ADHD – Page 19 – Mental Health Collaboration Hub

MHF-F11-1660

9/28: Youth still awaits placement to RTC.
9/19: Accepted to Nexus FACTS to assist with Placement Coordination.

9/14/23 UPDATE: Nexus YCT program looking into helping with this child.
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, significant behavioral change, abuse or neglect, anxiety, worsening psychosocial stress, suicidal ideation, depression. Patient was staying at a crisis residence after discharging from the ED on 9/1/23. Police were called due to patient becoming aggressive/violent, dysregulated and exhibiting SI/HI plans and threats. Staff at the crisis residence do not feel safe keeping patient at the home due to her violent outbursts, and fear for other residents’ safety.
Patient is a Hennepin County state ward. She has an extensive history of childhood trauma, including neglect, physical abuse, and suspected sexual abuse. She was also prenatally exposed to cocaine. Patient’s grandmother adopted her, who fled with the patient to a different state. Her grandmother’s rights were terminated, and patient has been living in foster care with her aunt since the end of June 2023. Prior to that, patient was living in a group home for approx. six months in Duluth, after completing residential treatment at Northwoods. She arrived to the ED on 08/09/23 following an episode of significant behavioral dysregulation involving throwing furniture down the stairs. She was subsequently admitted to 7ITC and discharged on 08/28/23, returning to the ED on 8/28, and discharging to crisis residence on 9/1. Has a CPS worker, who is her guardian, but no other services/case managers.

MCR-14-1888

a history of diagnoses of PTSD, reactive attachment disorder, Oppositional Defiant Disorder, ADHD and substance use disorder. Her social and developmental history is notable for significant early life trauma related to parental substance use, including at least one episode of Lily herself ingesting methamphetamine as an infant. She was removed from mother’s care at age 10 months and father’s care at age 5 years, and was adopted by maternal grandparents at age 7. She has had essentially lifelong difficulties with dysregulated behavior. She has been at Mayo Clinic since 9/6/2023 following an altercation at the home where she was staying. She was previously residing with a family friend, but is unable to return due to safety concerns by all adults involved, including Olmsted County who assessed this not to be a safe discharge location. Her legal decision maker is her maternal grandmother who has previously adopted her.

MHF-M12-1891

Patient presents to the ED via EMS, via police. Patient had altercation with brother, and pulled out a knife, threatening to kill his brother and grandpa. Patient has been diagnosed with depression, anxiety, bipolar and receives level 4 services in an intensive special education school. Grandpa has custody, as well as his parents, but state they cannot keep patient safe, as they live in a dangerous neighborhood.
Patient spent several months at RTC at BarNone and Gerard Academy, and returned to live with grandpa this summer. Patient has also done Peoples Inc. day treatment program, and PHP at Prairie Care three times.
Patient has placement at Northwoods in Duluth, and is waiting for an open bed.

MHF-F16-1061

Patient arrived via EMS due to her mother calling 911 after the patient made suicidal comments at home and conflict with her mother. Patient was engaging in sexual behavior with a strange, in exchange for drugs. Patient went home and told her mother what she did, passively stating she wanted to kill herself.
The patient has a history of risky sexual behavior, self-harm, and suicidal ideation. Patient also has a history of physical and verbal altercations with others including family and EMS / hospital / treatment staff, and has a history of 3 suicide attempts, most recent attempt was 1 year ago by ingesting bleach.
Patient has a past psychiatric history of ASD, ADHD, MDD, GAD, and Cannabis Use disorder.

RMC-M12-1802

2nd visit to RMC in one week for running away (from school and from home). Verbally abusive towards authority (Sheriff’s Dept. and his grandparents). Recent theft (stole a sweatshirt from the mall) and violation of school policy (vape found in locker). Patient is refusing to return home with grandparents (legal guardians since 10 months old), now claiming they physically and emotionally abuse him. Hennepin Co. CPS has no concerns with safety at home. Patient is now making threats to grandparents, expressing that he wants them to “be murdered.” Grandparents are concerned for their safety after threats made by patient.

MCR-F12-1396

Update on 8/17/23 – still waiting placement, relocated to peds area, not admitted, still an ED patient.

