Pt came to our ED on 4/20 from home, where she is unable to return at this time. CPS is looking for foster care placement. Open to DD waiver and crisis respite is also being sought, MCCP referral has been made. Do not believe pt has had out of home placement before. Had DA 3/31 and outpatient therapy was the recommendation.
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.
AH-M15-5556
Impression of Crisis Behavior (precipitants): Patient presented to the ED due to agitation and SI. The identified precipitant for this crisis is a verbal and physical argument with his mother and her boyfriend at the home. Patient was released from the JDC to home on 4/5/25.
Vulnerabilities: adolescent, ASD, h/o trauma, recently released from JDC, parent-child conflict, inadequate outpatient supports
Behaviors / Symptoms to address in the ED: deferred
Methods to increase desirable behaviors in the ED: meet basic needs, set behavioral boundaries/limits,
Barriers to Discharge include: At this time, patient is NOT felt to meet criteria for inpatient hospitalization. There are no new acute safety needs that warrant admission. His mental health concerns are chronic and environmental.
Mom is refusing to take him home, JDC won’t take him back as there are no new charges and he has no place to go. CPS is investigating allegations of abuse by parents and child but are not seeking placement. Mom does not consent to use of a shelter or Nexus YCT.
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
TO-F11-18
This is a TEST CASE please IGNORE. Substance abuse has led to reckless behavior and disruptive relationships. Fights with siblings and friends
MHF-M15-1275
Pt is presented to the ED via EMS for erratic behavior. Pt has twice presented to the ED recently after altercations at his group home and his crisis respite program. Pt has been discharged from both of these programs due to aggressive behavior. Pt was returned home after being discharged recently and collateral reports that pt’s behaviors have increased. This ED visit was due to pt beginning to escalate, and was about to throw rocks at his friend’s windows. Pt’s mother’s boyfriend ran out and stopped him from doing so and told him “no” which is a trigger for pt. Pt then began to start banging on doors after he was stopped from throwing rocks. Pt has an injured elbow which was in jeopardy of being re-injured. Pt wouldn’t stop so mom called the police, and they brought EMS who brought him to the hospital. Pt has a diagnosis of Autism Spectrum D/O needing substantial support, Level 3, Unspecified type and suspected intellectual disability. Pt has a hx of agitation, aggressive behaviors with frequent visits to the ED. Pt’s mother and staff deny any suicidal ideation and attempts. Pt currently has a PCP, psychiatrist, case manager, and social worker. Pt has very limited verbal skills, and responds to questions with one- or two-word answers, and a thumbs up/thumbs down.
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.
AH-M13-5387
Patient and family unhoused, staying in shelter. Due to a behavioral incident of aggression, patient unable to return to shelter. Family unwilling to pick patient up from ED. Hennepin County now granted interim custody. Shelters unable to accommodate patient’s needs. Patient does need help with some cares and activities of daily living.
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.
MHF-M14-5362
Kiddo was just boarding with us 1/30/25 – 2/18/25, and returned to our ED 3/9/25 after aggression in the hotel crisis setting and they are not allowing him to return. Has also boarded on our IP unit for extensive time in the end of 2024. There was a GH set up originally for 3/14 however they are having staffing shortages and so admit date was pushed back to an unknown time. CM is continuing to look for additional placement options.
CH-M15-5352
Patient presented via law enforcement after jumping in front of a vehicle in an attempt to end his life with additional thoughts to jump off of the bridge he was standing on until law enforcement intervened. Patient reports a 3 year history of auditory hallucinations that tell him to harm himself or others which occurs when he is alone or stressed. (hallucinations appear consistent with audible thoughts). This is his 4th inpatient hospitalization for suicide attempts and he has had multiple ER visits. While here, he attempted to assault a younger peer and was assaulted by a different patient. He was placed in the BICU where he has attempted to “snap” his neck on multiple occasions, head bangs, ingested hygiene supplies x1, and tied towel around his neck x1. Suicidal thoughts are perseverative when they occur and can be difficult to redirect.