The response to my initial complaint against both the Sussex Partnership NHS Foundation Trust and Southern Health NHS Foundation Trust was received on the 20th July, 2022 and allocated the reference designation SP22020, denoting the SPFT lead under CAMHS General Manager, Wanda Reynolds.
The response failed to address a significant proportion of my original complaint.
The response was at odds with many of the facts detailed in my disclosed medical records at the time.
The response became factually incorrect on other points of contention following later disclosed medical records.
The response raised even more questions than it purported to answer.
The response presented the final involvement of both Wanda Reynolds and Vicky Long in addressing my complaints. My revised complaint was lodged with PALS following SP22020 and subsequently handed over to Andy Ashby. Andy's careless and botched attempt to respond to my revised complaint will be addressed in A Murder of Conspirators # 18 titled Andy Ashby.
For now, here is SP22020, Wanda Reynolds and Vicky Long's response to my initial complaint.
'Chair: Peter Molyneux Chief Executive: Dr Jane Padmore Head office: Sussex Partnership NHS Foundation Trust, Swandean, Arundel Road, Worthing, West Sussex, BN13 3EP www.sussexpartnership.nhs.uk A teaching trust of Brighton and Sussex Medical School
Our Ref: SP22020
20th July 2022
In Confidence
Mr M Stock
Sent via email: ********************
Dear Mr Stock,
I am writing to you in response to your formal complaint regarding the work you undertook with Hampshire Child and Adolescent Mental Health Services (CAMHS). Thank you for your letter, for talking to me, and for your subsequent emails.
I want to start by acknowledging and apologising for your distress about the ending of the work that you had within CAMHS, your experience of the CAMHS service, and the way you have experienced services communication with you. I want to acknowledge that as a service we have made mistakes. The parent work that was offered to you appears to have quickly developed from parent work to therapy, which should not have happened, and by doing so we have caused you to feel distress, for which I am sincerely sorry. Whilst I do not believe this was intentional, I do recognise the pain that you have felt as a result of this work. In addition, I would like to apologise you have felt misrepresented in records and that this has distressed you further.
I have tried to answer the questions you have raised in your letter to both our service and Adult Services from Southern Health. The letter is written by both Southern Health's Adult Services Community Mental Health Service Manager, Vicky Long and myself each answering the questions about our respective services. I have gone through the questions and provided explanations in turn below. I hope this is helpful.
1) Was Sally suitably experienced and or trained to deal with 'transference' within the therapeutic relationship at CAMHS, particularly when involved with Parent work?
Sally was suitably experienced and trained, and is registered with both the Health and Care Pressions Council (HCPC) and British Association of Art Therapists (BAAT). Sally has many years' experience working with young people and family's within CAMHS.
2) What was the utility of the 'parent work' and how did it inform therapy that was being carried out in conjunction with the therapy being delivered by Mark Birbeck to my daughter Meg?
It is important that we work with parents alongside the therapeutic work with their child. As a parent you are well placed to support Meg's recovery. The purpose of the work is always about developing a greater understanding of the young person's difficulties, and how as a parent you are able to understand the Mental Health difficulty and support change. Sometimes this means changing ways of doing things to help the young person develop new skills.
Parent work may evoke thoughts and feelings about the parents own childhood and the experience of being parented. The impact of this on current parenting may be acknowledged in parent work, but if more in depth exploration/therapeutic support for a parent is identified this should be discussed with the parent in order to seek support from appropriate adult services. I apologise that this may not have been made more explicit to you and the work that you engaged with evoked painful feelings that could not be contained within the structure and timeframe of the work.
I am deeply sorry this opened up areas of your vulnerability and has left you felling exposed and raw. We are further investigating how this happened, to ensure that other parents are not offered therapy which should be provided by other services and that we are working within clear boundaries and frameworks.
3) Why was there no acknowledgement, no insight offered, no specific comments in the envelope of art therapy drawing I collected in 31st March?
The envelope contained nothing further because the last session with Sally had taken place and that, coupled with the letter dated 30th December 2021 marked the end of the work. I am sorry that this was not made expressly clear and you therefore expected further input.
4) Why was there no effort to provide written assessment of the work uncovering intergenerational trauma to support the unfinished intergenerational family tree included with the 'art therapy' drawings that I collected?
It would not be our usual way of working in CAMHS to provide an assessment of a parent, and the letter following your final session with Sally was a summary of the work. I am sorry if this is something that you had expected from the work, and again that the work you undertook felt unfinished.
5) What is the formal policy and where are the documented procedures and guidelines pertaining to CAMHS 'parent work'? Where are the empirical, multi varied studies into the ethics and efficacy of CAMHS parent work?
