Came to ED on 7/8 after parent-child conflict, verbal altercation and mother reports she was scratched. She had been attending Fairview’s PHP program but has been minimally engaged there, reports that she prefers individual therapy over PHP. She has not had any behaviors since being in the ED. Goal is for patient to return to family with services, but Mom has not been agreeable to pick up yet, continuing to work on services to support the family and see if pt can return home.
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.
MHF-M17-4109
Update: Discharging today 6/20 to hotel crisis respite
Came to the ED this time on 6/9, after refusing to do chores and punching a wall and tree. Dad is refusing to pick up. Was previously in our ED 5/4-5/18 and 5/25-5/28, returned home with Dad both of those times. Case Manager is looking for waiver paid placement, and has been for over a month. Had interview with potential provider 6/12- they are potentially going to do a variance for him to live in adult home if accepted (he’s 3 months from 18). At baseline has some auditory hallucinations, ongoing aggression- primarily verbal, occasionally property, along with some suicidal ideation.
EHS-M16-4154
Patient was brought to ED after making suicidal and homicidal statements during his psychiatric medication appointment. He was evaluated and inpatient psychiatric stabilization was recommended. While in the ED he has been calm and cooperative. Denying suicidal ideation or Homicidal ideation at this time. He does recognize that he has been dysregulated and struggling to find effective coping skills. Recent increase in conflict at home. Has been engaging in self-harm. Mom does not feel safe having him in the home at this time.
MHF-M11-3256
Update 6/7- Pt moved to IP unit to board there
Update 6/4/24- Pt was initially in Fairview ED for 2 months, transferred to inpatient to board there for 1 month, was discharged to a foster placement for less than a week, and returned again to Fairview ED 6/4 due to behaviors, is again boarding in ED. Struggling with appropriate placement due to autism, limited verbal skills, and ongoing aggressive behaviors.
Update 5/6/24- Patient was moved to inpatient unit to manage behaviors, but still remains boarding there. No longer followed by ED team.
Update: 3/21/24 Dad is not going to take the child back. Did get MA switched to MN.
Update: Meeting today 3/14/24, potentially back to dad? Working on switching MA from WI to MN
Patient brought in from home due to aggressive behaviors. History of autism, recently returned to living with father after being in foster care in WI. Since returning to MN, has had limited services set up. Father does not feel safe taking patient home due to aggressive behaviors and other children in the home. Case managers in Wisconsin & MN working together on determining placement.
NMH8R0MGH-M19-3995
19 year old left his adoptive home for a walk, then stopped at a private home and requested that 911 be called due to having suicidal thoughts. Patient is in high school. 4 visit to the ER in two weeks.
HCMCH-M16-3905
Update: O5/16, Central Pre-Admission denied the patient’s placement in CABHH, appealing this decision. Comprehensive Home Care (Respite Provider) accepted him moving date TBD.
Update: 5/15 referred to CABHH he previously denied on 3/29 along with residential and respite placement.
16 y/o M with hx of intellectual disability, poor distress tolerance, and maladaptive patterns to get needs met. Presents with chronic behavioral pattern of acting out to get needs met. Pervasive behavioral patterns in the community result in unsafe behaviors, high utilization of ERS, loss of placements, and exacerbating attachment struggles. He was d/c from respite placement through Twin Cities Home Care on 5/14 due to aggression and impulsive behaviors.
MHF-M17-3807
Pt came into ED on 5/4 via ambulance after property destruction at home. Parent is refusing to pick up. Was previously at Gerard for 45 day eval- discharged on 3/22 to parent. Has a DD waiver CM through the County and they report that he has been approved for out of home placement, making referrals for waiver paid crisis beds and group homes. He has a mild intellectual disability and has some auditory hallucinations that are baseline for pt, Gerard assessment suspected schizophreniform disorder, provisionally.
REH-F17-3586
5/2 Update: Client has been discharged home twice (contracted for safety) and returned within 24 hours due to attempting to run into traffic. Has been approved for PRTF and referrals have been made to Northwoods (2 year waitlist) and Grafton. Inpt behavioral health is not an option due to previous stays. CABHH referral pending and they are attempting to admit pt when they have discharges.
Presented with attempted suicide on 4/4 (superficial laceration on arm). Also attempted to overdose on Lithium on 4/2. Appears to have a developmental delay. Denied at multiple inpt facilities due to previous aggression. Turns 18 in July.
MHF-M11-3615
Came to ED 4/5 after some property destruction at family home. Previously in FV’s PHP program. Mom refusing to pick up and refusing family first services in home. County now has temporary custody for out of home placement, has not been in out of home placement previously. Ongoing CPS worker assigned 4/18 and is starting placement search.
MHF-F14-3452
Update: Has been accepted to out of state placement in MA however struggling with arranging secure transportation- not a County paid placement as family is guardian. Also moved to IP unit at hospital 4/13 to board there until placement.
Patient presented from guardians home due to aggressive behaviors and agitation. Patient has a history of autism and developmental delays. Guardian does not feel she can care for her any longer at home and feels she needs out of home placement. Has historically been in crisis respite placements and done well in these until guardian brings home, where behaviors will escalate.