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Over the past week RCN members have raised concerns around the national rollout of Serenity Integrated Mentoring (SIM) and other ‘high intensity support’ models across England.

A lived-experience led movement called , has received increased momentum in their drive to challenge a national rollout. The #StopSIM Coalition have set out their concerns in a letter addressed to NHS England, National Police Chiefs Council and Her Majesty’s Inspectorate of Constabulary and Fire and Rescue Service. They are 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.

The exceptional lived-experience drive around this issue cannot be ignored. An urgent RCN member meeting was held on the 6^th May, 2021, facilitated by the Mental Health Forum and chaired by the RCN’s professional lead for mental health. The group echoed the concerns raised by The #StopSIM Coalition, supporting the full content of their letter.

Members recognise the positive intentions behind many police and crisis workers to better understand and support people with mental health problems. The positive ambitions and achievements of these professionals must be acknowledged, supported and developed.

RCN members believe any framework, model or theory used to underpin ‘high intensity support’ practices must be co-produced and evaluated with service users, mental health professionals, the police, crisis and emergency workers. A key focus on person-centred care and patient safety is paramount. The personal outcomes of service-users must not be overshadowed by measurements of cost savings.

Members identified the need for an urgent training needs evaluation of mental health nursing (pre-reg and post-reg) to determine the profession’s capability and competence to support people with complex emotional needs (or 'high intensity users'). A training needs evaluation must also extend to the wider community of emergency and crisis workers (including A&E staff).

There must be an assessment of the capacity and structure of crisis and community-based mental health services for people with complex emotional needs. Services must align with the four areas of the :

• Access to support before crisis point,
• Urgent and emergency access to crisis care,
• Quality of treatment and care when in crisis,
• Recovery and staying well.

Concerns were raised that nurses working in line with the theory and framework of SIM, and other similar models, may be practicing in conflict with their professional conduct and capabilities. This must not happen. It is imperative that members are fully aware of their statutory duties under the .

It is vital that clinical leaders acknowledge their role in supporting, challenging, and reviewing the practices and services within their organisations. Accountability must be clear at all levels. This responsibility must not lie solely on practitioners and emergency workers.

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