Serenity Integrated Mentoring (SIM)

A Model of Care Supporting and Preventing

High Intensity Mental Health Crisis

Superintendent Dan Thorpe

August 2018

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South Yorkshire S136 Detentions

2016 2017 2018

“I believed from the outset that the SIM model was an important clinical

innovation, with huge potential to improve urgent healthcare. I have been

impressed way beyond my expectations with the incredible hard work,

absolute rigour, systematic training and delivery of the SIM content through

its own interactive, digital platform. It’s not often I recommend a programme

without reservation but this is one!”

Dr Geraldine Strathdee, CBE,

MRCPsych, Former National

Clinical Director for Mental Health,

NHS England

In November 2016, in recognition that SIM delivered all the key

requirements of the Five Year Forward vision, Sir Bruce Keogh, Clinical

Director of NHS England, directed that SIM be expanded across all NHS

Mental Health Trusts in England and Wales as part of the NHS

Innovation Accelerator Fellowship.

Sir Bruce Keogh,

Clinical Director of NHS England

Innovative model of care that brings together the police

and community mental health services in order to better

support “high intensity users” of Section 136 of the

Mental Health Act (MHA).

These individuals have complex and often unmet needs

and frequently use a range of high cost public services.

SIM model delivers significant benefits to these

individuals, their families and communities, as well as a

reduction in section 136 detentions and associated

costs.

Best evidenced by the findings from Hampshire

Constabulary and the Isle of Wight NHS Trust who

developed and launched SIM in July 2013.

Based on the data from SIM Isle of Wight, cost savings

and delivery of improved outcomes for individuals and

their families are estimated to be circa £20k per

reduction in S136.

SIM has since been adopted in other parts of the

country and is in the process of being implemented at

Doncaster with a view to roll out South Yorkshire wide.

treatment & advice

clinical behaviour social behaviour

bio-medical

boundaries consequences

community risk

Police Officer

medical risk

psycho-social

consent

Service User CHAOTIC

HIGH RISK

The SIM Model

COMPLEX

A FUSION OF SKILLS using a MENTORING MODEL

that is

integrated, personalised, consistent, resilient and supportive.

MH Nurse

Close relationship that is patient and builds trust

Joint development of a detailed response (care) plan

Support for whatever period of time is needed

Practical support as well as clinical support in every area of need

Allowing/encouraging individual to make their own decision about

their own care

Providing a positive future that does not mirror negative histories

Using structure, routine and discipline to help overcome patterns of

thinking and behaviour

Providing the right combination of skills to individuals with

unhealthy personality and behavioural traits

SIM Core Features

Identification of SIM Cohort

Initially high intensity users of s136 who are likely

presenting additionally within other settings such as ED

and/or subject of the Vulnerable Persons Panel.

Top 5 repeat 136 detainees identified from Trust data

covering the period January 2018 – July 2018.

The initial cohort will be reviewed once SIM Doncaster

is fully mobilised with a view to increasing the size of

the cohort

It’s estimated that the basic cost of a single “high

intensity user” of police and ambulance response, ED

attendances and mental health beds is at least

£19,800 per year (if there is no specialist intervention)

and that.

There could be as many as 3,500 “high intensity

users” needing this model of care across the UK at

any one time

That’s a £69 million problem

SIM Doncaster

1 x Police Officer – PC Gulshan Akram

1 x Mental Health Professional – Chris Guest, Dual

Diagnosis Nurse Specialist

2 x Mental Health Support Workers – Wendy Spencer

and Papinder Kaur

Co-located at the Opal Centre, St Catherines Hospital

Next Steps

Task and Finish Group to continue until SIM fully operational

(up to 3 months)

Register Doncaster SIM members with the National High Intensity

Network

Agree team name/branding/internal launch

Consolidate governance arrangements

Localise governance documents including Response (Care) Plans and

data collation templates

Training - initial 3 day classroom based training and ongoing training

accessed through the High Intensity Network.

Establish High Intensity User Sub Group/explore opportunity for linking

into existing forums eg YAS/ED Frequent Flyers Meeting