Emails released by a police force show how “hugely inaccurate” data was used to persuade NHS trusts across England to sign up to a mental health scheme branded unethical, unlawful and unsafe by disabled activists.
The release of the emails appears this week to have led to the former police officer who devised the Serenity Integrated Mentoring (SIM) scheme, Paul Jennings, closing down the network he set up to promote the programme and telling Disability News Service (DNS) that he was now “moving on with life”.
The Hampshire police emails show how unnamed figures within the force raised repeated concerns about the way that inaccurate data about how well it worked was being used by Jennings to promote the SIM system.
Critics of the system, which is now widely used across the NHS, believe it puts people in severe mental distress at risk of being denied vital support.
Under the leadership of a police officer and a mental health professional, SIM puts pressure on users of mental health services – often those at high risk of suicide and self-harm – who have not committed a crime but are seen as “high intensity users” of emergency services.
This can involve withholding assessment and treatment, and it gives police officers a key role in making clinical decisions when service-users are in crisis.
Following pressure from campaigners and SIM service-users, NHS England has already written to mental health trusts across England, calling on them to review their use of the scheme.
But disabled activists from the StopSIM coalition have called on NHS England to “halt the rollout and delivery of SIM with immediate effect” and order an independent investigation into its use.
The emails released by Hampshire police were all written in 2018, and refer to a pilot scheme, the Integrated Recovery Programme (IRP), which was trialled on the Isle of Wight by Jennings, then a sergeant with Hampshire police, in 2013 and 2014.
The results of this pilot, which was renamed Serenity Integrated Mentoring (SIM), were later used by Jennings to promote and market the SIM system to mental health trusts and police forces, with support from the High Intensity Network (HIN), which he co-owned with his wife.
The network was believed to be working with 23 of 57 mental health trusts in England when Jennings shut it down this week.
Campaigners have been concerned for several years about SIM and its rapid rollout across the NHS in England, including the lack of quality research into its impact on mental heath service-users, but those concerns became much more vocal this spring.
Now the Hampshire police emails have shown that inaccurate results from the pilot – exaggerating its effectiveness – were apparently used to sell SIM to mental health trusts across the country.
The IRP pilot appears to have worked with just six women, but one email from Hampshire police says that two of them were removed from the trial results, even though one of them left the process and then died and the other was admitted as a mental health inpatient.
Another woman left the scheme at the end of the first year, but the trial reported that she made zero demands on services throughout the second year, even though police records actually showed a “significant number of calls to Police from her throughout that year”.
The email adds: “All of these incidents have been removed from the data giving a grossly distorted set of statistical outcomes.”
Another Hampshire police email five months later says: “He is still representing data around the country that we know to be completely inaccurate when compared to both Police and NHS data, as well as being formulated in a way that is just not ethical.”
The next day, apparently in an email to Jennings – although all names have been redacted – he is warned: “This does seem to me as a method of unfairly bringing pressure on other trusts to join the network in an aggressive sales pitch, and I do see that suggested in some of the communications that you send out.
“I don’t think this is appropriate, and I do not want us to be any part of this.”
The Hampshire police email then tells Jennings that “the way in which you have then used that erroneous data to produce various charts and graphs is misrepresentative and not ethical”.
The email adds: “You have left out whole swathes of data that do not support your findings, and even worse you have submitted a ‘0’ response across all categories for one patient who you know actually did make many calls to services in that period.”
Despite these warnings, the inaccurate data was apparently still being used four months later, as another email from Hampshire police on 24 November 2018 says: “I have significant concerns about the data being used to sell SIM around the country.
“The raw data is not remotely accurate in a number of ways, and is then being presented in a way that is just not ethical.
“I have had to make it very clear that Hampshire Constabulary cannot have any connection with SIM in the way it is being presented around the country.”
In a statement issued this week, after being asked about the emails, Jennings denied any wrongdoing.
He told DNS: “We have done absolutely nothing wrong and I have not in any way been dishonest at any time about data or any other matter.
“There is a very complex back story involving former colleagues at Hampshire Police which has been going on for years and has been the subject of a review by the Hampshire Police Professional Standards Department for several weeks now.
“I can’t say anything more at the moment.
“We are just about to turn off our network emails as the stress has become too much.
“The network as far as we are concerned is closed. All our teams have had their portals turned off – the website is closed and we are moving on with life.
“Whether individual organisations continue this line of work is now down to each of them… they will ironically be less transparent, less accountable, less measured and less safe outside of a national programme… so if this campaign thinks it has won, it hasn’t.
“We are good people trying to make the world a better place. We have served the public for over 20 years each and have not lied once whilst at work.
“When we get our energy back, we will carry on being these people, operating with these standards.”
But one disabled woman on a SIM scheme who has spoken to DNS this week said she found the police emails about the inaccurate data “really distressing” and “really shocking”.
She said: “I feel totally betrayed, totally violated.”
She said the SIM scheme bullies women in vulnerable situations, and she added: “It’s based on discrimination and stigma. I think it’s horrendous.”
She was also critical of Jennings’ actions in shutting down the network, and said: “He’s trying to hide and run away and not allowing himself to be accountable.”
She backed calls for a proper investigation into the use of SIM schemes across England.
The activist who helped publicise the freedom of information release, @Sectioned_, told DNS today (Thursday) that she was concerned about the impact on those under SIM schemes of HIN’s sudden closure.
She said: “The whole model of care needs to be reviewed so people receive proper care rather than coercion and denial of potentially life-saving care – not just pulling the plug on the network overnight.
“It seems to be that, as soon as the evidence base for SIM, and its ethos and legality, began to be seriously called into question, the owners shut up shop.
“That seems highly irresponsible, especially given the vulnerable service user group targeted by SIM.”
She added: “A key priority for me is that, while NHS trusts review their SIM programmes, all threat of police sanctions should be removed.
“Some service users live in fear of arrest or prosecution for being in mental health crisis, which puts them at risk of harm because they are not asking for needed help.
“The need for help doesn’t go away just because someone is threatened with arrest or prosecution for asking for help; they may just stop asking for help.”
A Hampshire police spokesperson told DNS that SIM had been developed and piloted in the county in 2015 but was discontinued in 2017 after a review of the data and its findings, when “it became apparent there were inaccuracies in the way some of the data had been recorded”.
She said: “The SIM model was developed in partnership to help people in crisis with the specialist support needed from the right agency, reducing the use of detentions under section 136 [of the] Mental Health Act.
“Regrettably, the police data that was used to show the effectiveness of the system in reducing police demand contained some inaccurate data and its use was stopped.
“We informed other agencies regarding our concerns, and made it clear that our data should not be used as part of any further development of the programme.”
She added: “We have constantly sought to amend our approach to those who present to police when mentally unwell.
“The fundamental principle has always been to seek the best support for that individual at that point in time.
“We know that more often than not the police are not the right agency to respond. High intensity patients can span a broad definition and our work in this area was not, and is not, limited to the SIM model.
“Where individuals frequently present in crisis to police we will work with mental health trusts to develop plans to manage their needs and the demand.
“It isn’t for Hampshire Constabulary to comment on any subsequent evaluation of this delivery model nor on previously employed individuals who have voluntarily left policing.”
NHS England spokesperson had failed to comment by noon today (Thursday).
The two NHS organisations linked to the original pilot scheme and the police emails, Isle of Wight NHS Trust and Hampshire, Southampton and Isle of Wight Clinical Commissioning Group, had also both failed to respond to requests to comment by noon today.
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