatrist. Dawn Pritchard, Lived Experience Lead. Sheila Aked, Retired Counsellor. Dr Christine Haigh, Foundation trainee. Jill Amferson, Mental Health Researcher/Registered Social Worker. Mathilde Fulford, Principal Social Worker. Natasha Watt, Independent Social Worker & Senior Best Interests Assessor. Dharmi Kapadia, Senior Lecturer, Sociology, The University of Manchester. Louisa Harvey, Psychodynamic Psychotherapeutic Counsellor in Training. Bryony Hopkinshaw, Paediatric Doctor. Matthew Clemens-Lary, Mental Health Social Worker. Catherine Beard, Anonymous Profession. Liz Howard, Social Worker Professional Officer. Stephen McKenna-Lawson, Teacher and Mental Health Nurse. Ioana Cerasella Chis, Doctoral Researcher. Fay Maxted OBE, The Survivors Trust Chief Executive. James Bothoms, Mental Health Nurse. Emily Mizen, Assistant Psychologist. Dr Simone Helleren, Research Associate. Justin Howard, Advocate. Diana Serban, Communications Manager. Charlotte Turtill, Psychological Wellbeing Practitioner. Brindley O'Connell, Registered Mental Health Nurse. Chloe Slater, Trainee Clinical Psychologist. Louise Harvey, Psychodynamic Psychotherapeutic Counsellor in Training. Ruth Turner, Clinical Psychologist. John McGowan, General Secretary of the SWU. Benjamin Dorey, Coproduction Consultant. Salli Midgley, Registered Mental Health Nurse. Dan Robotham, Deputy Research Director. |
Emma Bainborough, Professional Youth Work Academic & Lived Experience Practitioner.
Dr Niraj Singh, Consultant Psychiatrist Caroline Strathearn, Specialist Occupational Therapist Andy Broughton, CJ Liaison & Diversion Social Worker. Dr Jay Watts, Consultant Clinical Psychologist. Tony Deane, AMHP. Emily Holmes, Trainee Clinical Psychologist. Helen Jolly, Occupational Therapist. Dr Chloe Beale, Consultant Psychiatrist. Dr Lisa Morriss, Lecturer in Social Work / Social Worker. Dan Warrender, Lecturer in Mental Health Nursing. Alexandra Phillips, Senior Peer Coach. Dr Jonathan Monk-Cunliffe, Core Trainee in Psychiatry. Veenu Gupta, Research Associate. Jacqui O'Riodan, Advanced Nurse Practitioner / ADHD Nurse Consultant. Charlotte Maxwell, Trainee Clinical Psychologist. Rebecca Bright, Trainee Clinical Psychologist. Dr Dominic Casey, Retired Consultant in Psychiatry (LD). Amy Sanderson, Senior Psychological Therapist / Art Therapist. Naomi Salisbury, CEO - Self Injury Support. John Tucker, Senior Practitioner, AMHP. Ella Bailey, Trainee Clinical Psychologist. Tom Wainwright, Independent Mental Health Advocate. Julie Williams, Post Doctoral Researcher and OT, Kings College. Kate Jones, Chief Communications Officer. Dani Chadderton, Trainee Clinical Psychologist. Natalie Finch, Assistant Professor Mental Health Nursing. Jazz Callen-Davies, Trainee Clinical Psychologist. Kath Rowe, Suicide Prevention Programme Manager. Nyla Moran, Counselling Psychologist in Training & Occupational Therapy Clinical Support Worker. Lauren Langley, PhD Student in Social Work / Justice / Policy. Stan Papoulias, Research Fellow, Service User Research Enterprise, King's College London. Shade Davies, Assistant Psychologist. Sally McManus, Senior Lecturer. Dr Leah Quinlivan, Researcher. Elizabeth Smith, Accredited Counsellor MBACP (Accred) Linda Gask, Emerita Professor of Primary Care Psychiatry Jessica Pons, Psychotherapist, Project Manager. Victoria McKinlay, Social Worker, AMHP. Dr Elizabeth Cotton, Mental Health & Education. Sue Kessler, Solicitor. Dr Sarah