All CAMHS interventions are evidence based and/or evidence generating. We work within NICE guidelines, and the core principles and protocols as identified within a range of professional trainings and assessment and treatment frameworks. The efficacy of work with parents and carers to support an understanding of their child's presentation and recovery is well recognised within this, and through our learning from clinical and professional experience, service user participation and feedback, national and international developed and reviewed models of interventions, and extensive research and studies. These are documented throughout a range of professional journals, publications and literature including The British association of Counselling & Psychology, Journal of Child Psychotherapy, Family Therapy, Psychiatry, Nursing and many more.
There is not a specific formal policy within CAMHS regarding parent work but in addition to the above we endeavour to adhere to the governance and trust policy guidelines regarding safe and effective clinical practice.
We appreciate that you understood the value and importance of parent work in agreeing to undertake this in order to support your daughter and we will continue to reflect, evaluate and learn from your experience of our service.
6) Whose decision was it to unilaterally terminate me? Was it Sally's decision to 'cut me off' or was she persuaded or her original decision over ruled by her superiors?
Discussions were held with senior managers and clinical leads following receipt of your letter to Sally at the end of December 2021. It was decided that, as the work with Sally had had an ending session and a closing letter, it was not appropriate to offer a further session. I recognise that this has been disappointing and caused you considerable distress and for this I apologise.
7) Why was the meeting with Sally on the 3rd February really cancelled? And what at such short notice? And 8) Why did I have to wait patiently and politely for almost 6 weeks without a follow up call regarding the missed 3rd February meeting?
The discussions that were had (as mentioned above) were delayed due to senior clinician's annual leave. Sally was also off work unexpectedly and these factors led to a delay in informing you that the final session could not happen. As we discussed; in hindsight, I recognise that it may have been more helpful if I had called and had a conversation with you rather than informing you by letter. I recognise that the waiting and not knowing what was happening further exacerbated your distress and apologise for this. You have subsequently asked for minutes of these discussions. The discussions that managers and clinical leads had were at an operational level are not minuted in care records. The outcome of this discussion was that there would be a request for a professionals meeting with our colleagues in adult services. As discussed previously you will receive the minutes from this meeting.
9) Why was a new appointment to meet to review the art therapy drawings not made before the closing letter dated 8th march? That’s almost six weeks opportunity to do the right thing?
As a CAMHS service our primary task is to offer mental health assessment and treatment to young people, working with parents alongside to support the young person. When parent work is offered we would not usually offer an additional appointment after the work has ended and any review, including creative material should take place during the work itself. As a service we understood the work with Sally had ended, and a further session to discuss the art work when you collected it would not therefore be appropriate.
We did recognise the depth of feeling that you had experienced during the sessions and the importance of having a clear boundary around the work. It is not part of the remit of our service to offer therapy to parents, and we are sorry that you have been offered something that feels to you to be unfinished. As I mentioned previously; the decision was made following consultation and a review of the records that this work had been completed with both an ending session and a final letter. I know we have talked about the boundaries and the ethical areas that you sought to navigate with how you felt. As a leadership team we felt that the boundary that we put in place was appropriate and needed. I do recognise that this is a very difficult message to hear and that you have been hurt by this decision.
10) Why was my daughter's case closed before my case was closed? We were not separate entities. My art therapy was conducted in conjunction with my daughters. My objective was to gain insight into my parenting of my daughter. Once case should not have been closed until both were ready to be closed.
I recognise how difficult the message I am relaying is to hear and I acknowledge that it might be felt that I am repeating myself. We felt that the work had had an ending session and letter for both yourself and Meg. As mentioned previously; the decision to not offer an additional appointment was made by senior clinical, professional and operational leads and was accepted by Sally.
11) Did Sally want to change her mind or want to reassert her original decision to meet with me whilst Wanda Reynolds was investigating?
The decision was made by myself and professional clinical leads that the further appointment would not be offered, this was following the receipt of your letter at the end of December. We were concerned for you in terms of your emotion and that the boundaries of the therapeutic relationship were not clear. The decision therefore, after much discussion, was to advise Sally that this meeting was not to go ahead. The decisions to liaise with our adult services colleagues were due to concern for your wellbeing and in recognition that you were distressed.
12) Why have I not been informed of all information relevant to me, either held by CAMHS or the Bridge Centre?
You have now received the records that we (CAMHS) have on Meg's notes pertaining to you. I am sorry that this took some time but there are various processes that need to be adhered to within our access to record process. As we are a CAMHS service all notes are on your daughters records so this took further time as consent had to be received from Meg.
You were sent copies of your mental health assessments and the outcomes following your assessments with Kirsty Henry in February and Laura Jones in April, in line with our processes and procedures. I understand your request for access to your clinical records has now been processed and you now have copies of your clinical notes.
