Patient presented to the ED via police due to physical and verbal aggression, threats to kill group home staff members, and damaging property. Patient became upset with group home staff after they questioned where she had received money during a shopping trip. After returning back to the group home, patient threatened to kill staff and threw a brick at their car. Group home staff report that patient is demonstrating a pattern of unsafe behavior and are not allowing her to return, citing police involvement on multiple occasions.
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.
PH-F13-1646
UPDATE 9/7/23: Pending potential foster/emergency beds.
UPDATE 8/31/23: Possible emergency foster bed open 9/5, emergent SMRT application in process. Still waiting living placement.
13 y/o female with a history of PTSD, depression, ADHD, mild CD concerns. Patient has a history of previous psychiatric hospitalizations related to increase in SI, SIB, and/or suicide attempts. Patient currently has an outpatient therapist and children’s mental health case manager; treatment history includes outpatient therapy and psychiatric hospitalizations as well as one prior placement at Northwoods crisis stabilization program. Patient is in foster care under guardianship of St. Louis County. Patient was in a foster home prior to inpatient hospitalization but is unable to return to that placement after discharge. Patient has Ucare PMAP insurance.
Discharge Recommendations:
Continue individual therapy established provider
Continue CMHCM with established provider
Continue primary care/medication management with established provider
Establish psychiatry (SW to refer/follow up with outpatient team RE: pending referral)
Estimated length of stay:
Until placement is established by the County (Patient is medically ready for discharge as of 08/16/23)
MCR-M14-1389
UPDATE: 9/7/23 – discharged to AMAS Inc (CADI group home)
UPDATE: 8/31/23 – Care conf tomorrow. Accepted by Sunset House, having zoom meeting with patient today to get to know him better before transition- waiting on them to get licensing.
UPDATE: 8/17/23 – Still in ED. Not able to go to Mille Lacs due to non-participation. There is a CADI group home willing to take him, working on licensing.
UPDATE 7/27 – had a video interview with Nexus Mille Lacs on 7/26, awaiting updates.
Previously MCR 1086: Discharged 6/15/23 to VonWald, returned ED 6/30. 14 year old with significant trauma history, ward of Hennepin County, recent placement at his request with young adult brother that was disrupted due to conflict. Briefly placed at Von Wald shelter but repeatedly eloped in an effort to reunite with his brother, and was brought to the ED. Calm overall except when relocated to a unit that required observation while in the restroom, then repeatedly escalated with verbal threats, closing himself in the bathroom, and hitting the walls. Had an interview with Nexus Mille Lacs on 7/26/23. He is familiar with Nexus Gerard and would feel comfortable there.
CH-M8-1340
Patient has a history of ADHD, DMDD, and trauma. He presented to the emergency trauma center with foster provider following an anger outburst where he hit himself. Patient also made comments about killing himself and threatened to kill another child in the home. Patient is unable to return to foster home.
MHF-M12-1583
Pt is presented to the ED via EMS after increased verbal and physical threats towards his family. Patient attempted to burn a locked door down with his mom and sister behind it. Patient’s mother called the police, and patient threatened to jump off of the balcony. Patient has a diagnosis of ASD and ADHD.
Patient was hospitalized and in outpatient program about 4 years ago. Per patient’s mother, the patient had been receiving wrap around treatment until he was discharged 4 months ago, when the patient brought a knife to therapy and threatened his therapist with said knife. The patient has been declined for all services by Prairie Care. Patient was assessed by Fairview recently and planned to start day treatment, but he refused to get in the car to go to therapy.
Patient has shown increasing aggression since about October 2022 when he decided he no longer wanted to have a relationship with his father.
C8SM8SP-M10-1459
Pt is a 10 yo male presenting due to increased aggressive and impulsive behaviors at home. Pt was attempting to light fires in the home prompting mom to call EMS. Mom has other small children in the home and feels as though she is not equipped to care for him. Pt has trauma history and has had inpatient mental health stays in the past. County recently approved funding for PRTF. Looking for a shelter in the meantime. Has sexual concerns so that needs to be considered with shelter placement. Extensive sexual and physical abuse history. Mom unable to take him back at this time, other children in the home. Has not has any sexualized behaviors while at the hospital. Nexus Mille Lacs is able to take someone with potential sexualized behaviors – and is interested in this child. Connecting offline.
MHF-M15-1498
Pt is presenting to the ED for the following concerns: verbal agitation, physical aggression, significant behavioral change. Pt had not been taking his medication, and had been awake for several days on his computer. Pt began waving a knife and scissors around the house, and refused to give them back to his mother. Pt’s mother was concerned that he was going to hurt her, so she called the police.
Pt seems to have limited potential to regulate his emotions and can be erratic without considering the consequences for his impulsive behaviors. Pt was discharged from inpatient treatment in July of this year, for a similar presentation.
PH-F16-1369
*UPDATE: Admission to Gerard 7/28/23- just pending county funding at this time, 2nd screening today, 7/20
16 YO Female in 10th grade. Two previous psychiatric hospitalizations (2/23/22-3/4/22 and 9/17/23-9/27/23) in addition to the current admission. Has attended Day treatment. No alcohol or Drug use. Increasing SI and history of self harm. Hx of sexual abuse at age 9.
DISCHARGE EFFORTS:
-RTC: Avanti Center for Girls (Referral sent, pt accepted, 6 month wait list)
-RTC: Gerard Academy (Referral sent, pt accepted, admission, 7/28/23, pending county funding)
-RTC: North Homes (Referral Sent, pt approved, opening estimated for August-September)
-RTC: Northwood Children’s Services (Referral Sent)
Interim Plan:
-Day Treatment: TSA (pt able to return if/when it is safe to DC)
-CMHCM: Janet, Isanti County
-DBT: (SW to provide resources upon DC for guardian to use after RTC)
MCR-M10-1427
History of DMDD and ODD with worsening of extreme violent outbursts since March without known trigger or stressor. Kicked out of PHP due to aggression, sent to SERCC and brought here from SERCC after an aggressive event. Family concerned about home safety.
MHF-M9-808
Patient is presented to the ED by EMS for aggressive behavior towards staff and another resident in his group home. At the group home staff brought the patient out to his school transportation but the patient became dysregulated when he saw the driver was different from prior trips. Patient then eloped to a neighbor’s house where he entered. Staff followed and called the police. Patient was brought back to the group home, but later got into a physical fight with another resident and staff member. Police were called a second time, and patient was transported to the hospital using restraints. The patient has a history of ED visits and has had approximately 6 previous hospital admissions (5/21; 7/21; 10/21; 11/21; 12/21; 9/22). The patient has a diagnosis history of DMDD, ODD, ADHD, GAD, depression, and RAD