We are a group of mental health service users, survivors and allies calling on NHS England to halt the development and rollout of ‘Serenity Integrated Mentoring’ (SIM), created by the ‘High Intensity Network (HIN), with immediate effect, and to conduct an independent review. We believe that SIM is an unacceptable step backwards in mental healthcare and has the effect of criminalising mental distress/illness. 

Full Petition Text

SIM is a model of mental healthcare targeted towards some of the most vulnerable and mentally unwell individuals in our communities, who frequently come into contact with emergency services. SIM refers to these individuals as “High Intensity Users”. SIM documents say these individuals place an “unnecessary financial burden”[1] on the NHS and use services in a “malicious” way[2]. The model is heavily reliant on “coercive” powers of the police[3] to enforce ‘behavioural responsibility’ and ‘behavioural management’[4] on ‘High Intensity Users’. “High Intensity Officers” are placed in mental health teams and have full access to the individual’s medical records, with or without their consent [5-7].

Messages such as: “We are responsible for the consequences of our actions and we need you to understand what the consequences of your actions will be if they continue” are “compassionately, but firmly reinforced over the course of several weeks/months.” [8]

Individuals are not placed under SIM because they have committed a crime. They are extremely vulnerable and frequently at high risk of self-harm and suicide. Despite these high levels of risk, patients under SIM have crisis ‘response plans’[9] which prevent them from accessing potentially life-saving treatment from services which they have been directed to for support during a crisis in the past (and which other users of mental health services are expected to use during a mental health crisis)[10]. This includes: ambulance services, A&E, mental health services and the police.

SIM has 5 key outcome measures that are used to measure the success of the programme, both at an individual patient level and a whole programme level[11]. These focus solely on reducing service demand (how frequently people come into contact with emergency services) in order to save money, rather than the patients’ well-being or experience. Additionally, they are not using any outcome measures commonly used in community mental health services to assess changes in the individual’s psychological wellbeing. 

We ask you to sign this petition, calling on NHS England to:

  1. Halt the rollout and delivery of SIM with immediate effect, as well as interventions operating under a different name, which are associated with the High Intensity Network (HIN).
  2. Conduct an independent review and evaluation of SIM in regards to its evidence base, safety, legality, ethics, governance and acceptability to service users.

Our concerns about SIM relate equally to interventions or service models which may be known by a different name, which are associated with the High Intensity Network.