Mental Health Collaboration Hub
Patient presented to the ED with her father after ingesting a screw while at school. EGD completed to remove the screw and she returned to the ED. Mental health team met with patient and father making the recommendation for acute inpatient MH placement. Patient denied ingestion to kill self and denied SI. She has a history of swallowing 2 AA batteries in Dec as well as another episode of swallowing a button batter a couple days prior. After those interactions she spent 11 on our medical floor waiting for a discharge plan. She was finally placed at an acute inpatient unit only to return home in a week with no additional supports in place. The original recommendation was for a long term residential placement but that was changed to discharging to home.
Ancillary Support Service: Mental Health Crisis Assessments
Mental health crisis assessment involves the following steps:
1. Immediate decision-making process: A mental health practitioner determines the lethality and referral needs of the client.
2. Triage assessment: Determines urgency and appropriate care options, such as emergency hospitalization, outpatient treatment, or support services1.
3. Psychiatric examination: Establishes a working diagnosis and treatment plan
SBMC-F15-6326
Patient presented to the ED after ingesting a button battery. Surgical intervention was needed to remove the battery. Safety plan competed to allow patient to return home with father. While at school the next day, she hid in the bathroom and broke open a calculator to swallow 2 AA batteries. Hospital admission needed until batteries passed the next day. Acute inpatient MH options explored with no accepting facilities. Remains admitted awaiting residential placement at this time. Father does not feel he can keep her safe at home due to the increased risk of swallowing objects.
PH-F10-5904
Pt is a 10 year-old female with historic diagnoses of anxiety, depression, ODD, specified neurodevelopmental disorder who presents today to address running away from home. Upon interview pt was observed to be easily distracted and appears to be guarded. Pt was resistant to the interview stating, “I don’t want to answer any questions.” After roughly 5 minutes pt refused the interview process leaving the room and forcefully pushing the door close with writer still in the room. Writer could hear pt yelling and laughing from the hallway “she’s locked in there” and “I locked her in there”.
Mother reports pt has been running away from home and putting herself in dangerous situation. Mother reports pt was sexually assaulted during one of her runaways. Mother reports pt’s motive for running away this time was to get on an airplane. Mother stated due to pt’s behaviors, pt has been hospitalized 3 times within one and a half weeks. Mother reports pt’s mental health is worsening. Mother reports pt struggles with authority figures and being held accountable. Mother states they use to have structure and routine in the home and is trying to incorporate it into the home again but when pt is held accountable, pt will threaten mother and think mother is “being mean.”
PH-F15-5000
Previously diagnosed with depression, anxiety, PTSD . Numerous admissions to psychiatric hospitals and Emergency Departments because of suicidal ideation, suicide attempts and self-injury. History of CPS, county mental health case managers and crisis services. Plan to jump off a bridge. Self injury has included cutting, scratching, burning and head banging.
RMC-M12-4515
12 yo male brought to Ridgeview Medical Center (RMC) via EMS after a verbal and physical outburst at home. Youth felt that his mother was “lying” about him to a visiting social worker and youth became aggressive, throwing dishes on the floor in the kitchen. Youth “pushed” his brother, who then pushed youth. No h/o violence or aggression at school or with individuals outside of his home. Most aggression is shown verbally towards his mother. Mother is not allowing youth back into her home right now. Carver Co. Crisis and COPE have assessed youth and are recommending psychotherapy and/or psychiatry/medication management.