Read the case notes and complete the writing task which follows

Notes

Harry Kovacs is a 5 year old boy who is the son of one of your newly referred patients in the community mental health centre where you are a mental health case manager.

Date of birth:                                   15 April 2006

Place of birth:                                   Sydney Children’s Hospital, Sydney

School year:                                    Kindergarten

Religion & ethnicity:                           Catholic & both parents Australian born Hungarian

Mother’s name:                                Elizabeth Kovacs

Mother’s community admission date: 16 May 2011

Diagnosis:                                     Mother – Major depression with psychotic features Son – ? Early onset separation anxiety disorder

Family/Psychosocial:                     * Elizabeth suffered PND – depressed since

*She sometimes hears voices calling her and sees ‘men’ running around her house – nil serious psychosis in functional terms.

* Recently 1^st psych admission for 6/52after high lethality DSH attempt.

*Harry’s psychological status ok until DSH and hospitalisation; after this +++ signs of separation anxiety

*Father is self employed and works long hours 7/7. Rarely sees Harry & dismissive of Harry’s emotional states, ‘He’s like a bloody girl now!’ he told us.

*Harry loves soccer and playing with his dog, ‘Rusty’.

Medical History:
Eczema

Serous otitis media – required grommets at 18 mths Hearing NAD now.

Medication        :                                                Nil meds

Case management care and progress:

• Elizabeth new to our area (from Parramatta) & referred to us post D/C from Bankstown MH inpatient unit 2/52 ago

*We will provide her with long term MH case management.

*Harry now 1) cries and panics whenever Mum leaves his sight 2) Socially withdrawn & refusing to attend kindergarten 3) ↑ insomnia & nightmares 4) preoccupied re Mum’s daily activities & that she might leave him again.

• This is greatly ↑pressure on Elizabeth when her MH is already fragile.
• Father, John, uninterested in meeting in person or discussing problems in detail.

*Harry attended initial assessment with Elizabeth and separation anxiety behaviour very obvious

Referral plan:                           * Referral to early childhood mental health team for assessment and management of Harry’s ? early onset separation anxiety disorder.

*Request joint meeting with case manager and Elizabeth.

You are the Case Manager caring for Harry Kovac’s depressed mother but due to his psychological issues need to write a referral for him to John Dyer, Clinical Psychologist on the Bankstown early childhood mental health team at Bankstown Hospital.

In your answer:

• Expand the relevant notes into complete sentences
• Do not use note form
• Use letter format

The body of the letter should be approximately 180-200 words.

Sample answer by Lifestyle Training Centre

9/24/2021

Dear Mr Dyer,

Re: Harry Kovacs, 15/04/2006

I am writing to refer Harry, who requires your assessment and management. He is suspected to have early onset separation anxiety disorder, following his mother, Mrs Elizabeth Kovacs’, mental illness and hospitalization.

Harry’s psychological status got affected and then it worsened after his mother’s high lethality self-harm attempt. His mother is diagnosed with major depression along with psychotic features, including hallucination. At present, she is admitted to our facility and will undergo long-term mental health care.

Harry cries and panics if his mother leaves his sight. He sticks with her and is afraid to lose her. He is socially withdrawn and refuses to attend kindergarten. He suffers from insomnia and nightmares. He has history of eczema and serous otitis media, but currently his hearing is fine.

Harry’s father, John, shows no interest in his current situation or emotional state ; he is busy, self- employed and rarely sees Harry.

Considering the above, it will be greatly appreciated if you could assess Harry and provide support. If a joint meeting with Mrs Elizabeth will help Harry’s situation, kindly arrange it.

If you have any further queries, please do not hesitate to contact me.

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