Dr Z Parvez

Advanced Medical Practice

Windsor

NSW 2756

06.02.2024

Re: Julie Fink (DOB: 07.02.1971) Review

Dear Dr Parvez,

In December, 2023, I sent you a review for Julie Fink. I write to provide you with an update to her care, which has changed since this last review.

On the 21st of December, Julie and I had correspondence where she requested to cancel all future appointments with me. On closer conversation with Julie, I became concerned that this was part of her suicidal ideation/plan to act on her thoughts. I discussed this with her and she was not able to give me an verbal agreement that she would not act on the thoughts at that time. I advised that I would need to refer her to the Access Team, for increased supervision over the Xmas period, which I subsequently did.

Unfortunately, Julie was upset with this course of action. She insisted that I cancel all future appointments., which I eventually did because of the strong insistence that I do so. I contacted her when I returned from holidays at the end of January, 2024 to ask how she was going and if she would like to resume sessions. The outcome of the complicated conversation was that she was still upset about the referral to Access and “struggled to trust anyone” and she didn’t know why I was calling as had already cancelled all sessions. I attempted to explain my position and care for her welfare, however Julie discontinued the call. I advised her by text message that I would close the referral, but if she changed her mind, to get back in touch to resume sessions.

Formulation from initial consult

52 year old woman of Aboriginal descent, living in rented accommodation with her youngest 2 children (teenager and young adult), working part-time and on Centrelink benefits, continuing to struggle with low mood and chronic suicidal ideation in background of multiple biopsychosocial stressors and past history of trauma.

Impression

Consider: Complex trauma; PTSD; Borderline personality disorder

Plan

MHNIP referral has been closed.

Should Julie wish to resume sessions at another time, I would be happy to see her. I have informed her that this is the case and to just get back in touch if and when she needs additional support.

Regards,

Michelle Hookham