Patient presents to the ED via EMS after his group home called 911 due to patient’s aggression. Patient reports that he threw a stool at staff when they asked him to go to bed. Group home to determine whether they will take him back.
Patient has a previous mental health diagnosis of Mood Disorder, Intellectual Disability, Nocturnal Enuresis, Anxiety, ADHD and Autism Spectrum Disorder. Medical records indicate patient presented with similar behaviors to the ED, including defiance, a history of emotional and behavioral dysregulation, and acting out towards staff.
This is patient’s 6th visit in the ED in 2023 for behavioral and/or mental health.
Psychiatric Diagnosis: Disruptive Mood Dysregulation Disorder (DMDD)
DMDD is a psychiatric diagnosis that applies to children and adolescents who exhibit severe temper outbursts and persistent irritability. It is often associated with difficulties in regulating emotions.
MCR-F12-5376
Adopted at age 8 from private agency (so ineligible for MA). Comes in with Homicidal ideation and threats to kill sister and burn down house. Family not willing to bring her home for safety. Have tried many services but terminated them about 2 years ago and now are trying to re-engage. No approval for placement at this time.
PH-M16-5290
Patient is a 16 yo male with history of DMDD, ADHD, GAD, and MDD. Patient has a history of at least 8 inpatient hospitalizations in the past seven years and has also participated in multiple outpatient programs. Stressors include family conflict, housing insecurity, and school.
MFIUP-F14-5242
Presented to ED for verbal agitation, physical aggression, significant behavior chance, suicidal ideation. Patient has also been engaging in SIB. Aggression has been ongoing for over a year and has intensified. Aggression comes on suddenly/does not seem to be predictable. Mom feels she has no control. Has an IEP for low IQ and learning difficulties. Refuses medications. Strained relationships with mother, father, and older siblings. Patient reports not having many close friends. Has engaged in lots of community and outpatient treatment options including individual therapy, family therapy, case management, school counseling, child protection, primary care, psychiatric medication management, day treatment. Has been hospitalized before at PrairieCare.
CH-F11-5026
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.
AH-M16-5148
The patient has a history of ADHD, disruptive mood dysregulation disorder, anxiety, and PTSD. Last night he became frustrated at residential treatment facility- Bar None, kicked a door with his right foot, and put a shoestring around his neck out of frustration. He states he was not trying to hurt himself and did not intend to hurt himself. Bar None completed an administrative review and will not allow his return.
MHF-M10-4649
Kiddo came to the ED 9/19 after aggression at his group home. Boarded at our hospital summer of 2023 for a few months. Team does not want him to return to his group home and is seeking crisis respite while they work on finding a new group home. Has DD waiver.
SL8SHOD-F15-4879
Pt has has multiple psychiatric hospitalizations, is aggressive often, and very unpredictable in her behaviors. She was in an ED for about a month, and was placed at Northwoods residential treatment. She was engaging in self harm. and making threats to jump out of a window. Pt assaulted police who came to remove her from the facility for psychiatric care. Northwoods does not feel that they can keep her or the other patients safe there, so they are not willing to accept her back.
MHF-M14-4646
Kiddo came into ED on 9/24 from school for aggressive behavior, was in foster care who is not willing to take pt back. Under custody of the County. Has history of both residential txt (Northwoods 2x) and juvenile detention centers, and has a rule 20. Referral has been made to Prairie Lakes, waiting for response.
EHS-F16-4792
Patient is a 16-year-old girl with history of mental illness who was brought to the emergency department from port group home where she has been residing for about 5 days. Patient states that she was in juvenile detention immediately prior to going to the group home. Patient has been prescribed psychotropic medicines in the past, but is not currently using any medications. Recommendation from probation officer and county social worker is juvenile detention center or psychiatric inpatient hospitalization pending long term psych placement. However, LE states they can’t bring her to JDC as she has no charges that would make that appropriate at this time without order from probation. Pt has been aggressive, verbally and physically while in the ED. She has eloped on multiple occasions and has attempted to harm herself.