Parkinson, Consultant Clinical Psychologist. Dr Juliette Brown, Consultant Psychiatrist. Stephen Williams, Mental Health Nursing Lecturer. Caroline Strathearn, Specialist Occupational Therapist. Aga M Buckley, Senior Lecturer/AMHP/BIA/Mental Health Social Worker/Social Work Education/Higher Education. Bartley Rock, Senior Occupational Therapist . Bernice Cullimore, Joint Campaign Manager. Caroline Aldridge, Independent social work trainer. Christine Parker, Community Worker. Dr Camilla Hogg, Clinical Psychologist. Dr Victoria Tew, Clinical Psychologist. Elizabeth Henshaw, Trainee Clinical Psychologist. Emma Pearce, Social Worker. Grace Curtis, Advocacy Worker. Hannah S-T, Occupational Therapist. Hattie Porter, Occupational therapist. Janet Regan, Occupational Therapist. Dr Michael Birtwhistle, Consultant Psychiatrist. Jo Markham, Mental Health Nurse. Kirsten Iles, Senior Peer Support Coordinator and Chair of Trustees. Dr Jo Varela, Consultant Clinical Psychologist. Munzar Sharif, Trainee Clinical Psychologist. Paul Atkinson, Psychotherapist. Dr Rich Moth, Lecturer in Social Work. Rachel Eborall, Deputy Head of Inclusion. Rosemarie Latham, Sarah Ransom, Psychotherapist. Theresa Jenkinson, Advanced Clinical Practitioner. Dr Amy Colla, Highly Specialist Clinical Psychologist. Dr Jennifer Burgess, Research Fellow & Psychiatry Registrar. Laura Tovell, Psychiatric Liaison Nurse. Keir Harding, Occupational Therapist. Rikke Albert, Consultant Nurse Mental Health. Claire Hayward, Occupational Therapist. Sara Vali, Counsellor. Dr Jennifer Burgess, Research Fellow & Psychiatry Registrar. Natasha Maddison, Psychological Therapist. James Watson, Emergency medicine physician. Rich Bell, Lecturer in Child and Adolescent Mental Health. Joe Hanley. Lecturer in Social Work. Dr Jill Pluquailec , Senior Lecturer. Dr Bill Penson, Senior Lecturer/CPsychol. Madeleine Kelly, Trainee Clinical Psychologist. Tamar Jeynes, Lived Experience Consultant. Katherine Hollis, Occupational Therapist. Tamar Jeynes, Consultant & Researcher (LXP). Maria McCullagh, Social Worker. Samuel Keefe, ASYE Social Worker. Dr Amber Tuthill, NHS Specialist Clinical Psychologist. Maria Kolitsida, Self-Harm Researcher. Rona Topaz, Campaign Co-ordinator. Siobhan Vassall, Social Worker, AMHP. Dr Mandy Mctaggart, Clinical Psychologist. Abigail Gagen, Senior Social Worker. Dr Sarah Steeg, Mental Health Researcher. Sarah Jones, Mental Health Pharmacist. Helen Rees, Mental Health Nursing Field Lead. Dr Sandip Talukdar, Psychiatrist (Older Adults) & Bioethicist. Kideshini Widyaratna, Clinical Psychologist. Rhys Gambold, Social Worker. Pete Graham, Counsellor. Jake Lake, Public Health & Prevention Lead. Erin Stevens, Counsellor/Psychotherapist. Sadia Nakimera, Founder. Michael Cheetham, Social Worker. Rowan Foster, Expert by Experience Lead. Alicia Painter, Healthcare Assistant, Public Governor. Ella Guerin, Mental Health Nurse Lecturer. Charlotte Palmer, Foundation Doctor, Researcher. Dr Siobhan Tierney, Lead Clinical Psychologist. Natalie Hicks, Student Occupational Therapist. Jennie Parker, Lived Experience Lead, Researcher. Abyd Quinn Aziz, Reader in Social Work. Matthew Hyland, Translator/Editor. Dr Andrew Grundy, Lived Experience Researcher. Dr Emma Warren, Clinical Psychologist. Fiona Harris, Senior Peer Support Worker. Tamsin Black, Consultant Clinical Psychologist. Jess Worner, Lived Experience Network Manager. Saskia, Assistant Psychologist. Christy