Dr Cynthia Anyasi

Advanced Medical Practice

George St

Windsor

NSW 2756

14.05.2025

Re: Kennedy Jackson (DOB: 09/02/1996) NBM13569 MHCP Assessment and Review

Dear Dr Anyasi,

Thank you for referring Kennedy Jackson for a Wentworth Healthcare PTS plan for psychological support for “Depression” in October, 2024. She attended her first session on the 15th of January, 2025. She engaged well and was able to open up about the challenges impacting her mood and wellbeing. She has attended fortnightly to monthly consultations since then and her PTS plan is now complete. I write to provide you with a report and to request an additional referral.

Initial Presentation

Kennedy reported a 10-month history of deterioration in mental health following separating from her de facto partner (Michael) of 7 years, and father of their 3 year old child, Evie, in March 2024. Initially, Michael wanted to hand over sole custody of Evie to Kennedy. However, he soon changed his mind and restricted Kennedy’s access to Evie, without a legal order, causing ongoing distress for her. At that time, we discussed a referral to Relationships Australia for mediation with regards to appropriate allocation of access to her daughter.

Communicating with her ex-partner increased anxiety and panic attacks for Kennedy. She reported having an acute startle response, flinching with sudden movements of other people, with an associated response to protect herself. She described her mood as "ok; not too low."

03.12.24: K10: K10: 38/50

Mental health history

Kennedy disclosed a history of trauma from her first relationship at age 19, to a person with an acquired brain injury, who was the perpetrator of domestic violence - physical, emotional and psychological, including entrapment in a garage for 6 months.

Kennedy reported ongoing challenges with anxiety and panic since that relationship. She had no prior mental health history.

Developmental history

Born in the UK. Her father was absent in Kennedy’s life until she was 17, leading to some feelings of not being good enough and not being wanted. She elected to have no further contact since Evie was born.

Parents separated when she was 2 and her mother re partnered when she was 5 and had another child. However, growing up with a half sister who was younger, Kennedy often felt left out.

Kennedy’s mother was in travel and they moved to Singapore and Hong Kong before eventually moving to Australia when Kennedy was aged 19.

She described her mum as a workaholic (career driven in sales), so Kennedy grew up more with her Nan.

Kennedy reported not being academic at school; “always behind; procrastinated”

Then went travelling and met Brayden (D/V relationship)

Found beauty therapy and started career in beauty; “loved it and excelled; got recognition”

Got a job in beauty then lost job and salon due to covid, causing a deterioration in mood and feelings of low self-worth and loss of confidence.

AOD

Currently is binge drinking and reported the binges have increased in quantity of alcohol; drinks to stop thoughts; has blacked out; wakes feeling remorseful.

Smokes tobacco; would like to quit

History of cannabis use; started during D/V relationship as helped cope with the entrapment/coercive control; smoked heavily then stopped abruptly when returned to UK after relationship broke down; then started again on return to Aus. Stopped when pregnant with Evie

Supports

Kennedy is in a new relationship with her current defacto partner and they reside together.

Supports Kennedy's mother lives in Australia and is supportive; she lost a lot of close friends following the recent relationship breakdown.

Works full time in Rhodes as an operations manager in retail. She is not happy in the role and would like to change, however she is loyal to management who have supported her throughout these difficult times.

Physical health

PCOS

Medication

Metformin for PCOS

Mental state examination (at time of initial consultation)

Caucasian female, born in UK; wearing fitness clothing;

Quiet demeanour; good eye contact and easy rapport

Reporting history of anxiety and low mood in context of multiple psychosocial stressors

“Mood has been low; no patience; lashing out with partner. Angry most of the time because of everything happening. I don’t have anyone to talk to; feel alone; hold emotions in then blow it out. It’ been tough. I’m not confident to deal with conflict, especially in professional situations.”

Denies suicidal ideation

No evidence of alteration in perception or other psychotic symptoms

Oriented to time place and person

Cognition not formally assessed, but working in high functioning role

Assessment

PTSD from past D/V relationship; Situational crisis from compounding life stressors

Update

Over the course of the plan, Kennedy has made significant improvement in her mental health. She engages well in every sessions and a range of psychotherapeutic tools have been utilised to support her recovery. She has gained considerable insight into behaviours and patterns stemming from adverse life events and is integrating the learning into her life.

Relationship dynamics with her ex-partner continue to be an ongoing cause of distress, particularly when shared care for Evie is compromised. Kennedy considers that lack of information about her rights to access contribute to a lack of assertiveness in the situation and she has affirmed her decision to consult with Relationships Australia in the near future.

Kennedy had a set back following a work review, however it inspired her to follow an performance plan, which has improved her functioning at work, which she feels good about.

The other major stress during this period was having to move house from the Hawkesbury to Penrith. Kennedy experienced some misunderstanding with the real estate, which went before a tribunal, causing distress and had financial implications. She is emerging from that and is otherwise happy with the move.

The above stressors have affected Kennedy’s mood. At the time of her review on the 14th of May, she reported feeling irritable and short tempered with her partner. She recognised her pattern to hold emotions in until they can no longer be contained (see MSE). However, she has good insight about this and is striving to work towards resolving. Her current strategies are to improve self-care by returning to the gym and exercising more frequently.

Formulation

29 year old employed mother of 3 year old child, living in rental property with her de-facto partner, presenting with anxiety and depression in background of multiple psychosocial stressors, including adverse childhood events and past history of trauma (D/V relationship/entrapment).

Impression

Consider: situational crisis; trauma disorder

Plan

Kennedy finds the sessions helpful and would like to continue. She plans to come and see you to request another Wentworth Healthcare PTS plan. Could you please contact the PTS intake line on: 1800 223365 when Kennedy is with you? She might qualify for a flood plan, as she was impacted by flooding whilst living in the Hawkesbury.

Regards,

Michelle Hookham