The patient is a 13 Y year-old male with a history of autism spectrum disorder, disruptive mood dysregulation disorder, ADHD, and depression who presented to the ER on 4/5/24 via EMS from his residential facility for assessment of aggression and suicidal ideation. He has a long history of aggressive behaviors that per chart review worsened around October, 2023 and he has not been able to be safely maintained in his home since that time. He has had several extended hospitalizations and since he was admitted to residential on 2/5 has had 41 incident reports related to attempts to harm himself and aggression when staff attempt to intervene. He has had increasing dysregulation resulting in an increase in restraints, length of time in restraints, and the amount of staff it requires to calm him resulting in the inability to return to residential. Home is not an option at this time.
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.
HCMCH-M16-3181
Per Emergency Protective Care Order, in need of out of home placement. Legal guardian through county, living with father in ND wasn’t successful.
Foster placement is not being recommended. Kinship placement has not been successful and is not a current option.
Patient has gone through Hennepin County QRTP screening – residential placement is recommended and is in alignment with psychology and psychiatry consult recommendations.
CH-M17-3298
Update 3/14: Planning for DC back to home 3/15. Provided mom with resources for group home placement
Patient presented to the ER via law enforcement for suicidal ideation after getting into an argument with his brother and attempted to jump out of a 3rd story window and the vehicle. Mom does not feel safe with him at home due to ongoing aggression. Patient has ABA therapy and social worker.
MHF-M17-3101
Patient presented to the ED from school reporting suicidal ideation. Is able to safety plan for discharge however mother not answering calls and unable to discharge related to this. Historically has been in crisis respite placement after mother refused home last fall from a hospital stay.
AH-M16-2983
This child has a history of chaotic/unstable social/living situation. There is a long history of CPS involvement including being removed from his home living environment. There has historically been concerns for medical neglect (mother refusing to consent to treatment/medications, poor/lack of outpatient follow-up) and physical abuse. In recent months he has spent time between living with his mother in Minnesota and his father in North Dakota (parents are divorced). Parental rights were recently terminated and as of ~1 week ago is now under the legal guardianship of Hennepin/County/Sarah Conway (he was reportedly recently physically assaulted by mother). There is a history of trauma with maladaptive coping including chronic suicidal ideation with significant history of self-injury and/or suicidal threats. There is also a history of endorsing auditory command hallucinations of a male or female voice telling him to harm/kill himself. It has previously been noted that he copes with stress/frustration/emotion by acting out/harming self and running away.
Patient is not recommended for inpatient mental health and needs support in establishing safe placement in the community.
MHF-M15-3003
Patient presented from crisis respite due to increased dysregulation and behaviors. Crisis respite discharged patient and there are no alternative options. Patient with historical diagnosis of autism with developmental delay. Case manager working on crisis respite referrals and long term group home placement.
SBHC-M10-2773
Behavioral issues, parent takes him on a leash when taking him out of the home. Physically and verbally aggressive to parent(s) and others (peers and staff). Throws items, pulls fire alarms, attempts to elope. Receives CTSS services and has demonstrated significant behaviors within those services. Had been in homebound school program, attempted re-entry into school setting and on first day back, damaged property and assaulted staff as well as directing violence towards peers, resulting in transfer to ER for placement. Treatment team questioning consistency of receiving medications appropriately in the home setting and are recommending residential treatment or a shelter bed until residential treatment can be secured.
CH-F16-2246
Update: 1/15/24- Patient has been accepted by Nexus with an admission date of 1/16/24!!
Patient presented to the ER from out of state due to being kicked out of residential treatment for elopements and aggression towards staff and peers. She was boarded in the ER for a significant amount of time before being admitted to the mental health unit for boarding. Patient has CHIPS case though parents are actively involved in her care. Patient has an extremely high risk of elopement and has a history of being sexually trafficked while on elopement. Patient struggles with conduct, low academic performance, and history of aggression. She has had 2 rule 20 assessments and was found incompetent. Patient has been declined from PRTF’s from over 25 states.
MHF-M16-2680
Patient presented to the ED after making a suicide gesture in a grocery store (held knife to neck) in order to be brought to the hospital. Baseline SI and no history of suicide attempts. History of autism. Has complex psychosocial history, was living in Fargo with father however father brought to MN and left to return home without patient. Mother currently homeless in MN and has no ability to take patient in with her. Patient has no active services in MN due to most recently living in Fargo. Need shelter placement alongside establishing providers for long term placement.
SMCTRF-M10-2621
Significant behavioral issues, Parent takes him on a lease when taking him out of the home. Physically and verbally aggressive to parent(s) and others (peers and staff) throws items, pulls fire alarms. Attempts to elope.