NSUN supports recommendations from new Medact report, ‘Criminalising Distress’

Medact have published a new report, ‘Criminalising Distress‘, which builds on the work of the StopSIM coalition to explore both the Serenity Integrated Mentoring (SIM) scheme and ongoing SIM-like practices in mental health care that function to criminalise people in distress.

Despite the demise of SIM as a specific model, and NHS England’s call for SIM-like practices to be “eradicated”, the report outlines current and ongoing police and NHS schemes which continue to criminalise distress, using threats, exclusion, denial of care, behaviour contracts, civil orders and prosecution. The report argues that:

  • The systemic conditions which enabled SIM – entrenched coercive mental health care practices, behaviourism, neoliberalism and the stigmatising ‘personality disorder’ construct – remain intact
  • Service users’ testimonies show SIM-like practices caused iatrogenic harm, while health workers who tried whistleblowing were punished for speaking out
  • A culture of unaccountability and blame-shifting has resulted in a lack of meaningful institutional change
  • Though NHS England called for SIM-like practices to be “eradicated”, our research found multiple ongoing schemes which continue to criminalise distress including PAVE, FERN, HaRT and Op Ipsum.

NSUN fully supports the report’s calls for an end to punitive, exclusionary and discriminatory practices and NHS collaboration with police to criminalise people in distress, for NHS England to apologise to the StopSIM Coalition (following their failure to publish a joint policy developed in collaboration with the StopSIM coalition) and launch an independent inquiry into ongoing SIM-like practices, and for the government to address the social determinants of mental ill-health as well as funding non-coercive, community-based crisis support.

We echo the report’s concluding remarks:

“SIM was an example of a wider problem. Lack of compassion, failure to respect confidentiality, coercive practices, exclusion, denial of care, criminalisation and outright abuse are all far too common. Nor can we hope to truly eradicate SIM-like practices while the NHS’s culture of blame-shifting and unaccountability at the top remains intact and whistleblowing frontline staff continue to be punished. This same culture meant that the medical establishment waved through SIM, and it was left to people with lived experience of prior harm and injustice in the mental health system to challenge the programme. The abject failure of NHS England and the Care Quality Commission to meaningfully listen to survivors’ voices and take responsibility for creating real change means that patients – in particular, some of the most profoundly traumatised, stigmatised and failed by society – continue to be criminalised, neglected and used as scapegoats for a grossly inadequate system in need of radical overhaul.”

The report finishes by making recommendations to health workers, royal colleges and other mental health charities, NHS trusts and ambulance services, NHS England and the government. We urge each of these groups to heed these recommendations.

Read the report via Medact’s website.