17 y/o male with MDD with psychotic features, neurodevelopmental disorder, intellectual disability. He recently discharged from CABHS. Waiting for MSCOCS placement hopefully will be admitted on 10/2. There concern of excessive irritability, agitation, disorganized thoughts, delusions, history of auditory or visual hallucinations, history of self injury and impulsive behaviors leaving to being in dangerous situations.
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-F13-4577
Pt presents from school after high level of aggression, homicidal threats, and property destruction resulting in multiple hours of restraints. Patient has longstanding history of aggression and impulsivity with recent increase and daily occurrence consistent with starting new school. Pt newly to a group home from home placement as of May 2024. Now discharged from level 4 school due to behavior leading to presentation. Looking for IP for medication adjustments, though making changes in the ER in the interim. Difficult placement given neurological functioning, level of aggression, and acuity.
MHF-M7-4555
Came to the ED on 8/27 after behaviors at home of head banging and screaming. Mom has refused to pick pt up thus far, wanting medications prescribed before she is willing to do so. Our psychiatrist has been trying to work with Mom on potential medication changes, but there has not been an agreement thus far. CPS has opened a case and is investigating, and Nexus YCT intake was yesterday. Patient is primarily non-verbal. Mom is reporting he needs residential treatment, but there is no professional recommendation for that at this time and due to age and autism diagnosis, options would be very limited. Mom has connected with Chelida in WI. Pt has DD waiver with in-home services, as well as Washburn ready to come out at discharge.
MHF-M12-4491
This pt discharged from our ED on 8/6 after being here since 7/22, went to a Beacon crisis home for approx 24 hours and returned to the ED again on 8/7, after aggressive behavior. Previous number was MHF-M12-4418. Also boarded in our ED in April 2024 for 20 days, and at different hospital in June. Hennepin County has temp custody and he is on DD waiver. Currently looking at a CRS home that requires exception bed approval through DHS, Grafton, remains on the MCCP crisis pool list, and judge is making determination if returning to Mom may be an option. Has been to Zane crisis, Beacon crisis, VOA Bar None, and done PHP with FV.
MHF-M12-4485
Pt came to our ED on 8/10 from Grandparents home who were providing foster care and there was an altercation. Grandparents are refusing to take pt back. Hennepin County CPS/ICWA have temp custody. Pt not appropriate for IP due to fecal incontinence and struggles with communication. County is looking for DD waiver CRS and doing a MNchoices assessment on 8/16.
MHF-M12-4418
Came to us 7/22 via EMT after aggression and property destruction at hotel crisis respite, provider wont take pt back. Previously boarding in our ED 4/5 to 4/25, with somewhat frequent ED visits between. Has previously been to VOA Bar None. Hennepin County has custody and our team was struggling with reaching the CPS worker yesterday/this morning- going to continue reaching out for further plan/details.
CH-M10-4290
Patient presented via law enforcement to the St. Cloud ETC after eloping from mother’s home and found wandering on Highway 10. Initially aggressive/combative with law enforcement. Patient was cleared for discharge but refused to go with mom, because combative and required PRN to calm down. Was kept overnight. Patient’s mom refused to pick patient up once cleared for discharge due to his ongoing aggressive behaviors. CPS is involved and a new report was filed.
Police hold initiated 7/9/24 and CHIPs petition is being pursued. County CPS worker is seeking foster care placement.
Update (7/18)- Court hearing for CHIPs petition. County CPS case worker is continuing to look for foster care placement. Patient will have twice weekly phone calls with his mother.
MHF-F13-4407
Patient came to ED on 7/19 from Nexus East Bethel PRTF after swallowing a foreign object. Was in our inpatient unit from 7/15-7/19 and discharged for only hours before returning. Reports that repeat behavior was pt seeking to be removed from program. Nexus PRTF is not accepting pt back at this time and Mom is unable to have pt return home. Sending referral to Nexus YCT to assist with placement.
CH-M16-4217
Brought to ER after assaultive behavior towards group home staff. Since being in the ER, patient has denied SI/HI and been behaviorally regulated with the exception of one incident after being here for 6 days, and was asked to go to his room to avoid potential problems with other patient’s in the ER and he was upset and got restrained. He’s been up for discharge back to his group home since the day he presented to the ER. The county worker has been main contact with group home and are trying to problem solve ways to support patient at the group home. Ombudsmen involved.
Update 7/10 – patient remains boarded, now on EmPATH unit (observation unit/extension of ER) without aggression or behaviors. County guardian making referrals for placement options including respite, crisis, group home, shelter
MHF-M15-4172
Pt came to ED from North Homes, after increase in physical/verbal aggression and 30 day notice was given and lapsed without another placement found. Was boarding in our ED in Nov 2023 prior to admit to North Homes. Planning to connect with parent/County about re-involving Nexus YCT. Some sexual inappropriate behavior making him difficult to place.