Content warning: A triggering discussion with mentions of abuse, self-harm, suicide, systemic abuse.
I'm taking a break from my usual topics today to bring your attention to a harmful programme being used by 23 out of 52 NHS trusts in the UK. Please stick with me until the end and I will try to explain why you should sign a petition and write to your local MP.
Serenity Integrated Mentoring (SIM) is a scheme developed by Sgt Paul Jennings (ex police in Hampshire constabulary). It is worth mentioning that Jennings' limited company (HIN) is in the private sector. SIM allows emergency services/crisis services to turn so called 'frequent flyers' away; even if these people are actively harming and suicidal. Let's run through a scenario of how someone could be flagged, put on the SIM list, and what this would mean for them:
For the last few years I haven't been coping well with life. I was abused throughout my childhood and grew up living in fear. When I finally found a way to leave my abusive home, it was through moving in with a partner. Here I experienced sexual abuse and domestic violence. I began self-harming. Healthy coping mechanisms were never modeled to me in childhood, so I become extremely overwhelmed by even small stressors. The self-harm was a way of coping. On my dark days I feel empty, I feel hopeless, and I think that everyone I love will leave me. But, I don't want to hurt people by taking my own life, so I go to get help from mental health professionals. They tell me that I should just stop self-harming, that I should use better coping techniques, but waiting lists for the treatment that will teach me those skills are years long. I am sent home with a harsh word and no support. Over the next few years I frequently turn up to A&E begging for someone to help me. Each time they tell me to stop what I'm doing and offer a limited service (usually involving 1 or 2 home visits before immediate discharge). They grow increasingly sick of me as they are not trained to help me. One day they tell me that due to my frequent contact they will no longer be allowing me to come to A&E or use crisis services. They have given up on me, just like everyone else in my life has. Despite my increasingly self damaging self-harm and suicide attempts, I am told that I am an 'attention seeker' that I am 'wasting public funds' - finally they have confirmed what I have always known - nobody cares if I live or die.
These are common life experiences (and emotions) of people with complex needs and personality disorders. This leads onto the topic of who is being affected by these barbaric practices:
Heavily traumatised women with complex PTSD
Survivors of repeated rape, incest and other abuses
Those diagnosed with a personality disorder are more likely to be listed
Those who grew up in poverty
Those who are homeless and/or involved in sex work
BAME and/or LGBTQ+ people
The only 'support' (as HIN describes it) that those on the SIM list are offered, is to be assigned a police officer who discusses management of their 'behaviour'. Police officers are there to enforce the law and shouldn't be used to coerce people into not seeking psychological support. In many cases the trauma that people have experienced has involved the criminal justice system, especially in the case of BAME and LGBTQ+ people.
Personality disorders are described as severe and enduring mental health conditions. In fact Emotionally Unstable Personality/Borderline Personality Disorder has the highest mortality rate of any mental health condition (excluding eating disorders for physical health reasons). 10% of people living with BPD will complete suicide, compared to 0.0112% within the general population. By rolling out SIM the NHS is choosing to minimise these statistics and create their own reality, in which they ignore the suffering and potential risks of those with complex needs. It is widely known that personality disorders don't simply clear up on their own. It takes years of intense therapies such as DBT. Without these interventions outcomes are deeply concerning. These people are consistently presenting to crisis services, because society and the system has failed them. We also know that severe mental health conditions, if not treated, will worsen and increase the likelihood of poverty and homlessness, vulnerability to further abuse, and substance misuse.
For anyone who understands mental health, it is clear to see that SIM is an unethical scheme not fit for purpose and is actively causing lethal harm. There have also been no trials made public that support its use in improving outcomes for any patient groups. It also comes with an extremely dangerous idea bubbling just under the surface. 'People presenting in this manner are not mentally ill and do not need treatment. This is the way forward for treating people with complex trauma.' Having worked in the mental system for many years and having been a service user myself for even longer, I know that ideas like this spread like wildfire. Part of my current role involves looking at the treatment people with complex needs experience. Our service user led team has been fighting the stigma and trying to improve attitudes among healthcare professionals. The NHS trust that commissioned us, actively using SIM, is massively undermining all the work that we are doing. It is moving away from a people first model and onto a business first model. Read: Saving money over lives - siphoning money out of the NHS and into the wealthy pockets of private business owners.
There is currently no independent enquiry or investigation taking place. Some trusts have promised an internal investigation, but 'marking your own' work is not sufficient when we are talking about the lives of severely traumatised individuals. As of last week HIN appears to have removed their website for unknown reasons.
Please sign the petition for a halt to SIM and an independent enquiry to be launched. I've included a link to more information and on this page you click to sign the petition. https://stopsim.co.uk/
Let's end the systematic neglect and abuse of those living with complex mental health needs.
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