Adeola Braham, Researcher. Denisha Makwana, Trainee Clinical Psychologist. Beatrice Millar, Retired Counsellor. John Puntis, Consultant Paediatrician. Sue Wellstood-Eason, Retired Psychiatrist. Jonathan Swift, Retired Health and Social Care Worker. Judith King, Retired GP. Lis Davidson, GP. Alex Mercer, Mental Health Nurse. Dr Daniel Hadley, Psychiatry Trainee. David Jenkins, Retired Consultant Physician. Keith Walton, Human Givens Therapist. Maarja Sukles, Midwife. Yasmeen Hanifa, General Practitioner. Molly Skeil, Medical Student. Laura McGregor, Trainee Clinical Psychologist. Emily Curry, Early Help Manager. Dr Cheryl Hunter, Clinical psychologist. Reinhard Huss, Retired Public Health Academic. Dr Thanos Tsapas, Consultant Psychiatrist in Psychotherapy. A S Collins, Peer Worker and Advocate for the Homeless. Rachel Piper, Activist / MA Gender Studies Graduate. Douglas Alexander Landman, RMN. Dr Elisabeth Murray, Retired Consultant Clinical Oncologist. Nicola Tyler, Occupational Therapist. Sorcha Dunne, Occupational Therapist. Diana Harris, Independent Social Worker. Hilary Cornish, Counselling Psychotherapist. Dr Andrew Grundy, Lived Experience Researcher. Nikki Swan, Clinical Psychologist. Jeff Slominski, NHS Worker. Shelagh King, Doctor. Jane Street, Retired Clinical Psychologist. Dr Joanna Natarajan, Doctor. Dr Barbara Vogel. GP Registrar. Anonymous, Independent Mental Health Advocate. Dr Chris O’Mahony, Clinical Psychologist. Anya Ustaszewski, Autism Advisor. Selina Wallis, Public Involvement Manager. Dr Amy Chandler, Senior Lecturer Health in Social Science. Dr Kim Bowen-Jones, Clinical Psychologist. Dr Ben Greenhalgh, Psychiatry Registrar. Mark Hutton, Retired Social Worker Supporting Organisations: DCC Interactive Ltd (known as DCC-i) Centre for Mental Health. NeuroClastic. University of Central Lancashire. City, University of London. Free2BMe Therapy Services. Make Space Collective CIC. KONP/SHA Mental Health Network. Empower the Invisible. Institute of Mental Health, University of Nottingham. Sussex Partnership NHS Foundation Trust and Recovery Partners. Is Anyone Listening Lincolnshire. Defend Our NHS Wirral. 999 Call for the NHS. Asylum Magazine. BASW England Mental Health Thematic Group. The Open University. Pink Sky Thinking. Community Glue CIC. MAC-UK Association of Neurodivergent Therapists. Let Us Communicate. Stop the Scan Campaign, The Racial Justice Network. The Mental Elf. The Social Care Elf. Medact. National Survivor User Network. Wish - A Voice for Woman's Mental Health. The Survivors Trust. WISH. McPin Foundation. Social Workers Union (SWU). |
Help us to share the message...
Silence should never be the response to oppressive practice #stopSIM
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For further information contact [email protected]
INFORMATION FOR THE PRESS:
Serenity Integrated Mentoring (SIM) was introduced across healthcare and police partnerships as an ‘innovative’ approach to manage mental health presentations which included high intensity use of public sector services. SIM is a model of care for mental health service provision developed by an ex-police officer, used in 26 NHS trust areas, the model identifies individuals who repeatedly present with self-harm, suicide, and severe distress, who once identified, are not provided with appropriate treatment or support but instead redirected to reduce the burden on NHS and emergency services.
