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.

PH-F14-3375

Update 4/12/24: Patient discharged from inpatient to home, while waiting for RTC admission.

Update 4/11/24: Patient scheduled to discharge from inpatient on 4/12/24, stepping down to outpatient supports, while waiting for RTC. Intake process is moving forward at North Homes RTC, with potential admission on 4/18 or 4/19.

Update 4/4/24: Patient has been accepted at North Homes RTC with a potential admission mid-April. Patient has now been assigned a CMHCM, waiting on screening for county funding.

Update 3/21/4: Pt is under review for acceptance at North Homes pending county funding, Waiting assigned CMHCM, parent is currently doing the intake process at the county to get a CMHCM for the Juvenile Screening.

Patient is a 14-year-old transgender male presenting at PrairieCare’s inpatient hospital. Patient presented to Sanford Bemidji Medical Center on 3/4 when parents brought them. That night while parents were away from home patient was aggressive toward sister. Family called crisis and were directed to bring to ED for evaluation. This is after a similar event last week where patient attempted to stab sister with a knife and father had to intervene.

CH-F16-3629

Patient presented to the ER via law enforcement for aggressive behaviors at shelter care resulting in property destruction. Patient is not able to return to the shelter and does not have any safe disposition options.

CH-M13-3592

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.

MHF-M17-3467

Pt came to ED 3/25 after being on the run for a few weeks. Was previously at hotel crisis respite prior to being on the run, damaged property there and can not return. County is current guardian, though patient turns 18 very shortly and will be his own guardian at that time. History of behaviors, verbal and physical aggression and property destruction. Has been denied from shelters due to behaviors and previously denied from RTCs in and out of state, though due to age would no longer be an option. Refuses all mental health services and has not had a DA since 2020. Is on CADI waiver. Recommendation on weekly call to discuss benefits of IRTS program/treatment with him.

NMH8R0MGH-F14-3413

Presents from home after altercation with mother and sister. Family does not feel safe with patient returning home.

MHF-M17-3392

Patient presented with police after being found as a runaway from parents home, staying at friends house. Patient reportedly having increased aggressive episodes at home towards parents and property destruction. Parents unwilling to have patient in the home at this time. Working with family and case manager on shelter or alternative placement need.

MHF-M14-3383

Patient presented to the ED from Aspen House after destroying property and agitation. Unable to return and unable to return to adoptive parents home. Boarding in the ED for shelter placement.

MCR-M14-3272

Comes from shelter placement (Von Wald) due to aggression. Has probation with court on 3/14/24. Voluntarily placed with Rice County by family due to safety concerns. The CASII score is 6 with strong recommendation for wilderness residential programming, as he has been through a few ‘traditional’ residential programs, so he has some buy-in for wilderness type residential. Looking for shelter vs group home as waiting for residential programming. Parents hesitant to look at out-of-state programs.

ADYC-M14-1768

Update: 1/19/24 Pt. still looking for placement.

15-year-old male looking for a group home and residential program. Children’s Mental Health Case Manager has tried everything, and doors are being shut. Client has a physical aggression, verbal aggression, history of PTSD and sexual abuse. Client has experienced abuse from biological father who is in still in the home, and sexual assault that happened possibility of more than one with an older cousin sister. Client mother is giving up on hope on trying to help her child. Client is struggling at home, school, and community. Children’s Mental Health Case Manager has been trying everything to find a placement for him. He’s been going in and out of the ER like every two months now. Children’s Mental Health Case Manager still trying to offer support the way she can by being there every hospital stay, seeing client like twice a month, and having mom keep her on speed dial to talk to client.

Because of experiences, client is chemical dependent on marijuana, perks, and opioids.

MCR-M12-3200

Conduct disorder (childhood onset), Parent-child relationship problem, ADHD, Borderline intellectual functioning
Pt has outbursts and behaviors causing family in the home to feel unsafe, he has been utilizing a respite home but recently became dysregulated in this setting additionally and struggles with boundary and limit setting. Home environment appears to reflect chronic chaos.