Dr Michelle Li

Bligh Park Family Practice

Shop 10/6 Colonial Drive

Bligh Park

NSW 2756

30.09.2025

Re: Selena Glover (DOB: 10.08.1977) Review

Dear Dr Li,

Thank you for referring Selena for a PTS SOS plan under Wentworth Healthcare, for therapeutic support for major depressive disorder and PTSD. I write to provide you with a review and to request a new referral.

Selena had previous referrals to see me, commencing on the 17th of August, 2022, with a series of referrals under the MHNIP. Since her last review in March 2025, Selena has attended fortnightly to monthly consultations and has made significant progress with her recovery.

Please see previous correspondence for a comprehensive mental health assessment and reviews.

Initial Presentation

At the time of her initial presentation in August, 2022, Selena reported a history of deterioration of her depression and suicidal ideation following the sudden and unexpected death of her husband in May 2022. He had collapsed in the bathroom, blocking the door and preventing Selena from providing emergency first aid. This added to her grief, since she felt guilty and had recurrent thoughts that if she had been able to get to him, he may have survived.

Selena and Adrian had been married for 15 years. Selena reported an unhappy childhood and stated that after meeting him, her life improved and she found happiness, companionship and support. She struggled to want to live without him and was scared that her life may go back to the unhappiness she knew prior to Adrian.

Selena works in a childcare centre and loves her work. She reported that her mood is better when she is immersed in work, however plummets at the weekend, since these were the times she and Adrian spent together.

15.08.22 K10 score: 35/50

Mental health history

Depression, anxiety and PTSD – diagnosed 2023

Ongoing psychotherapeutic support with Michelle Hookham since August 2022

Update

Selena has attended fortnightly to monthly consultations over the last six months and continues to make steady progress with her recovery. She has navigated multiple stressors, including work place issues since stepping up to acting manager of the childcare facility and ongoing disappointment, confusion and sadness regarding the breakdown of relationships with her siblings and the resultant estrangement with her family system. April/May are difficult times for Selena, due to the anniversary of Adrian’s death, his birthday and her aunt’s death. This year, Selena had to navigate grief and loss without the support of her sister, which added a layer of complexity.

At times, these issues have contributed to overwhelm, low mood and lack of motivation, however Selena’s capacity to deal with adversity has significantly improved. She has been able to keep going and utilise resources to maintain functioning at a high level, evidencing improvement in resilience. In March she went on a cruise with friends for 10 days to New Zealand and was able to relax and enjoy herself fully for the first time since Adrian’s death.

In July 2025, Selena became the foster mother for Lucas, a three-year-old with complex needs. She brought him to an appointment in August and it was evident that they had bonded very well and the transition has been smooth. Selena is loving being his mother and is occupied with attending to his physical health needs including chronic URTI, an episode of pneumonia, dental issues and developmental delays. She has been coordinating work and multiple appointments for him, all of which have required her to take time off work, adding additional pressure. At the time of her last consultation, Selena reported having an emotional episode at work when feeling overwhelmed, however she was able to take time out and regain composure. Despite this, she was looking well, and I had no concerns about her safety.

13.12.24 K10 score: 26/50

Physical health

Selena has recommenced Ozempic after a few months of the medication being unavailable. Selena had some adverse reactions to this, including nausea and abdominal discomfort.

11 year history of hypertension.

Continues to struggle with hypertension, despite having commenced on anti-hypertensive medication. After a recent increase in blood pressure, Selena’s GP changed her medication, however she experienced side-effects of nausea.

Has a history of diabetes, however managed with exercise and diet.

Diabetic retinopathy: Hypertension/diabetes-related eye pathology, requiring injections (not macular degeneration), diagnosed in June, 2023. This was very distressing for Selena.

Medication – from GP referral

Coveram 10mg/10mg one tablet daily - mane

Effexor XR 150mg one capsule daily

Effexor XR 75mg one capsule daily

Gliclazide MR 60mg one table twice a day

Jardiamet 12.5mg/1000mg one tablet twice a day

Lipidil 48mg one table at night

AOD

1 glass of alcohol per day.

Supports

Friends in Melbourne.

MSE

Appearance: Caucasian female, dressed in work uniform. Good attention to hygiene and grooming.

Behaviour: engaged well; good eye contact, easy rapport.

Affect: Reactive. Congruent with mood. Laughing and smiling; crying and expressing grief at times.

Mood: “I’m feeling a lot better.”

Thought form: Logical; sequential; no FTD

Content: as stated above

Cognition: not formally assessed.

Orientation: oriented to person place and time.

Insight: Good. Is aware of the impact of childhood trauma and recent grief on mental health.

Judgement: Good. Coped really well with the challenges. Accessing therapeutic intervention when needed.

Formulation

48 year old Caucasian female, working in child care and living in private rental with foster son, Lucas, presenting with resolving major depression, PTSD and grief following the sudden death of her husband in 2022; in background of complex psychosocial issues, including childhood trauma.

Impression

Grief and loss; Major depression; PTSD. Recovering and doing really well.

Plan

Fortnightly to monthly consultations sessions for psychotherapeutic intervention.

Monitor mood

Focus on self-care and diabetes management

Dr Li, Selena’s PTS SOS plan is due for renewal. She would like to continue for another year, as she finds the support an essential part of her recovery process. Could you please contact Wentworth Healthcare’s intake line on: 1800 223 365 to request a further plan? Her previous plan was a MHNIP, which is also another referral pathway.

Thanks and regards,

Michelle Hookham