Patient is ward of state with guardianship by Otter Tail County. On a stay of commitment. Terrible trauma history and aggression – toward inanimate objects, but occ if staff gets close, she will be aggressive toward a person. Multiple hospitalizations/boarding situations, multiple (5-6) PRTF placements and failures, including an out of state facility that was suddenly shut down. Was in Rochester for hotel with respite, but they brought her in after less than a week due to behaviors. Struggles to regulate when frustrated.

MHF-F13-1289

Update 9/28/23: Has potential placement. Awaiting.
Patient was brought in by medics after she was physically aggressive with a staff member at The Aspen House, where she has been living for two months.
Patient has adoptive parents and adoptive siblings. She was adopted when she was two years old, and has recently reconnected with bio-dad.
Patient had prior diagnoses of depression, ADHD combined type, anxiety, neurocognitive disorder related to maternal meth abuse while patient was in utero, and learning disability. She’s been in M Health FV IOP, since she’s been there. She does not participate in groups or other activities much. She’s been in an inpatient mental health unit, mostly at M Health FV, at least four times. The last admit was 4/21-4/27/2022 at FV. She’s had the following RTC placements: Eau Claire Academy, 4-8/2022, CRTC 8/2022-1/2023, and Avanti 1-4/2023. She receives Psychiatry and Therapy services through the group home.
She has had two prior suicide attempts by choking herself.

MHF-M16-1797

Patient is presenting to the ED for the following concerns: physical aggression. Patient has prior diagnosis of ASD, ADHD, Intellectual Disability, and Mood Disorder. Patient has prior presentations for behavioral issues and outbursts at United, Mercy, and Abbott. Patient lives with his mother and 5 other siblings. Patient and his family were outside, when he says his sister started mocking him. Patient hit his sister twice, and then his brother. Patient then came up behind his mother, as if to hit her, and his brother stepped in. Patient’s mother is refusing to pick him up.
Patient’s family is moving this week, and he does not want to move.

SMCF-M14-1785

14yr old male who presents to Emergency Dept with homicidal ideations with dad from school. He denies making statements of a homicidal nature but per report he threatened to kill his school paraprofessional and “shoot up the school.” Patient has access to means and at the time reported intent. He also make threats to hospital staff when angry and has made several comments about owning a gun. He has a history of acting violently and notes when he is angry he could do something to harm others. He missed several days of his psychiatric medications which may be contributing to this escalating behavior. Medication was restarted two days ago but he needs a safe secure environment to restart medication and to further evaluated his risk of threat to others. Patient is perseverative in this thinking, restless, and with disorganized thinking which may be in part due to not receiving his ADHD prior to this assessment but also deserves further assessment.

SMCW-F15-1775

Pt is brought to the ED by law enforcement due suicidal ideations. Pt has a long standing mental health history. She Has been hospitalized innumerable amounts of times for suicidal ideations. In August alone, she was hospitalized for mental health twice. She has a case worker with social services who is supposedly working on long term placement for her. She is living at home again. In the past, it has been shown that this living situation is not ideal and she has innumerable mental health hospitalizations as she reports self harm and suicidal ideation and plans. 2 days ago, she was walking in the road hoping to get hit by a car. The sheriff was called and pt removed herself from the road and went back home with her mother. Crisis team was called again last night. Pt was outside walking and threatening self harm for 12 hours. Her CSS worker was there during this time. She threatened to hang herself with the clothes line. She finally agreed to go home and watched TV until she fell asleep. She slept until 1:30 pm today. Tonight she was at the church and took a cord and wrapped it around her neck threatening self harm. Law enforcement was contacted as she was refusing to leave the church. She was brought to the ED for evaluation.
Pt reports she doesn’t feel safe to return to home. She reports she wants to die and threatens to cut herself or overdose on medication.
Mother reports pt has a PCA that she stays with. This PCA is her cousin. The cousins father died and pt has not been able to go to stay with her for the last week. Pt has been staying at home with her mother, father and siblings.
Mother reports that this is overwhelming to her and her other children. Supposedly social services is working on long term placement for this patient.