Serenity Integrated Mentoring (SIM) A Model of Care Supporting and Preventing High Intensity Mental Health Crisis Superintendent Dan Thorpe August 2018
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