Dr Meeta Mahale

Hawkesbury Family Practice

86 Lennox St

Richmond

NSW 2753

18.06.2025

Re: Alannah Sullivan (DOB: 05/07/2002) PTS MHCP review

Dear Dr Mahale,

Thank you for referring Alannah Sullivan for a Wentworth Healthcare PTS Young Person’s plan for psychological support for ‘Acute stress disorder and possible PTSD after a natural calamity whilst overseas’ in March 2025. Alannah attended her first session on the 24th of March, 2025. She engaged well and was able to open up about the challenges impacting her mood and mental health. I write to provide you with a review at the end of her treatment plan and to let you know the referral has been closed.

Initial Presentation

At the time of her initial consultation, Alannah reported anxiety following an earthquake (7.4 rictor scale) whilst in Vanuatu on holiday with friends in December 2024. They were evacuated by military plane following a week of daily quakes. Since returning to Australia, Alannah reported being hyper reactive to storms/thunder; and having intrusive anxious thoughts of things going wrong, such as the train will crash or there will be a fire in the high rise and she won't be able to get out. She said that the acute impacts had started to decrease after three months.

Alannah reported the main stress at that time was in the family home, where she lives with her parents and younger brother. Her younger sister had just moved out with her boyfriend and in the lead up and since, Alannah considered that her mother was not coping. She reported her mother to be crying, yelling and seeking support from Alannah, which put increased pressure on her. Alannah said that she felt out of her depth to know what to do and felt upset, stressed and stuck; wanting to move out but unable to afford it as is not working.

Alannah was observed to be emotional during the first consultation as she spoke of the traumatic events and other stressors.

18.06.2025: K10 score: 31/50

Family history

Family history Mother started antidepressants recently

No other family history of MI

Mental health history

Alannah has a past history of anxiety at times, with vomiting.

No other previous psychiatric history

No history of psychotropic medication

Supports

Macquarie Uni student - law and arts (music major)

Alannah is close with her MGPs and has spent a lot of time with them, She lives with them part-time during the uni term

Developmental history

2nd oldest of four children

Older brother is 25 and lives out of home

Younger sister 20 just moved out

Younger brother 18 lives at home

Alannah reported being independent

Went on exchange to Liverpool UK for 6 months and had a very good experience

Physical health

Alannah reported stomach issues since the earthquake, which has increased anxiety. She had a colonoscopy which was normal and ruled out IBS.

Update

Alannah engaged well in fortnightly consultations, with a total of four sessions. During one session, she disclosed some challenges during her teenage years with a school friend of a personal nature, which affected her wellbeing/self-worth for a period of time afterwards. A range of psychotherapeutic interventions were utilised to support Alannah’s recovery and to assist with coping strategies for anxiety

At the time of her review on the 2nd of June, 2025, Alannah reported:

“I’m very on and off; sometimes I feel a lot better and other times the same. I still have a lot of stressors. Over the past week, I’ve been able to get the train with ease (exposure). I’m no longer afraid of storms; planes used to scare me but I’m fine now.”

At home she reported that challenges with her mother had settled. She was applying for jobs with the view to leaving home in the near future.

02.06.2025: K10 score: 21/50

This demonstrates a decrease in anxiety since beginning of plan.

Formulation

22 year old university student, living at home with parents and brother, presenting with increased anxiety following an earthquake experience whilst traveling.

Impression

Consider:

Acute stress disorder

Situational crisis

Plan

Discussed care with Alannah. The referral has been completed. She is unsure whether she needs another plan at this time. She suggested to close the referral and will see her GP if she needs further sessions. She is aware that I am away for the month of July. In the meantime, she will use the anxiety workshop to strategies to manage anxiety.

Regards,

Michelle Hookham