Dr Rory Webb

Kurrajong Village Medical Centre

Shop 1, 66 Old Bells Line of Rd

Kurrajong

NSW 2758

13.06.2025

Re: Dolores Craig (DOB: 05.11.1963) MHNIPS review

Dear Dr Webb,

Thank you for re-referring Delores for a Wentworth Healthcare MHNIPs plan in May 2024. I write to provide you with a review and to let you know that the referral has been closed as Delores has moved out of area.

Initial Presentation

Delores Craig was initially referred to me by her GP in November, 2019 for psychological support for complex post-traumatic stress disorder (CPTSD), generalised anxiety disorder and depression, associated with multiple biopsychosocial stressors.

Delores reported a ten-year history of not coping with everyday life, due to impacts of traumatic life events. She reported high anxiety and panic about everyday functioning, including situations that require engaging with the community, seeking employment, managing activities of daily living and meeting financial obligations. She stated:

“Anxious thoughts become overwhelming to the point where I just freeze and then can’t go outside.” Delores frequently has dissociative episodes and withdraws from people and becomes socially isolated, which contributes further to low mood. She stated that when anxious thoughts “all come crashing in, I have dark thoughts about not wanting to be here.” She reported suicidal ideation and thinks about ways to end her life when emotions become overwhelming. She frequently reported states of terror, with high levels of fear, out of proportion to the trigger, associated with the PTSD. At these times, she experienced agitation, shaking throughout her body, followed by periods of fatigue that lasts for days. Nightmares and flashbacks were impacting sleep, further affecting functional capacity.

The 2020 – 2022 Hawkesbury bushfires and flooding events were more recent triggers for anxiety, with further activation of PTSD, because of the association with other traumatic life events involving the death of loved ones in a house fire. Delores has experienced an additional reminder of past trauma associated with the registered missing person, and previous partner.

Mental health history

2024: Diagnosed with CPTSD by Dr Ruby Thavakulasingam (possibly other diagnoses, however I have not seen the report)

2016: Diagnosed with anxiety and depression.

2017: Diagnosed with anxiety and PTSD. Delores stated that the PTSD stemmed back to the disappearance of her partner in 1989 (who has never been found and whom Del continues to have nightmares about his disappearance).

Update
Delores moved to a private rental in Campbelltown in March, 2025 with her son and grandchildren. The move has been very positive for Del. She is enjoying being close to her daughter and her grandchildren. This, together with being approved for the DSP have taken considerable pressure off, with significant improvements to her mental health. At the time of her review today, she reported feeling much happier; with less anxiety. She stated that she still has low days, however is able to push through. She denied suicidal ideation and has plans for the future.

Delores’ next priority is to pursue public housing for long term housing security. I have provided a support letter to ensure they consider accommodation suitable for her mental health (with a garden and/or close to nature). She would also like to meet other people, as she feels socially isolated in the new area.

K10 scores over this period:

22.04.2024: 35/50 22.11.24: 33/50 13.06.2025: 20/50

Functioning and Supports

Delores lives with her son and grandchildren in Campbellt

She is now on the DSP

Delores has 3 children: Paloma: 27 (next of kin), Son, Beau: 31, Stien: 35

She has a few friends, who are supportive.

Her daughter, Paloma, lives close to her new home

Formulation:

61 year old woman presenting with anxiety, depression and CPTSD in background of complex psychosocial stressors, including childhood trauma and recent suicide of her brother, seeking therapeutic support to reduce symptoms, improve her functioning and get her life back on track. Currently stable and doing well.

Impression:

CPTSD

Anxiety

Plan

Referral has been closed as Delores has moved out of area and is doing very well with her recovery.

Yours sincerely,

Michelle Hookham