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.

MCHSRW-M12-5457

Patients mother shared that the patient has an extensive treatment history, but has continued to struggle with challenging behaviors and emotion dysregulation. Mom described that “over the last few days he’s just been a terror, despite our best efforts. He freaks out when we try to redirect him. Mom reported that the patient has “aggressive towards people, getting physical and violent, he’s been assaulting his younger brothers.” Mom described that on the day of admission the patient had been going into his brother’s bedroom “trying to annoy them,” and hitting them. Mom called her husband, the patient’s step-father, who is currently out of state for work. The patient’s step-father spoke to the patient over the phone and told him that he needs to change his behavior and reminded him that he has been through so many different programs and should be able to “put on the breaks” with his behavior. The patient began talking back and got confrontational with his step-father, asking “what are you going to do about it?” The patient’s step-father indicated that their would be consequences when he returned and urged the patient not to put his job at-risk by making him return home early to deal with his behaviors. The patient challenged his step-father further making statements such as “fuck you, why don’t you say that to my face?” and “bet, come home then and see what happens.” The patient further stated “I’ll shoot you in the fucking face, right through the eyes.” Mom reported that their is a gun in the home, however it is locked in a gun safe and the patient does not have access to this. Mom then asked the patient where he would get a gun from and the patient indicated that his friends at school have guns. Mom expressed “this has escalated so far beyond me. We are walking on eggshells from the time he gets home from school until he goes back the next day.” Mom reported that she did not feel safe bringing the patient back home. She reported that she had attempted to press charges on the patient today, however police had declined and brought him to the emergency department instead. The patient is uninsured, county is working on his application, but he does not have a county social worker. Has a contracted mental health case manager through Fernbrook.

MHF-F13-5435

Youth came to our ED 3/24 after altercation at home with Mom. Mom is refusing to pick her up. Has briefly boarded with us twice in the recent past, discharged home both times with WARM and FRSS services. Has contracted CMH CM. Mom is wanting RTC or PRTF. Reportedly County is working on switching her to operated CM to potentially access the screening team and those services.

MHF-F14-4898

Pt came to us 11/18/24 after an altercation at her ongoing GH in which she physically aggressed against another youth. Its reported that youth plans to press charges. She is not allowed to return to that GH, but that provider is working to see if they can set up a new setting for this pt, both temporary and ongoing. Team also has another GH they are looking into for her. This kiddo boarded with us previously, prior to discharge to her last GH, 9/24-11/1 of last year. Dakota County currently has custody. She is also open to CMH and waiver.

GC8S-F14-863

14-year-old adolescent female with a history of ADHD, witnessed verbal and physical abuse, multi-substance use with significant behavioral issues at school. Pt was admitted to Gillette Children’s on 4-30-2023 with an acute hypoxic ischemic brain injury secondary to hanging herself in a suicide attempt. Pt has made significant improvements in her cognitive and motor functioning since her initial presentation. Pt does not have a previous history of suicide attempts but does have a history of non-lethal cutting behaviors. She has been involved with various mental health providers on an outpatient basis over the past several years. She has never been hospitalized for mental health issues. Pt is currently not suicidal. Pt currently presents with a flat affect and difficulty comprehending the gravity of her suicide attempt. Pt will be ready for discharge from a medical standpoint mid-next week and is expected to be independent in mobility and self-cares, although she will require supervision in the home setting. Pt has the endurance to complete a full day of activity. Please consider Pt for intensive mental health services and parental support as she transitions back to her home setting.

Update 5/18/23 from Mallory at PrairieCare: Amy and I messaged, this pt will DC from RU 5/24/23 and has not had any SI or SIB plans, means, or intent. Likely initially declined for Inpatient due to medical condition. Once medically cleared, discussed referral for PHP due to needing intensive therapeutic intervention, but not imminent danger to self. Amy plans to refer for PHP.

MHF-M14-1900

Patient presents to the ED via EMS after his group home called 911 due to patient’s aggression. Patient reports that he threw a stool at staff when they asked him to go to bed. Group home to determine whether they will take him back.
Patient has a previous mental health diagnosis of Mood Disorder, Intellectual Disability, Nocturnal Enuresis, Anxiety, ADHD and Autism Spectrum Disorder. Medical records indicate patient presented with similar behaviors to the ED, including defiance, a history of emotional and behavioral dysregulation, and acting out towards staff.
This is patient’s 6th visit in the ED in 2023 for behavioral and/or mental health.

MHF-M17-5398

This kiddo has boarded with us in the past. Was just with us 2/17/25 – 2/27/25 when he discharged to the Bridge shelter. Returned to us 3/17/25 after refusing to attend PHP for SUD and the shelter will not take him back. His parents are refusing to have him return home. He is a few weeks from being 18 and there is no plan to pursue guardianship of him at that time. He is not agreeable to any sort of SUD treatment. Has CMH and CADI waiver CM.

MHF-F13-5331

Kiddo was brought to our ED 3/4 by Mom. Had discharged from our ED hours prior, but returned after another altercation at home regarding pts phone. Mom is trying to get a DA from ongoing therapist, reports one was completed, to get CMH CM. Does not have any ongoing County CMs at this time. Our team tried to make parent-referral shelter referrals however Mom reports she is unwilling to agree to the terms of those programs, which include that Mom will need to pick up if pt becomes dysregulated. No waiver or CMH worker involved to approve any alternative placements at this time. CPS just opened today 3/5. Care Conference taking place 3/6 to gather further information.

MCR-F12-5376

Adopted at age 8 from private agency (so ineligible for MA). Comes in with Homicidal ideation and threats to kill sister and burn down house. Family not willing to bring her home for safety. Have tried many services but terminated them about 2 years ago and now are trying to re-engage. No approval for placement at this time.

MHF-M15-5368

Kiddo came into ED on 3/11 after an altercation at home with parent over electronics. Parents are refusing to pick up. Mom has been working on CMH worker however current staff assigned explained they can not do anything currently as they have not met with parents yet and don’t have any paperwork signed, planned to meet next week Wednesday. Unclear if out of home placement would be supported even after that meeting. Mom is not agreeable to parent referred shelters as she wants longer term placement/residential.