Pt presented from home, adopted parents, for aggressive behaviors. Third ER visit this month, unable to take pt back home due to frequency and intensity of behaviors as well as 4 other children in the home. Pt initially recommended IP hospitalization, however unable to find placement due to acuity, no beds, or declined due to IQ (56) and inability to participate in programming. Medications adjusted in ER. No violence since medication increase. Family/CADI worker have been looking for more support for several years and pt seems to fall through the cracks due to IQ and aggression.
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.
PH-M15-4994
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.
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
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-M13-5023
Kiddo came to our ED 12/23, came from North Memorial ED after incident with Grandma at home, brought to us from County Case Manager. Grandma has custody. Has history of physical aggression, primarily directed at family. Has been calm and cooperative in our ED. CM is currently exploring parent referred shelter programs but all thus far have denied due to age/behavior. OP therapist is recommending RTC for long term plan but needing interim plan as well, Grandma reports it’s not safe to return to her.
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.
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.
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.