The trouble with SIM

People living with mental illness have faced many years of discrimination and stigma, and when combined with marginalisation and poverty, care is often provided through contact with the police, the criminal justice system, on sections of the Mental Health Act leading to forced treatments and coercive practices.

Community care seeks to transform that, but the community also need better knowledge and clarity about their role in improving public mental health. Black and minority ethnic people with mental illnesses are over-represented in the groups receiving coercive care, and subject to wider negative impacts through structural racism in society and institutions as well as experiences of interpersonal racism, which are traumatic and lead to, and worsen, mental illnesses.

The Serenity Integrated Mentoring (SIM), which conceives of those needing and seeking care repeatedly as a nuisance, to be criminalised and callously denied support, is not a professional, ethical, compassionate or emotionally intelligent response. This is disquieting as a consequence of this unevaluated and unethical approach will be to further criminalise and diminish the importance of timely intervention.

SIM will not entice trust and therapeutic engagement – or relationships. We should be reducing the use of coercion in mental care, and certainly not promoting it or threatening people – terrifying them into neglecting their health and wellbeing, to struggle in silence and isolation.

This can only result in more tragedy and palliative inquiries to rediscover what we already know – that the malignant alienation of people living with mental illness is not an acceptable response, and they deserve better care services and the best evidence-based therapies.

The whole programme raises questions of how such interventions come to exist, perhaps as further manifestations of prejudice, discrimination and the harsh institutional responses to people with mental illnesses. SIM should be criminalised, not the people seeking help for mental ill health.

We support the call for a full public inquiry of how the NHS, research systems and the police and social care came to collude in these unacceptable practices.

Picture credit: Matheus Ferrero.