Recommendation is level 5 QRTP, patient is currently inpatient.
Patient is a 14 y/o male w/ hx of depression, anxiety, ADHD, conduct disorder, ptsd , FSIQ 77, currently presenting due to ongoing mood/behavioral dysregulation resulting in hospitalization after aggression w/ mother and boyfriend. Biologically, there is a genetic predisposition for depression, anxiety, substance use. Patient w/ a long hx of impulsive/aggressive behaviors (runs away frequently, physically/verbally aggressive w/ authority figures, ect). Patient is a poor historian per outpatient psychiatrist and parents which impacts ability to know how he is actually doing. At this time, outpatient psychiatrist recommended RTC, and patient is on the wait list.
Patient has previously engaged in PHP, IT, CMHCM, and Intensive outpatient services
RTC
– Northwoods (referral submitted by CMHCM, year long waitlist 6/27)
– Gerard (referral submitted by CMHCM, under review 6/27)
PRTF
– Grafton (referral submitted 6.26)
Patient presented from home with mother and grandmother due to ongoing concerns for substance use (fentanyl, mother believes others but unsure what). Mother not comfortable discharging until in CD treatment.
Pt presents to the ED via EMS for the following concerns: aggression. Pt was refusing to take her medication, and became aggressive with her parents when they tried to make her. Parents called 911 due to pt becoming aggressive with them, and punching holes in the walls. Medical records indicate mental health diagnosis of Unspecified disruptive impulse control and conduct disorder, major depressive d/o, unspecified anxiety and binge eating d/o. Pt has a rule out diagnosis of autism spectrum d/ and other neurodevelopmental disorder. Pt has a hx of mental health admissions as follow: 3/12 – 3/17/2023. Pt had frequent visits to the ED due to behavioral and emotional dysregulation at home as follow 3/20 – 3/21/2023, 3/22-3/31/2023, 04/02 – 04/03, 04/07-04/11/2023, 04/18/23, and 4/19- 04/20/2023.
