Patients a 16yr female with a history of albinism, anxiety and depression, ADHD, unspecified intellectual disability and borderline personality disorder presenting to the ED with complaints of suicidal ideation with plan. Was discharged from PSJ on 11/08/23. Started PHP at PSJ on 10/9/23, became aggressive and had a episode with SI statements and brought to the ED. Extensive inpatient psychiatric hospitalizations over the past year with >4 at Prairie St Johns, and 4 months at Prairie Care Medical Center from 4/18/23 -8/25/23.
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-F6-2388
Update: DIfficult to place, haven’t been successful at contact w family
Patient is presenting to the ED for the following concerns: physical aggression, significant behavioral change. Patient has Autism, is non-verbal, has a developmental delay, speech delay, PICA and behavioral issues at home that have been increasingly difficult for the family to manage. Patient was seen her earlier this month after ingesting a battery. Patient reportedly has been accepted for a residential treatment facility in Missouri – Lake Mary Center, though they currently do not have a funding source and intake is not until the end of December. Family has been working with Aurora Behavioral Services, as well as psychiatry and PCA services.
CH-M11-1984
Patient presents from PHP where he was discharged due to ongoing aggression and attempts to urinate on staff and floor. Patient currently struggling with family dynamics, limit setting, gender identity, disrobing, property destruction, and aggression.
EH8D-M19-2375
ASD, aggression, DD, language impairment
RH-F15-2367
1 week prior to ED pt was found tied up in her home by her parents. She was taken to Children’s and placed into foster care. Mother didn’t believe in Western Medicine and was using THC and tying her up to treat pt’s agitation in the home. Pt presented to Regions ED from the foster home due to increase agitation and needing more staff support, pt has severe ASD, DD. Hx of violence towards self and others. She can’t eat without someone holding her hands because she hits everything away. She is mostly nonverbal, only knows a few words.
Has been in the ED for over 165 hours, she has been started on medications and we have seen a decrease in her level of agitation. She has been more cooperative with ADLs, takes medications, and eating meals w/ assist and staff have been able to redirect her before a code needs to be called. Pt has been declined by all inpatient facilities at this time. CPS in Anoka is current guardian. Has DD waiver. Regions providing sensory support, weighted blankets, stuffed animals, music. Needs 24/7 support.
Mom currently in custody.
C8SM8SP-M12-2334
Emotional dysregulation, discharged from crisis respite home due to aggressive incident. Frequent episodes of dysregulation around electronics. Has been calm & cooperative in our hospital. Mom’s rights are terminated, but she had daily phone contact and monthly visits.
MCR-M11-2224
This child is a ward of Steele County with Significant aggression and significant trauma. Mom died in 2019, Dad in group home for TBI. Suicidal/homicidal statements, thoughts. Tried to place with 19 yo sibling which lasted for a month, but brother doesn’t think he can keep him safe any longer. Came from SERCC to Mayo ED when he escalated to a point that they couldn’t care for him. He has been doing OK since he got there but has had a few instances of escalating to the point of needing to be restrained with holds and sedation. Struggles with conspiracy theories, as his mom died of a septic kidney infection, but he believes that her boyfriend poisoned her. He is fearful of being poisoned; he won’t sleep without someone watching over him. Not safe for a group home at this point.
MHF-M7-2180
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression. Patient currently lives with foster mom and dad, mother will soon be entering IRTS but intends to take son back afterward. Patient has been not been taking his medications and engaging in behavior that puts himself and others around him in danger. Patient has high sensory needs that if not attuned to will begin to hurt self and others. Patient was last admitted on 10/20/23 and was inpatient until stabilization. Patient has been attempting to “scratch out” his eyes and turn off devices of his fellow foster care children. Pt is diagnosed with Autism Spectrum Disorder and significant early childhood trauma. Collateral reports that when pt takes meds, he can calm down. Patient is non-verbal.
MCR-M16-2136
Twin brother adopted from Ecuador at age 11. DD, operate at about 5-6 year old. No MA or waiver due to parent income. County case manager referred to MSOCS and CSS. Mom working with Kennedy Krieger. Barriers: no MA, waiver or declined due to DD or aggression. DC from Chileda due to behaviors.
MCR-M16-2149
Twin brother adopted from Ecuador at age 11. DD, operate at about a 5-6 year level. No MA or waiver due to parent income. County case manager referred to MSOCS and CSS. Mom working with Kennedy Krieger. Barriers; no MA, waiver or declined due to DD or aggression. Discharged from Chileda due to behaviors. The family wants to keep him at home, but is intimidated by how big and aggressive he’s become.