ADHD – Page 19 – Mental Health Collaboration Hub

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.

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.