In relation to the professionals meeting held by CAMHS and the Crisis Resolution Home Treatment Team (CRHT); neither Kirsty Henry or the Meadows CMHT were invited or involved with this decision making. The professionals meeting was led and organised by CAMHS and as the lead agency they would have had responsibility for sharing any outcomes with you. Kirsty did appropriately note the meeting had been held and sought liaison with Sally Mungall from CAMHS to ensure there was no new information that could change her clinical assessment of your needs. She was advised a member of the CAMHS team would discuss the meeting with you. I understand Kirsty advised you of this at the time and explained this rationale to you.
Sean Dale Molloy has not seen any documents relating to you outside of his clinical notes regarding the ending of the relationship with Sally Mungall. I am not aware of any documents that exist outside of the RIO clinical recording system that the team use or have access to.
13) What other information has been held from me or not forwarded to me?
You should now have received all clinical documents held by our teams via the Southern Health Access to Records process and the Sussex Partnership Health Records team.
14) Why is it that I still have not been offered carers support? Sally said she would ask for carers support for me back in December 2021. Kirsty Henry recommended carers support in her report dated 16th February 2022.
We do not have access to CAMHS clinical notes, so I am not able to account for the offer of carers support from Sally. Wanda has reviewed the CAMHS notes and can see that Sally discussed this with you, which was why she also completed the safeguarding referral on 13th January 2022, which would trigger a carers assessment. There was no indication from Sally that there would be an assessment. CAMHS are unable to determine the services that the CMHT can offer and can only share information deemed to be relevant.
In regards to Kirsty's recommendation; she was new to the team at the time and did discuss the options available for carers support with the team. However, she did not include this in the recommendation letter. I apologise you were not signposted to the appropriate partner agency for carers support.
Since this time, our service has a newly appointed carers peer support worker who is able to offer up to 3 sessions of carer support and signposting. Hampshire County Council have the duty to offer an assessment of carers needs under the Care Act 2014 and I will request that our carers peer support worker supports you with this as part of your role as a carer to your daughter.
15) Why did Kirsty Henry not respond to my letter hand-delivered to The Bridge Centre between 24th February 2022 and 14th March 2022?
Kirsty did receive your letter in February and she responded to this on 25th March. It was forwarded to our admin team to send out. Unfortunately, I have not been able to establish if this was sent to you and for this I apologise.
16) Why was complex PTSD or autism not identified in either of my mental health assessments?
The assessments undertaken by our service are based on the presenting needs and situation. Our assessors do not diagnose and would not have the clinical expertise to do this. They are able to assess and identify clusters of symptoms and difficulties that they then present to the senior members of the team, including a Consultant Psychiatrist and Psychologist. A joint decision is then reached over appropriate support and treatment options.
According to our records, you have not been formally diagnosed with Complex Post Traumatic Stress Disorder (PTSD) and as a result this is not recorded. It is acknowledged during the assessments that you report you feel you have Complex PTSD. We are not a specialist autism
service and would not formally diagnose autism. We are able to signpost to Hampshire Autism and I understand you have already accessed support from this service.
17) Why is it that I have two different lists of recommendations following my two separate mental health assessments made by the Bridge Centre?
Recommendations are based on the presenting needs at the time of the assessment. It is possible that the assessors felt different signposting was needed at different points, depending on the needs they identified with you at the time of your assessments. I can see that both assessment outcomes had a consistent view that iTalk psychological therapies for Cognitive Behavioural Therapy (CBT) was appropriate and further suggestions to consider the Wellbeing Centre and Recovery college in your most recent assessment were also made.
18) Why should I trust either mental health assessment when the recommendations are so different?
The recommendations made for suggested treatment options with community partners do not have to be followed and is entirely down to individual choice. I can see evidence of robust risk assessment around your distress and openness that you had thoughts to end your life and appropriate safety measures were discussed with you during those periods of distress. Both assessments primary recommendations were iTalk psychological therapies for ongoing psychological intervention.
19) Why am I being denied immediate access to my medical health records at CAMHS.
You have now received the records that we have on Meg's notes pertaining to you. I am sorry that this took some time but there are various processes that need to be adhered to within our access to record process. As we are a CAMHS service all notes are on your daughters records so this took further time as consent had to be received from Meg.
20) Why has it been necessary for my GP, Dr Dougan to continually and persistently chase up The Bridge Centre, iTalk and Social Services?
Dr Dougan has been updated with your care and suggested treatment pathway with copies of your assessments. I have also written to Dr Dougan in response to a more recent letter sent to my service.
21) Is Laura Jones either an Approved Clinician or a Responsible Clinician? And 22) I recounted my telephone conversation with Laura Jones of the 4th May in a conversation with Sean Dale-Malloy later than afternoon and was informed by him was told by that such staff were not trained to deal with suicide talk from distressed patients. Was he wrong? And 23) Will Laura Jones be disciplined? She has been rude and contemptuous throughout my experience. My daughter has also been assessed by Laura Jones and felt intimidated by her attitude.
