Dr Dilani Balendran and Dr David Chow

Tindale Family Practice

115 Lethbridge St

Penrith

NSW 2750

14.10.2024 CONFIDENTIAL

Re: Jasmine Wilson (DOB: 26.12.1951) Mental health assessment

Dear Dr Balendran and Dr Chow,

Thank you for referring Jasmine for an Extended care plan for therapeutic support for “depression and anxiety disorder” in October, 2023 and subsequent referral in July, 2024. I am her allocated provider through the Wentworth Healthcare PTS program and write to advise that her care has been transferred to another provider.

Jasmine was previously referred to see me via Head to Health in August, 2022 and by Dr Arun Reddy in January, 2023.

Initial presentation

At the time of her initial presentation in August 2022, Jasmine reported feeling depressed. A single woman living alone, social isolation related to Covid lockdowns had impacted her. She stated that she had lost confidence in herself and expressed low self-worth.

Jasmine lives in a flood-prone area of the Hawkesbury and experienced increased anxiety about evacuations in 2022.

Jasmine reported a lack of energy, “with a feeling of heaviness as if hard to lift the feet and walk”, however medical tests had been NAD.

Over the course of her previous plan, Jasmine outlined a history of complex psychosocial challenges stemming from her childhood and her two previous marriages. These resulted in difficult relationships with some of her children, which continue to cause emotional distress.

22.08.22 K10 score: 21/50

22.01.23 K10 score: 16/50

See previous correspondence for comprehensive mental health assessment.

Mental health history

Disordered eating – reported a history of emotional binge eating and associated guilt; “acting out with food”. Jasmine reported a history of brain fog after bingeing and also anxiety about social engagement afterwards because of the impact of this on her digestive system.

Update

Over the past six months, Jasmine continued to process emotional challenges associated with previous adverse life events and associated negative core beliefs and behaviours. She has enjoyed the deep psychotherapeutic work and the insights she gains about her responses and coping strategies. Relationships with her daughters has been gradually improving.

In September, 2024, it became apparent that the main focus of Jasmine’s psychological distress was her eating patterns. She has a strict diet, which she was advised to follow over 35 years ago. If she deviates from that plan, she reports digestive disturbances of bloating, flatulence and diarrhoea, which she attributes to irritable bowel syndrome (IBS). Her challenge with eating is around wanting to binge on extra gluten and dairy free products at night, particularly if she has had a bad day or poor social experience. She then removes herself from social situations, because of her IBS symptoms and not wanting to be around other people when these are heightened. This then affects her mood.

Over the past few months, we had tried a few psychological approaches to improve the eating pattern. Whilst I thought it might be helpful to explore the underlying cause of the strict eating habit, Jasmine considered the main issue was to manage her urge to binge eat these additional foods.

At the time of her last appointment, on the 29th of September, we discussed the opportunity to change provider of psychological support to a specialist in eating disorders. Jasmine was keen to do this, and together we explored the options through Wentworth Healthcare. Contact was made with Proactive Psychology in Penrith and care transferred to Rebecca Dawson. Wentworth Healthcare have likewise transferred the referral to Rebecca.

Regards,

Michelle Hookham