Dr Alison Taggart

GWAHS

2 Palmerston Rd

Mt Druitt

NSW 2770

10.12.2024

Re: Tanya Mott (DOB: 22/10/1987) NBM10809 MHCP review

Dear Dr Taggart and other GPs at GWAHS looking after Tanya Mott,

Thank you for re-referring Tanya Mott for an Aboriginal Torres Strait Islander plan for ‘anxiety and depression’ in July, 2024. 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 request another referral.

Tanya first started coming to see me in November, 2023. Since that time, she has subsequent referral through Wentworth Healthcare, and has attended fortnightly to monthly consultations. She is making significant progress with her recovery, and would like to continue with another plan – see Update below.

Initial Presentation summary (see previous correspondence for MH Ax)

At the time of her initial consultation in November, 2023, Tanya reported a deterioration in mental health following a range of psychosocial stressors (please refer to previous correspondence for a comprehensive mental health assessment).

At that time, Tanya stated that she felt overwhelmed with all of the stressors and was unsure how to manage. She 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.

Tanya has a history of depression since the age of 14, and episodes of deliberate self-harm (DSH) between the age of 15 and 18. She reported a history of childhood sexual abuse and associated PTSD. She was on antidepressant medication from age 15, but stopped 3 years ago. She has a history of cannabis use for the past 3 years to “sleep and relax”. However, is now using medical cannabis. She denies other substance use.

24.11.2023 K10 score: 44/50

19.07.2024 K10 score: 37/50

20.11.2024 K10 score: 28/50 – congruent with presentation and general decrease in psychological distress.

Supports

Tanya has been on the disability support pension (DSP) for 10 years. She has recently separated from her partner of 20 years and has moved into an independent dwelling on the same property as her parents’ rental property. She is close to her family and has two dogs.

Update

Over the past six months, Tanya has made significant improvement in her recovery. Her anxiety levels are lower and she is coping better with stressors in her life, as evidenced by her K10 score of 28/50. She continues to have contact with her ex-partner, in a complex relationship dynamic that causes stress and confusion for her. However, she is learning to stand up for herself and is less impacted by the situation. She has a new person in her life and is enjoying time with someone who treats her very well.

At the time of her review on the 4th of December, 2024, Tanya reported feeling much better. She stated “I’ve been doing a lot better since seeing you; talking about things helps.” She reported that she hadn’t had suicidal thoughts for many months. In recent sessions, Tanya has explored underlying patterns and negative core beliefs around not feeling worthy or valued or respected, which was very insightful. She is currently reflecting on how that impacts her relationships going forward, and to reconsider the position that she deserves to be treated well in relationships.

MSE: taking good care of personal appearance; engages well with good eye contact and easy rapport; she describes her mood as “up and down; good.”; affect is reactive and congruent with mood; thoughts are logical and sequential; no alteration in perception or expression of hallucinations or delusions; denies suicidal ideation and has hopes for the future. She is developing insight and shows good judgement in decision making and actions.

Formulation

37 year old single woman of Aboriginal heritage, on DSP, 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

Plan

Continue fortnightly to monthly sessions.

Could you please contact the NBM PHN’s PTS intake line and request an ‘extended’ care plan for Tanya?

The contact number is: 1800 223 365

Thank you.

Regards,

Michelle Hookham