16^th September 2022. T-Minus nine days and counting.

The prospect of waiting another nine to eleven months for the Parliamentary Health Service Ombudsman to allocate a caseworker made me feel vulnerable, as though I were perched on the rim of a vast caldera fearful of an eruption. Doom was approaching, manifesting out of the intergenerational trauma recently unpacked by Sally Mungall and given tulpa-like form through the blueprints of my unprocessed art therapy drawings. The crust over the cauldron had been broken. Beneath it was a cesspit of awful shame. Sally Mungall’s own words, cruelly imposed themselves on me. ‘The aura of disgust about you was so strong that when I went home I immediately needed to shower myself off to feel clean.’ It was like standing knee-deep in that cesspit while my very skin felt disgusting. Sediments of shame and layers of disgust.

And alongside the shame and disgust was prickling fear, drenching humiliation, cold abandonment and a pervasive powerlessness.

It felt like I was losing control, control of autonomy, my mind and even my identity. I was becoming disconnected, unattached to any real sense of who I was and my place in the world.

I desperately needed accountability, honest answers to a plethora of reasonable questions. I needed resolution and closure. I may as well have been stranded on an island in the middle of a vast and empty ocean. Wanda Reynolds had been disingenuous. Andy Ashby had been desultory. Julie Yalden had simply disregarded me.

And Sally Mungall had remained silent, throughout.

I had entertained the idea of enlisting Sally as a private therapist, to continue the work started at CAMHS, as far back as December, 2021. I had aired the same suggestion in my 12 page letter handed over at the end of our art therapy sessions. There were other significant psychological issues that Sally wanted to pursue. And then there was  the ‘big’ academic paper that she wanted to write about me. My best friend had even offered to pay her fees but something didn’t sit well with me. There was resistance, a question of ethics that I couldn’t rationalize or put into words. In the wake of the news from the PHSO I returned to Sally Mungall’s art therapy website and reevaluated the idea. It was then that I noticed her affiliation with two organisations.

The first was the British Association of Art Therapists. Their website states

‘We are the professional membership organisation for art therapists in the UK. We work to promote art therapy and provide professional support and advice to our members. We represent art therapy to commissioners, policy-makers and opinion-formers and work to ensure that the wider public understands what art therapy is and how it can help transform lives’. ‘Our full members are all qualified art therapists, regulated by the Health and Care Professions Council, a statutory requirement in the UK for art therapists’.

The Health and Care Professions Council was Sally Mungall’s second affiliation.

The Health and Care Professions Council (HCPC), is the statutory regulator of over 280,000 professionals from 15 health and care professions in the UK. The main purpose of the HCPC is to protect the public. It does this by setting and maintaining standards of proficiency and conduct for the professions it regulates. Their website states

‘We protect the public by regulating 15 health and care professions in the UK

To do this we:

SET STANDARDS for professional’s education and training and practice;

APPROVE PROGRAMMES which professionals must complete to register with us;

KEEP A REGISTER OF PROFESSIONALS, known as ‘registrants’, who meet our standards; and

TAKE ACTION if professionals on our Register do not meet our standards.’

My attention was drawn to ‘set standards’ and ‘take action’. The HCPC have 10 sections listed under ‘Standards of conduct, performance and ethics’. Section 8 of that list is titled ‘Be Open When Things Go Wrong’.

‘OPENNESS WITH SERVICE USERS AND CARERS’

8.1 You must be open, honest and candid when something has gone wrong with the care, treatment or other services that you provide, by: 

- where applicable, alerting your employer of what has gone wrong and following the relevant internal procedures; - informing service users and where appropriate carers, or where you do not have direct access to these individuals the lead clinician, that something has gone wrong;- providing service users and carers with a detailed explanation of the circumstances in which things have gone wrong and the likely impact; and- taking action to correct the mistake if possible and detailing this action to the service user and where appropriate, their carer.

8.2 You must apologise to a service user and their carer when something has gone wrong with the care, treatment or other services that you provide.

DEAL WITH CONCERNS AND COMPLAINTS

8.3 You must support service users and carers who want to raise concerns about the care, treatment or other services they have received.

8.4 You must give a helpful and honest response to anyone who complains about the care, treatment or other services they have received.'

Further reading of the HCPC website revealed the following

‘Fitness to practise - Raising concerns

We protect the public by investigating concerns about the fitness to practise of our registrants.

Anyone can raise a concern about a registrant’s fitness to practise. This includes members of the public, employers, colleagues, the police, other organisations and other health and care professionals.’

FITNESS TO PRACTICE

In medical law and medical licensing, FITNESS TO PRACTICE is a concept in the regulation of medicine regarding whether a health professional or social worker should be allowed to work.

The HCPC regulates ‘fitness to practice’. Their website states, ‘If you are unhappy with the care or service you have received from one of our registered professionals, it is usually best to tell the professional or other management staff at their place of work. This will give them the opportunity to put things right and is generally the most effective method of resolving a complaint.

So, here was an opportunity for formal recourse, a mechanism of accountability, made possible through a ‘fitness to practice’ complaint. Such a complaint would lead to an investigation that would almost certainly answer my questions and ultimately lead to closure. But this became my ethical dilemma. A ‘fitness to practice’ complaint can lead to punitive sanctions against registrants. Indeed, the ultimate penalty that the HCPC can impose is ‘STRUCK OFF’, meaning that the registrant is removed from the HCPC register and no longer legally allowed to practice. I did not want Sally Mungall to face a reprisal that would risk her livelihood.

I returned, instead, to the ‘Standards of conduct, performance and ethics’ and Section 8.1 to 8.4. My formal complaints addressed to PALS at the Sussex Partnership NHS Foundation Trust had been batted out of bounds and into the long grass. It was a ball that the PHSO was in no hurry to collect.

And so I decided to reach out to Sally Mungall , privately, using contact details advertised on her Art Therapy services website. In keeping with Section 8 of the ‘Standards of conduct, performance and ethics’ laid out by the HCPC, I began drafting a letter asking Sally Mungall for help in understanding what had gone wrong in the therapy that she had provided and why she and her clinical cohorts had misrepresented me. Even at this late stage I was convinced that Sally Mungall was fundamentally honest and committed to the care and wellbeing of her mental health patients.

I was wrong.