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: Adjustment Disorder
Adjustment Disorder is a psychiatric diagnosis given to individuals who experience emotional or behavioral symptoms in response to a specific stressor or life change. These symptoms can disrupt daily life but are not as severe or long-lasting as those of other disorders.
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-M15-2014
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-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-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-M13-1809
Patient presents to the emergency department for the 4th time in 12 days. Patient was discharged from the hospital, went home with his mother, and got into a verbal argument in the car. Patient reports his mother kicked him out of the house, so he went to school. Patient arrived at school and was told that he was not allowed to be there due to historical violent threats against other students, so school staff called police. Patient has recently engaged in property damage at his home and made homicidal threats towards his step-father.
Patient’s father is incarcerated for murder. Patient’s mother has history of childhood sexual trafficking. Patient has ongoing parent-child conflict. Patient has no history of inpatient mental health admission or intensive outpatient treatment. Patient is involved in a youth runaway program. Patient has a school social worker. Patient has established medication management.
Patient’s mother is refusing to pick patient up due to homicidal threats towards family.
HCMCH-F15-1627
15 y.o. female with history of childhood sexual abuse and more recent sexual exploitation in 2023 with concern for victim of sex trafficking. Presents with suicidal ideation, self-harm behaviors including substance abuse. During this admission drug screen positive for fentanyl and methamphetamine. Patient transferred from HCMC to Sacred Hearth Inpatient Behavioral Health Unit 8/23/23; long term recommendation is residential care. Substance use and placing self in high risk social situations occurs in the context of her trauma history.
MHF-M16-1654
UPDATE : Transferred to BAr None shelter 9/13/23
UPDATE 9.7.23 – working with Nexus FACTS for Placement Coordination Services. New Diagnostic Assessment 9/7.
Patient presents to the Emergency Department from a residential treatment facility, following attempted self-harm and suicidal ideation, with a plan to slit his throat with a screw. Staff monitored and stopped the patient from harming himself. The patient experienced intense emotions as he thought about the trauma he experienced at the hands of his father.
Patient was seen in the ED on 8/14/2023 with a similar presentation. Medical records indicate a hx of physical and sexual abuse, conflicts with his father, patient had pulled a knife on this father, and hx of substance abuse. Patient denies current substance use, and has 60 days of sobriety.
8/24- Patient was discharged from residential facility
MHF-F11-1552
UPDATE: Accepted to Gerard Pending date next week.
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, anxiety, worsening psychosocial stress. Patient was threatening to attack kids in her neighborhood with a knife, and threatened to stab her grandfather when he attempted to intervene. Patient’s grandfather locked her out of the house, so she wasn’t able to get anything else to hurt someone with, and patient kicked the lock off of the door.
Patient recently lived in a youth shelter/transitional home called Dignity House for 1.5 weeks until 8/3/2023. She was then sent to the ED for aggression. She had a warrant for arrest due to an assault and threatening homicide to family members. She was taken to JDC on 8/3/2023, had court, and then she was sent to the Bridge for Youth Shelter. Patient got into a physical altercation at The Bridge and was sent back to the ED on 8/8/2023. While in the ED, patient physically assaulted a nurse and was picked up by her grandfather.
Within this year, the patient has had approximately 13 ED visits due to concerns including runaway, aggression, abuse/neglect, and altercations with family members.
MHF-F14-1736
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.