Laura Jones is Social Worker who has now left our team. However, I would like to assure you that Southern Health NHS Foundation Trust take suicide prevention very seriously and our strategy and support “Every Life Matters” can be found via our website (https://www.southernhealth.nhs.uk/help-crisis).
Further, all of our clinicians are given support and training on supporting individuals who are distressed and feeling unsafe. I am sorry you did not feel supported by the conversations you had with Sean Dale Molly or Laura Jones on 4th May.
I am also sorry you felt Laura’s attitude to you was intimidating during your assessment. I am not able to discuss this further with Laura because she has left our team.
24) Why did my daughter and I both have to wait so long for the reports of our assessments?
Routine assessments are presented for an outcome within 1 week of the assessment date. I can see your assessment was presented 3 days after your assessment. Specifically, your assessment with Laura was undertaken on 26th April. The assessment was presented at the multi-disciplinary
team meeting on 29th April and Laura telephoned you on 4th May to discuss the outcome. The assessment was sent to you on 11th May.
Assessors need to advise the outcome of the assessment both verbally and in writing within 1 week of the outcome. Whilst I can see Laura contacted you by telephone within that timescale, your assessment was not sent to you until 11th May, which is a delay from our expected timescales. The delay was caused by staffing shortages in our administration team and I apologise for this.
I have not found evidence of a recorded call made by Kirsty Smith with you to send to our team. Kirsty did follow up with an email to the team for the outcome of your assessment, but by this time you had already spoken with Laura and so she took no further action.
25) Will I have access to the document seen by Sean Dale Molly that details the unilateral decision made between Kirsty Henry and Sally to 'cut me off' from Sally?
No member of Meadows CMHT (including Kirsty Henry and Sean Dale Molly) were involved in the decision making around Sally's therapy ending with you during your time with CAMHS.
26) Was Wanda Reynolds privy to the decision made to 'cut me off' from Sally?
I can confirm that in my capacity as General Manager I was part of the decision making alongside my professional lead colleagues. The decision was based on Meg's case being closed and the evidence in the records of an ending session and ending letter. As already mentioned; we recognise that this has caused you distress but this is an appointment that should not have been offered and it was important that we made that clear to you.
27) Why is it that my mental health was allowed to deteriorate to the point where I felt my only option was, and still is, suicide?
I am very sorry that your mental health has deteriorated as a result of your experiences over the last few months. When we met with you we acknowledged the distress you experienced in the work with Sally and CAMHS. We are striving to support you via the most appropriate agencies.
I have reviewed your most recent assessment with Dr Matthew Spencer, Clinical Psychologist Lead and Dr Martin Scholtz, Consultant Psychiatrist for Meadows CMHT on 10th June and we support the recommendations to access iTalk psychological therapies. I have contacted you separately to outline the most recent decision from iTalk and I also understand you have accessed private counselling from Basingstoke Counselling service. I am sorry the decisions have not been what you were expecting after your experiences with CAMHS and that this has further added to your distress.
28) Why was I originally referred to iTalk but later denied access to that service? And 29) if iTalk are a recognised healthcare provider offering CBT for mental health issues including PTSD they why are they so nervous around patients expressing suicidal ideation? And 31) why does the latest assessment carried out with Laura Jones recommend I self-refer to iTalk?
iTalk are a partner agency and I have discussed your concerns Natalie Brown-Kennedy who is the service Clinical Lead. iTalk psychological therapies are able to work with patients who express suicidal ideation and self-harm behaviour, however patients are assessed as individuals and the degree to which they can engage in therapies and maintain their own safety. iTalk will work with individuals collaboratively on a safety management plan to manage their suicidal thoughts. Patients need to be able to commit to these plans to maintain their safety and be able to engage with therapy.
have advised that due to the impact of your current situation that they do not think you would be able to engage in therapy at this time. The team have discussed with you previously that engaging with the Wellbeing Centre to learn emotional coping skills to stabilise your distress and then self-referring to iTalk was one pathway that could be considered.
30) Who, at the Wellbeing Centre, is trained to deal with people with PTSD, complex PTSD or suicidal ideation?
The Wellbeing Centre are a partner agency who are able to provide support with varying levels of mental health needs. The purpose of the Wellbeing Centre is to promote recovery and support and have trained staff to work with patients with varying levels of needs.
I hope we have been able to address your concerns in full. However, if you have any further questions or concerns, or wish to discuss your response further please do not hesitate to contact the Complaints and PALS Team for Sussex Partnership on the details provided at the top of this letter.
Alternatively, if you wish to take this matter further please contact the Parliamentary and Health Service Ombudsman. I have enclosed their leaflet for your information.
Yours sincerely,
Wanda Reynolds Vicky Long
General Manager - Hampshire CAMHS Meadows CMHT Service Manager'
