Dr Alison Taggart

GWAHS

2 Palmerston Rd

Mt Druitt

NSW 2770

28.02.2024

Re: Tanya Mott (DOB: 22/10/1987) NBM9970 mental health referral and review

Dear Dr Taggart,

Thank you for referring Tanya Mott for an Aboriginal Torres Strait Islander plan for ‘anxiety and depression’ on the 6th of November, 2023. I am her allocated provider through the Wentworth Healthcare PTS program and write to provide you with feedback at the end of this plan, and to acknowledge her new referral.

Tanya attended the first consultation on this plan on the 24th of November, 2023. She attended fortnightly to monthly consultations and continues to engage well.

Initial Presentation

At the time of her initial consultation, Tanya reported a deterioration in mental health following a range of psychosocial stressors including:

Relationship stressors with her partner of 19 years, including his infidelity, substance abuse and associated changes in personality and her feeling “abused and treated badly”

House being raided by police for partner’s offences, which led to his incarceration in July 2023 (currently out on bail)

Uncertainty over the future of their relationship and wanting to separate

Her being charged with possession of cannabis

Eviction notice for current rental accommodation

Flood impacted 3 times, however was not able to access financial support

Tanya stated that she felt overwhelmed with all of the stressors and was unsure how to manage. Moving was a particular stress, as her partner’s belongings are extensive and difficult for her to pack up (cars, tools etc.).

Taya stated “I can’t endure anymore. She reported suicidal ideation, but stated “I haven’t acted on the thoughts and couldn’t do it to myself.”

Tanya showed signs of emotional distress, including anxiety and frequent crying when talking of her situation. Her thought processes showed a continual rumination of stressors, which was affecting her ability to make decisions and think clearly about a plan of action to tackle the challenges, not helped by her apparent lack of confidence in her ability to function independently. She was using cannabis to self-medicate, both to manage her anxiety and help sleep, which she was finding difficult.

24.11.2023 K10 score: 44/50

Mental health history

Anxiety and depression since age 14yrs.

Had counselling previously in Penrith.

History of deliberate self-harm (DSH) between age 15 and 18.

Family history

Diabetes;

Mother: Myocardial infarction

Physical health

History of asthma

Medication

Was on antidepressant medication from age 15, but stopped 3 years ago.

Medication for asthma (See GP referral)

Developmental history

Second oldest of six children. PGF: Aboriginal; PGGM Aboriginal (stolen generation); Taree Birapurra tribe.

Parents separated during Tanya’s childhood but reconciled and continue to live in the same dwelling in their later years.

Tanya reported a history of learning difficulties as a child and struggled with grades in high school.

Left school early

Reported history of suicidal ideation from teenage years

Teenage years: sexual abuse by boyfriend’s father and friends for some years. One of the perpetrators was convicted and incarcerated. Tanya endured 6 years of court related to this matter, which was traumatic.

Reported becoming withdrawn and isolated after that, losing close friends.

AOD

Using cannabis for the past 3 years to “sleep and relax”. However, now using medical cannabis.

Occasional alcohol.

Denies other substance use.

Supports

Tanya has been on the disability support pension (DSP) for 10 years

Lives in a rental property with two stories. Her brother currently lives downstairs with his partner and children.

Has two dogs.

Tanya is close to her family.

Formulation

36 year old woman on DSP, at risk of homelessness, presenting with anxiety and depression in background of complex psychosocial stressors and history of childhood sexual abuse.

Impression

Situational crisis.

Trauma disorder

Lack of self-confidence and self-worth

Lack of meaningful occupation and purpose in her life

Update

Tanya continued to struggle with anxiety and low mood throughout the referral period, due to ongoing stressors in her life. Her rental situation came to a head when she was served an eviction notice a month ago, with the date to leave the property now imminent. I have been supporting Tanya to access services for emergency housing, since she has been unable to find a property to rent within her budget. She submitted an application with Link Housing last week.

Another stress was her partner’s release from jail, on bai. He is required to remain at his parents’ address. Tanya has been ambivalent about the future of their relationship and his release increased her anxiety as she is unsure how to proceed. He has also not been arranging the removal of his possessions from the rental property, causing additional stress.

Tanya engages well in sessions, keen to seek help and express her thoughts and feelings. At the time of her review on the 31.01.24, she concluded that she wanted to continue sessions and you have since provided her with a second referral.

Addit: Tanya has just secured a rental property, which is an independent dwelling on acreage where her parents and brother’s family will have other dwellings on the same property. She is very happy to be moving forward with her life.

Plan

Continue fortnightly to monthly sessions.

Thank you for sending through Tanya’s second referral.

I will provide an update at the end of this referral period.

Regards,

Michelle Hookham