Mental Health Matters: Plot thickens around controversial care model

Last month, Mental Health Matters explored the controversy surrounding the Serenity Integrated Mentoring Programme.

The scheme was launched in 2013 in the Isle of Wight and Hampshire. SIM places a police officer within a healthcare team charged with supporting patients who frequently attend emergency services in crisis. At least 22 NHS trusts have used it at one point or another.

However, controversy around the schemes’ methods and lack of evaluation arose earlier this year, prompting NHS England to ask all trusts to review their use of it.

Now, there is a new twist in the tale after Hampshire Constabulary released emails to a group of patient campaigners, called STOPSIM, and HSJ. 

The emails reveal the Hampshire police force attempted to cut ties with the SIM programme in 2018.

In one email to the programme from July 2018, the constabulary said: “Neither Hampshire Constabulary, nor any of the trusts down here are part of your network. I note other trusts in green elsewhere in the country who were also not part of the network…

“This does seem to me as a method of unfairly bringing pressure on other trusts to join the network in an aggressive sales pitch… I don’t think this is appropriate and I do not want us to be any part of this.”

Were trusts pressured by SIM’s claimed popularity? It is not uncommon for innovations to quickly become the flavour of the month within NHS policy land. However, trusts still have a responsibility to do their due diligence.

The email added: “I am also still seeing data being used that I have told you is hugely inaccurate. The figures you use for your data set from the original IOW scheme do not bear any resemblance to the data held by Hampshire Constabulary and the IOW NHS, and the way in which you have then used that erroneous data to produce various charts and graphs is misrepresentative and not ethical.”

A more softly worded letter from February 2018, obtained by HSJ, revealed The Isle of Wight Trust and Portsmouth Clinical Commissioning Group had also agreed to move away from SIM to a slightly different model focussing on “high-intensity users”. 

This raises the question of why did the Hampshire organisations pull out?

In an email from March 2018, Hampshire police simply said it was “disconnecting” with the network to develop its own high-intensity programme with local trusts. 

This statement does not raise concerns about the model. Indeed, it is perfectly reasonable for organisations to end involvement in a care programme if they discover it is not meeting their needs.

However, the tone of the July email from Hampshire Constabulary suggests underlying issues. 

‘Horrendous’ behaviour

In response to the Hampshire emails, SIM creator Paul Jennings said: “We did not ever misrepresent data within the SIM pilot report as suggested. These statements are based on incorrect assumptions and data retrieved from a less reliable data source than I used at the time…

“We were simply trying to deliver better care (based on our own lived experience of crisis and crisis response) for some incredibly complex service users, struggling to cope with extremely challenging types of distress. ”

Mr Jennings told HSJ the SIM network has now been closed. “After eight years of working 50-70 hour weeks, we have made the decision to hand back the development of effective solutions to local crisis care providers,” he said.

The former police officer claimed there had been a campaign to discredit his reputation and has made complaints to the police’s professional standards departments. He added there was “horrendous” behaviour by key organisations within the police and NHS. 

Spread and adoption 

Within its string of emails released under a Freedom of Information request, Hampshire Constabulary also revealed it never evaluated the programme. 

This is an example of the core problem within the whole SIM debacle — no organisations appears to have stopped and fully evaluated the model for itself. 

Several sources have raised concerns to Mental Health Matters over the involvement of the Academic Health Science Networks, set up by NHSE, in the spread of SIM.

In 2018, as Hampshire organisations were distancing themselves from the model, the AHSN chose SIM as one of a dozen programmes to roll out nationally. 

The central concern from sources surrounds what evaluation and data the decision was based on. One source claimed to Mental Health Matters the programme does not ask for any patient reported outcomes — this would surely be vital for a service aimed at the most vulnerable patients. 

In response to these questions, the AHSN told HSJ its support for the spread and adoption of SIM was always planned as a two-year programme and it has not been involved since April 2020. 

It added: “The AHSN Network focussed on providing funding for training in local NHS trusts interested in rolling out the model. Engagement with service users and collation of patient experience feedback would have been led by the service providers themselves.”