Arrived to ED due to dysregulation at home, which is baseline. Patient’s mother does not feel safe with patient coming home without more intensive outpatient services in place. County not supporting residential at this time, reports need for PHP/day treatment.
Psychiatric Diagnosis: ADHD
ADHD is a psychiatric diagnosis characterized by persistent patterns of inattention, hyperactivity, and impulsivity that can significantly affect a person’s daily functioning, especially in academic and occupational settings.
MHF-M17-2591
Patient presented to the ED after threatening father and becoming agitated. Father refusing to pick up or allow to discharge to another family member. Patient with SUD concerns and after completing CD assessment, recommended for residential SUD treatment. Referrals being made for this, parents will not pick up until treatment is secured.
MHF-F14-2469
Patient is presenting to the ED for the following concerns: suicidal ideation, depression. Patient reports he tried to kill himself last night by stabbing himself with a dull pencil. Patient reports suicidal and homicidal thoughts that have increased in last two weeks. He has been at North Homes for three months. He was discharged to North Homes after a hospital stay at UMMC in September for SI. At North Homes, the patient escalated and told staff he was suicidal. He took the batteries out of a remote and tried to swallow them. He also tried to stab self with dull pencil. He became combative and needed to be restrained and then kicked staff in chest and tried to kick another staff. Patient then stated he would find each clients personal info and then take pictures of other clients after he killed them and send to parents. Patient told staff he would kill other clients and himself.
Patient reports long history of MH including PTSD, MDD and GAD. Patient has been hospitalized 2 x in past 6 months. Patient reports history of trauma. Patient states he has history of SIB.
CH-F6-2448
Patient was dropped off at a different ER by the parents of her 4th foster home placement where she was placed 3 days prior as the foster parents didn’t feel they could provide care for the patient due to hyperactivity, impulsivity, aggression, elopement, and sexualized behaviors. Her social workers picked her up from the outside ER and while in route to human services center to board until a new foster home was located, the patient was attempting to remove her seatbelt and she was brought to this ER where initially inpatient psychiatric hospitalization was recommended due to a lack of safety awareness, elopement, sexual behaviors, and need for medication assessment. She was trialed on guanfacine, developed hypotension and this was discontinued, and she was started on Concerta where her elopement attempts, impulsivity, and hyperactivity improved. She remains boarding in the ER while the county pursues foster home placement.
CH-M11-1984
Patient presents from PHP where he was discharged due to ongoing aggression and attempts to urinate on staff and floor. Patient currently struggling with family dynamics, limit setting, gender identity, disrobing, property destruction, and aggression.
CH-M13-2506
The patient is a 13 Y year-old male with a history of fetal alcohol syndrome, separation anxiety, ADHD, RAD, sensory processing difficulty, DMDD, conduct disorder, and ODD who presents to the ER on 12/2 via law enforcement for assessment of aggression, suicidal, and homicidal ideation after physically assaulting his adoptive mom and brother and threatening to use a knife or gun to hurt the family when they weren’t looking. The patient made threats to kill himself with a colored pencil. The patient has aggressive outbursts several times per day when he is told no.
The patient has a long history of psychiatric services including residential at Northwoods x3, inpatient hospitalization x1, group home placement, PHP and further outpatient services. The county is currently in the process of developing an individual home for him which is thought to be completed in January though still requires licensing.
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.
HCMCH-M17-2402
attempted strangulation with the dog leash. HX of MDD, PTSD, ADHD & anxiety.
C8SM8M-M9-2342
ADHD, adjustment disorder, anxiety, Developmental delay, ODD, aggression, sexualized behavior. FAmily was living in shelter. Disregulated episode- tried to strangle self, to ED for assessment. Initially rec for inpt, then decided he did’nt need inpt. Family leaving shelter soon, so not able to take him back at this time. Mom says addicted to porn. Became disregulated once but otherwise has been stable, no SI. Henn county won’t get involved- saying it’s not abandonment, doesn’t have a county case mgr. Some services thru Dakota county. Level 4 school setting. Looking into other shelters. Family thinks he needs tx. Referrals to nexus, Prairie Care, Henn County Peace offering made. Gap in services. 7/21 was at Prairie Care. Mom open to foster home, he doesn’t necessarily need residential. Mom isn’t visiting bec she is scared he will be sent home with her.
Previously attended IP MH at PC in July 2021, no current acute SI, safety concerns in hospital, pt and his family are homeless, got kicked out of shelter due to aggression, pt currently does not have any county supports. Patient’s family moved from St. Cloud. Due to pt’s age, history of aggression, and sexualized behavior (watching porn, taking photos of privates, exposing himself to siblings) mom has been unable to find a shelter that will accept them. referral for services was put in with Hennepin county. DC’d to home with mom.
AH-F15-2303
PTSD, Disinhibited Social Engagement Disorder, Conduct Disorder, ADHD, ODD. Just got approval from HC for funding. Case mgr will start making calls. Doest present well on paper. Challenging behaviors – gets escalated and disreg. with peers. Is able to walk away. Threatens to hurt people but hasn’t yet. Remorseful about behavior. Learning about her dx. Fun kid, gets along with certain peers. Doesn’t work well with peers who have made statements about race. Ready to benefit from res. tx. and work with people 1 on 1. A lot of early childhood disruptions. Not sure why removed from bio mom – per aunt and gramma, she didn’t know how to be a parent. Aunt and gramma say that she has tried to kill them, threatens people, hard to know what’s what and what is recent behavior.