Dr Dovini Sooriyabandarra

Conrad Road Family Practice

45 Conrad Road

Kellyville Ridge

NSW 2155

06.02.2024

Re: Belinda Hunt (DOB: 27.04.1983) NBM10167 SOS referral review

Dear Dr Sooriyabandarra,

Thank you for referring Belinda Hunt to the SOS MHCP with Wentworth Healthcare for major depression, anxiety, following a suicide attempt by overdose in November, 2023. I write to provide you with a review at the end of this referral.

Initial presentation

At the time of her initial presentation, Belinda had just been discharged from Westmead Hospital following an attempted overdose, by taking antibiotics she had a known anaphylactic allergy to. She recognised that this occurrence was a crisis response to emotional distress associated with a complex range of psychosocial stressors. Subsequently, she expressed feelings of guilt about how her suicide attempt had impacted her family and she had made a promise to not do that again. She had made a plan to take time out should she get to that point of impulsivity again. Following her suicide attempt, Belinda had significantly decreased her alcohol consumption, which had caused some withdrawal symptoms.

Stressors included:

her husband being off work and on worker’s compensation since July, 2023

husband’s recent disclosure of childhood sexual assault (CSA), and deteriorating mental health, which triggered her own traumatic childhood events; also gambling addiction (husband) financial stress and debt

death of her father

managing full-time work, domestic load and children

relationship stress due to all of the above, including emotional dysregulation and arguments

some feelings of intimidation when husband is angry

working from home with the whole family being around

Belinda reported broken sleep, due to getting up to the children, and her partner’s CPAP machine, which also were contributing to her low mood and emotional dysregulation.

23.11.23 K10: 37/50

Past history

History of domestic violence with previous partner.

History of CSA by her brother, from age 7 until 12 (only sibling); complicated emotional attachment to brother as a result of abuse and ongoing family relationship challenges because of dynamics of abuse.

Family history

Mother: hoarder

Father: deceased – 2025 - cancer

Physical health history

Anaphylaxis since Covid vaccination

Medication

OCP

Prednisone for reaction to antibiotics

AOD

Cannabis and alcohol use from age 18

Past history of methamphetamine addiction – age 20 until 2015. Had difficulty coming off it.

Past history of cocaine use – daily for 4 years

Alcohol dependency – up to 2L vodka per week.

Supports

Works full time, mostly from home.

Lives at home with partner and two children: Nathan, age 4; Layla, age 3.

Mother is supportive and minds children 3 days a week; father is deceased.

Intervention:

A range of psychotherapeutic interventions have been utilised to support Belinda’s emotional wellbeing. We have considered strategies for emotional regulation, and ways to improve communication in the home. Child protection and safety were explored, however Belinda was able to assure me that even though they were experiencing relationship stress, things were improving and the children’s welfare was a priority and motivator for them both to get better. We explored the possibility of family systems therapy and/or couples therapy in the future.

Progress

Belinda reported significant improvement by the beginning of January. She had managed to introduce strategies at home, which had made a big difference to communication in the home. She reported her and her partner were listening more and arguing less and “growing more together.” She stated “everything has definitely improved.” Consequently, the children’s behaviour had also improved.

Belinda has ongoing work to do around processing adverse childhood events and associated family discord and she has good capacity for psychodynamic approaches to explore these challenges, with good effect.

At the time of her review on the 02.02.24, Belinda reported “I’ve been really good. I’ve stepped up at work to ‘acting’ manager” and was enjoying the challenge. She stated “things are getting better; arguing is less; the house is so much better.” She described her mood as “stressed but happy; nothing like it was before.” She had occasional suicidal thoughts, but no intention or plan. Belinda continues to decrease her alcohol intake and is happy to report that it is significantly less than before and she has plans to quit smoking as well.

02.01.24 K10 score: 22/50 – significant improvement.

Formulation

40 year old Caucasian female, mother or two, living with her de facto partner, presenting with anxiety and depression and suicide attempt in November, 2023 in background of childhood sexual abuse within a multi-stressed family system and past history of poly substance abuse.

Impression

Complex trauma

Plan

Belinda would like to continue to see me.

She plans to see you for a review and to discuss other referral pathways.

She may be eligible for other Wentworth Healthcare mental healthcare plans, which you can explore together. I recommend that you speak with the WHL intake line on: 1800 223 365 to explore plans that might be applicable for Belinda. Due to personal debt, a WHL plan would best support Belinda being able to access ongoing psychological support.

Regards,

Michelle Hookham