Mental Health Collaboration Hub
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.
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.
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.
MCR-M11-2224
This child is a ward of Steele County with Significant aggression and significant trauma. Mom died in 2019, Dad in group home for TBI. Suicidal/homicidal statements, thoughts. Tried to place with 19 yo sibling which lasted for a month, but brother doesn’t think he can keep him safe any longer. Came from SERCC to Mayo ED when he escalated to a point that they couldn’t care for him. He has been doing OK since he got there but has had a few instances of escalating to the point of needing to be restrained with holds and sedation. Struggles with conspiracy theories, as his mom died of a septic kidney infection, but he believes that her boyfriend poisoned her. He is fearful of being poisoned; he won’t sleep without someone watching over him. Not safe for a group home at this point.
HCMCH-M17-2004
Update: Accepted by PrairieCare but waiting on funding. looking for respite while waiting.
A 17 year old, African American, assigned male at birth. He identifies with “both” genders (boy and girl) equally. Alternates between male and female persona. Medically stable and boarding on Pediatrics while awaiting placement disposition. History of being bullied.
Approaching his cluster of symptoms from the lens of comorbid autism spectrum disorder and mild intellectual developmental disorder is likely to lead to better treatment adherence and response to intervention.
Given his intellectual concerns and history of emotional dysregulation, the patient would benefit from residential treatment. Such a treatment facility should have access to mental health resources, independent living skills training, and regular recreational and social-emotional supports.
MHF-M15-2183
Patient is presenting to the ED for the following concerns: self-harm. Patient has a history of self-harm, through primarily biting his arm, punching other things or scraping himself with a tack. Mom reported that today was the first time he self-harmed with a blade. Mom reporting increased aggression in the home and at school and feels that patient needs inpatient. Mom explained the patient is in a level 4 school setting. He recently did PHP at Prairie Care and was discharged after three days due to concerns about aggression and inappropriate sexual comments. Mom shared the patient has made comments about wanting to strangle others.
Mom explained that patient may already be on the waitlist for the Village Ranch residential treatment in Cokato. They are also exploring North Home in Bemidji. Mom reported that patient has been diagnosed with ADHD, ODD, PTSD and ASD. She also wonders about FASD due to his biological mothers, drug and alcohol use. Patient was adopted at age 7 by his adopted mom and adopted dad. Mom was his PCA in his last foster home for one year before adoption.
RMC-F17-2074
History of suicide attempts and self-harm, verbal and physical agression, DD, FAS, ADHD, identifies as non-binary
MCR-M16-1842
Long history of impulsive behavior and emotional dysregulation in the context of in utero substance exposure, prematurity, and repeated disruption of parental caregiver relationships. The current history suggests that he functioned fairly well over the last couple of years with relatively low level mental health services – highly experienced foster parent, individual therapy every 1-2 weeks, and occasional pharmacology. However, he began using cannabis more regularly and was unable to stop use when limits were set, leading to disruption of his foster placement. He has had significant dysregulation in a shelter and then crisis center setting since losing his foster home placement, including threatening peers, brandishing makeshift weapons, destroying property, and then finally physically attacking a peer (we do not have information about what provoked this) leading to his being sent to the ED. He has been consistently calm and polite here, though withdrawn, without evidence of clear active mood, psychotic, or anxiety disorder that would indicate a need for psychiatric hospitalization.
MHF-M14-2026
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, and significant behavioral change. Per patient’s mom, patient has been struggling for several years with anger and aggression, but this past month things have been escalating. Patient got upset at home, threw things, and punched his mom in the face. Patient’s mother called the police. Patient was in Riverside’s inpatient unit 3x in 2020. Patient was referred to PHP, and attended a 3-week PHP at Children’s Hospital. At the completion of the 3-week PHP, patient was recommended for additional treatment in a residential/inpatient setting. Patient has previous mental health diagnosis of PTSD, ADHD, DMDD, anxiety, and depression. Patient has a mental health CM and a psychiatrist.
MHF-F11-2021
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression. Patient was discharged from residential treatment last week. Patient was supposed to discharge to a group home, but her CADI waiver had expired, and she was discharged home without services. Patient became upset after a stressful day, and began arguing with her brother and mother. Patient “destroyed her room”, attempted to kick out her window, and ran a piece of glass under her nails. Patient’s mother called the police.
Patient has a history of ADHD, depression, anxiety, and aggressive behaviors. She had 5 admissions to inpatient psychiatry, with the most recent one on 9/28/22.
MHF-M15-2014
Patient is presenting to the ED for the following concerns: physical aggression. Patient became escalated at home, following his PCA staff leaving for the night. Details on the escalation are unclear at this time. Patient is diagnosed with Autism with little to no verbalization. Patient has a case manager, PCA support for before and after school until 8 pm, and on weekends from 8 am – 8 pm. Patient has a history of biting himself, scratching himself, and aggressive behaviors towards others. Patient historically escalates before/after school, and after his PCA staff leave for the night. Patient has been to the ED 19 times in 2023, due to aggression/symptoms of ASD.
