Psychiatric history of autism spectrum disorder, anxiety, and ADHD, with no prior psychiatric hospitalizations, with no prior reported self-harm, with no prior reported suicide attempts, who presents to PrairieCare due to safety concerns after patient jumped out of his window to run away(he hurt his leg, and was found semi-hypothermic in water) due to anxiety about an upcoming court case regarding him lighting his house on fire with his family inside last month.
Psychiatric Diagnosis: Autism Spectrum/PDD
Autism Spectrum/PDD encompasses a range of neurodevelopmental disorders characterized by difficulties in social interaction and communication, as well as restricted and repetitive behaviors. Autism is considered a spectrum because it can vary in severity and presentation.
CH-F13-4941
Patient presents via law enforcement for increased aggression and outbursts, threatened to hurt self and staff with a knife, recently broke a staff members nose. Facility next door to group home is a day care and Pt threatened to slit the kids throats (has a history of aggression towards small children). She was seen by psychiatry who felt behaviors were chronic in nature and would not improve with inpatient hospitalization and return to group home was recommended. Each attempt and returning to her group home resulting in her assaulting staff and need for restraints and IM. Group home has since suspended services.
MHF-M13-4922
Pt is adopted, Pts parents signed a voluntary out of home agreement with Rice County, Pt has not been home in approximately 3yrs. Numerous failed placements due to aggression. There has been zero movement in regard to placement options. Patient is very aggressive and has been so on the psychiatric unit. Pt presents with all the symptoms of RAD
GC8S-M10-4890
Patient was at school when he began having hallucinations, pulled his hood over his face, then ran into a concrete wall. He was admitted to Gillette for medical management of his bleed needing surgery to repair. Initially he was calm and not demonstrating behaviors then once he was fully off all sedation, he began showing his behaviors. He verbalized thinking everything is poison so he wouldn’t eat or drink, hearing and seeing things that are not there, extremely anxious and afraid. He needed physical holding for safety this am due to behaviors that put him at risk for his safety and others in the room. Patient has a history of this behavior prior to this incident. Strong family history of schizophrenia, this is currently in question for patient. Have connected with Children’s, Abbott and Prairie Care for possibly inpatient psych placement and med management.
CH-M15-4864
The patient is a 15 Y year-old male with a history of TBI, autism spectrum disorder, and is nonverbal who presented to the ER by EMS for agitation. Pt became upset after mom told him ‘no’ when he tried putting his hand in hot oil. He reportedly did put his fingers in the oil, however no injury observable. At home, he began to hit himself, slapping his wrist, pacing, kicking things. Mom tried to give him PRN hydroxyzine and haloperidol but he spit out some of them. Mom indicated the behavioral outbursts have started to occur more frequently and she is no longer to redirect or manage pt due to his size. Mom is attempting to find long term placement
NMH8R0MGH-M13-4848
Patient was placed in residential treatment for one year in 2022-2023 from the ER. Grandmother/legal guardian does not feel safe with patient in her home as he has been physically aggressive with her, she is declining to pick him up from the ER and wants out of home placement. Per Grandma, he was successful in the home following residential treatment, however, this year his aggression has become worse. Community case manager has been unsuccessful in securing placement.
HCMCED-M11-4844
On 11/14/24 the patient’s foster parents brought him to HCMC APS after he was discharged from Children’s Hospital St Paul because of his aggressive behavior. When in APS the patient began hitting his foster mom and becoming increasingly agitated. Security had to assist in transporting the patient to an emergency department bed, where he was then put into restraints for his and others safety. He was given sedative medications, IM.
The patient has been in foster care since he was 7 years old. He was physically and emotionally abused by his biological mother. He has been hospitalized at Fariview inpatient pediatric psych for a year, where he was then transferred to a residential treatment center. He has been with his current foster parents since August 7th, 2024.
HCMCED-M11-4841
The patient presented to HCMC emergency department on 11/13/24 with police after running away from home. He is still currently in HCMCs emergency department. He was found on a metro transit bus where he became agitated, fighting and fleeing from officers, making suicidal comments. When in the emergency department the patient significantly agitated, pacing room, yelling. He began destroying hospital property and was physically restrained by security and placed in pediatric violent restraints. He repeatedly shouted, “just kill me” and threatening harm to self and staff. He has been angry and agitated about his situation at home. When he doesn’t get his way with his mother, he acts out, runs away from home, and he places himself in danger as he is impulsive and does things that place himself at risk. The patient was given sedatives for the agitation and heightened state on two different occasions so far.
Presented to the emergency department at HCMC on 11/9/24 for suicidal ideation. The patient ran away from home two hours prior to arrival at the ED. He was encountered by police and was very upset, refusing to go home because he did not like it there. Made suicidal comments, prompting PD to bring patient to the ED. Patient currently is adamantly denying any suicidal attempts this evening. He endorses self-harming in the past by punching himself in the head, no self-harm tonight. He reports that he feels safe at home, but that he does not want to be there because it is boring.
He was at an inpatient psychiatric from 9/6/24-9/24/24, which was his first inpatient hospitalization. The patient was brought in by ambulance from school after an aggressive outburst. Patient was verbalizing suicidal thoughts. He was aggressive in school and required ketamine and restraints during transport. Patient presenting with episodic episodes of dysregulation of such magnitude that he requires multiple psychotropic medications as well as physical restraints to calm him down for his safety and that of others.
EH8D-M14-4364
This patient was brought to the hospital by police for aggression and dysregulation exhibited at the group home. He was charged with 5th degree assault after injuring staff members at his group home. His behavior has persisted despite medication adjustments and behavioral plans. He struggles in settings where there is too much sensory input and lack of structure. He has been destroying property and presenting with escalating aggressive, dangerous behaviors, homicidal threats and sexualized behaviors. Despite his impulsive behaviors and subsequent harm to staff members, he displays no remorse, though some question of whether he is able to adequately engage in reality testing possibly related to intellectual disability.
He is a ward of the state. He was placed in foster care at age 6 after suffering from neglect by his biological family. Their rights have been terminated.
NMH8R0MGH-M18-4738
Patient with autism and agitation sent from his new group home awaiting placement options. pt’s DD CM Deqa (612-472-2572) to gather more information regarding the Exception Bed Referral. Deqa shared that she was told that she can either refer for the Exception Bed or MFOC but not both. She is moving forward with the MFOC referral, as it would be a long term placement which would be better for the pt in the long run. She has made it known that the referral to MFOC is urgent. If the MFOC referral is denied, Deqa plans to either push on DHS as they have had an opening for 1 year and have not filled it, and/or pursue the Exception Bed. Deqa said she submitted for the Minnesota State- Operated Community Services (MSOCS) referral on 10/15. DHS Complex Transitions Team referral made on 10/15/24.