The model perceives such distress as being positively reinforced by emergency team response (999 police calls) and should not be provided treatment but instead directed to a high intensity team for active management. In many cases this has led to arrests for wasting police time or denying individuals access to both physical and mental health treatment as a planned response. The initial business case indicated that a cost-saving of £1.4 million could be achieved across the London services and based on this the scheme was signalled for roll-out across the county. The AHSN Network was commissioned by NHS England to implement and review the scheme.
In 2021 debate across the sector in relation to the safety, effectiveness and the ethical underpinning of the approach began, with many stakeholder organisations raising concerns. The #stopSIM coalition was established to challenge the evidence for its implementation, critics of SIM included:
In May 2021 NHS England paused the implementation plans and asked NHS mental health trusts to review their use of SIM approaches, with a range of stakeholders calling for a full review of the model before further roll-out took place.
Whilst NHS England statements in 2021 stated that the approach was not mandated, the stopSIM coalition, via a series of freedom of information requests and other research have identified 26 NHS mental health trusts using the SIM model (or equivalent).
The stopSIM coalition has been working with NHSE for the last 15 months to review the scheme and develop national policy to ensure individuals rights are upheld and the proactive duties under the Human Rights Act for protection and safeguards are in place.
On 10th March 2023, without consultation with partners in this work, NHSE issued a position statement rather than publishing the policy, undermining the coproduced position and further disenfranchising those involved in the process or who have been subject to SIM (or HIN, PPO or other similar schemes).
We are calling on professionals across the field to join us in supporting the #stopSIM coalition and showing solidarity by adding their names - either individually or on behalf of organisations - to this open letter. Coproduction and rights are fundemental, not a nice luxury and its time to call out the systems for what they are #oppressionissilence.
For further information contact [email protected]
Serenity Integrated Mentoring (SIM) was introduced across healthcare and police partnerships as an ‘innovative’ approach to manage mental health presentations which included high intensity use of public sector services. SIM is a model of care for mental health service provision developed by an ex-police officer, used in 26 NHS trust areas, the model identifies individuals who repeatedly present with self-harm, suicide, and severe distress, who once identified, are not provided with appropriate treatment or support but instead redirected to reduce the burden on NHS and emergency services.
The model perceives such distress as being positively reinforced by emergency team response (999 police calls) and should not be provided treatment but instead directed to a high intensity team for active management. In many cases this has led to arrests for wasting police time or denying individuals access to both physical and mental health treatment as a planned response. The initial business case indicated that a cost-saving of £1.4 million could be achieved across the London services and based on this the scheme was signalled for roll-out across the county. The AHSN Network was commissioned by NHS England to implement and review the scheme.
In 2021 debate across the sector in relation to the safety, effectiveness and the ethical underpinning of the approach began, with many stakeholder organisations raising concerns. The #stopSIM coalition was established to challenge the evidence for its implementation, critics of SIM included:
- #stopSIM
- Centre for Mental Health Statement
- British Association of Social Work Statement
- Royal College of Psychiatry Statement.
- National Service User Network Statement
In May 2021 NHS England paused the implementation plans and asked NHS mental health trusts to review their use of SIM approaches, with a range of stakeholders calling for a full review of the model before further roll-out took place.
- Tim Kendall’s letter to NHS Trusts – 11 May 2021
- Claire Murdoch’s letter to the #StopSIM coalition – 11 May 2021
Whilst NHS England statements in 2021 stated that the approach was not mandated, the stopSIM coalition, via a series of freedom of information requests and other research have identified 26 NHS mental health trusts using the SIM model (or equivalent).
The stopSIM coalition has been working with NHSE for the last 15 months to review the scheme and develop national policy to ensure individuals rights are upheld and the proactive duties under the Human Rights Act for protection and safeguards are in place.
On 10th March 2023, without consultation with partners in this work, NHSE issued a position statement rather than publishing the policy, undermining the coproduced position and further disenfranchising those involved in the process or who have been subject to SIM (or HIN, PPO or other similar schemes).
We are calling on professionals across the field to join us in supporting the #stopSIM coalition and showing solidarity by adding their names - either individually or on behalf of organisations - to this open letter. Coproduction and rights are fundemental, not a nice luxury and its time to call out the systems for what they are #oppressionissilence.
For further information contact [email protected]
