Patient endorses homicidal ideation towards his sibling. Increasing behaviors at home. PHP (Clara’s House) attempted and will be discharged with recommendation of high level of care (residential). Patient has significant trauma after extensive physical abuse from biological mother and likely operates at a much younger age. Patient was removed from his mother’s custody by Ramsey County CPS in May 2024. Aunt is foster care provider.
Ancillary Support Service: IEP or 504 Plan Support
IEP (Individualized Education Program) or 504 Plan Support involves helping students with disabilities receive the educational accommodations and support they need to succeed in school.
RMC-F16-4041
16 year old female who was brought in by EMS in 4-point restraints after being restrained by PD trying to enter river to “drown herself”. Patient argued with her mother just before she threatened to “drown herself in the river;” destruction of house/property per mother’s report. Patient admits to past similar behaviors and has multiple MH hospitalizations on record.
PH-F11-3982
The patient presented after expressing homicidal thoughts (threats of aggression) toward her grandmother with whom she lives. Patient was on her way home from school when she pulled her school lvan driver’s arm to the back of the van as she did not want to return home. Patient was then returned to her school where her grandmother picked her up and eventually brought her to the Emergency Department. Since her presentation to the Emergency Department, the patient has not displayed any aggressive behavior. Patient has irritability and emotional outbursts with grandparent(s) and has displayed these behaviors at school as well. Has mostly been pleasant and cooperative in the Emergency Department. Has some attention seeking behaviors when the Emergency Department is busy.
RMC-M15-3979
Suspended (5/17) for bringing a knife to school. Went to school on 5/20 with uncle to search locker (items were missing from home-guns, knives, etc.). Pt became agitated and began banging his head on the wall. He also punched his uncle.
HCMCECC-M13-3482
**Contact department: HCMC Acute Psychiatric Services (APS) 612-873-9300
13 y.o. male boarding in ED. Brought in by adoptive mother after running away from home 3 times. Multiple suspensions from school (including currently) for fighting. Mother unwilling to bring patient home. Physically assaulted mother after he was brought back home. Went to Uncle’s house and left via window. Has been making passive comments indicating suicidal ideation and not having any sense of danger- getting into cars with strangers. Significant increase in challenges since he began going through puberty about 6 months back.
Copied from ED note:
“Collateral from mother and family:
Foster mother took in his sister first, took him as well at 16 months old. States that when he first came to live with her he would eat out of the trash, and from bowls on the floor like a dog. Took several months to correct this. Patient was then returned to his paternal grandmother in chicago, but was only there for two months. Foster system asked mother to adopt him and keep him with his sister. Some school issues, briefly on IEP. Mother was kindergarten teacher.
In the past 6 months, since hitting puberty and undergoing a growth spurt, patients behaviors have been worsening. In Nov of 23 patient attempted to start a fire in his bedroom. He has been in a plethora of fights at school. Is currently suspended. Believes that everyone hates him. Since January he has been making comments to family about ending his life. Reportedly had knife in his room at one point. 3x running away from home. 1st time was not far and he came home quickly. 2nd he made his way from north Minneapolis to S St. Paul, and was with a complete stranger for approximately 9 hours. Family reports that patient refuses to speak about this time. Was acting strangely after he returned. 3rd was yesterday after he became angry and physically assaulted mother. Was found by police (allegedly engaging in burglary?) Was brought to uncles house per request of mother, as he had been quite belligerent with her earlier. Patient normally behaves well with uncles, but today he waited until he was unsupervised and climbed out of a ground floor window to run away again.”
Not appropriate for inpatient pediatric medical floor. Boarding in HCMC Emergency Department. HCMC Acute Psychiatric Services do not feel patient needs an inpatient psychiatric admission. Family and NEXXUS advocate not comfortable with discharge unless plan for significantly increased outpatient support. No formal diagnoses. Has been completely compliant and appropriately behaved since presenting to the ED 32+ hours prior.
AH-M15-2038
UPATE: 1/18/24: Still inpatient. May be going to crisis programming in the near future, but no date yet.
UPDATE 11-15-2023: Still inpatient 1:1 staffing, strict behavior plan.
Patient is a 15 yo M with a past psychiatric history of RAD, PTSD, and ADHD as well as unspecified mood disorder (MDD vs DMDD), spells of trembling, and unspecified anxiety disorder, mostly documented as GAD. Multiple previous inpatient admissions, most recently Feb 2023. Has had numerous ED visits since 02/2023 for aggression. He has a psychosocial history of early parental loss, institutional care, neglect, and profound physical and sexual abuse while living in an orphanage in Ghana following the death of his biological mother in child birth. He was adopted when he was seven years old. Since that time, he has struggled with physically aggressive behavior, typically triggered by losing control of situations by not getting what he wants, being challenged, etc., assaulting both parents and endangering siblings. He can also become agitated and engage in aggression and property damage at the school. When he is not aggressive, however, he presents as extremely polite, pleasant, playful, and affectionate, and he does not struggle with chronic irritability or agitation. His family has worked to keep him in the home and community by maintaining two residences, with father caring for him in a rental and his mother caring for his sibling in their family home for safety over the past three years. He has had numerous inpatient stays, crisis placement, shelter, and residential stays as well as outpatient psychiatric and counseling services in clinic and in the home. Still, his behaviors remain persistently dangerous, culminating in the sexual assault of his father on 10/21/23.
Reach out to Heather Hanson, Social Worker at Abbott with questions or possible matches. She can be reached at 612-863-8569 and/or heather.hanson2@allina.com
SBHC-M10-2773
Behavioral issues, parent takes him on a leash when taking him out of the home. Physically and verbally aggressive to parent(s) and others (peers and staff). Throws items, pulls fire alarms, attempts to elope. Receives CTSS services and has demonstrated significant behaviors within those services. Had been in homebound school program, attempted re-entry into school setting and on first day back, damaged property and assaulted staff as well as directing violence towards peers, resulting in transfer to ER for placement. Treatment team questioning consistency of receiving medications appropriately in the home setting and are recommending residential treatment or a shelter bed until residential treatment can be secured.
SMCTRF-M10-2621
Significant behavioral issues, Parent takes him on a lease when taking him out of the home. Physically and verbally aggressive to parent(s) and others (peers and staff) throws items, pulls fire alarms. Attempts to elope.
RMC-M11-2238
Ward of the state-currently under Wright County Guardianship. Parental rights have been terminated. History of aggressive behavior with homicidal and suicidal comments towards multiple people/on multiple occasions. On 11/15/23, patient was sent to a “calming room” at his school due to throwing a ball at another students face. This caused him to miss out on an outdoor activity that he wanted to attend. Patient was upset and punched one of his teachers (mental health support services personnel) in the nose, causing a broken nose. Had been living with bio-grandparents prior to this incident. He has been removed from foster homes in the past due to homicidal threats to the foster parents/others in the home.