History of DMDD and ODD with worsening of extreme violent outbursts since March without known trigger or stressor. Kicked out of PHP due to aggression, sent to SERCC and brought here from SERCC after an aggressive event. Family concerned about home safety.
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-M17-283
State of MN is trying to find a way to build his own home, timing TBD.
Aggressive, DD, low IQ – 40-50, FAS, ward of state, targeted case mgr. Was provisionally discharged from CABHH, not allowed to return. Perhaps a plan is a state run group home, in development?
MHF-M9-808
Patient is presented to the ED by EMS for aggressive behavior towards staff and another resident in his group home. At the group home staff brought the patient out to his school transportation but the patient became dysregulated when he saw the driver was different from prior trips. Patient then eloped to a neighbor’s house where he entered. Staff followed and called the police. Patient was brought back to the group home, but later got into a physical fight with another resident and staff member. Police were called a second time, and patient was transported to the hospital using restraints. The patient has a history of ED visits and has had approximately 6 previous hospital admissions (5/21; 7/21; 10/21; 11/21; 12/21; 9/22). The patient has a diagnosis history of DMDD, ODD, ADHD, GAD, depression, and RAD
PH-F13-458
Pt has had 4 psychiatric hospitalizations, PHP twice, and outpatient services. Needing RTC and bridging plan. >Discharge from PC Inpatient is 5/11 at 1400, will discharge home until RTC.
Discharge Plan:
RTC-
Avanti (Referral made, declined for admission due to history of aggression)
North Homes (Referral made, 6-8 week waitlist)
Village Ranch (Referral made, pending acceptance)
Gerard (referral made; pending acceptance)
Northwood (referral not made; waitlist over 6 months)
Newport Academy (referral not made; insurance not accepted)
Grafton (CMHCM making referral; though likely doesn’t meet criteria due to no ASD/ID/DD diagnosis)
CRTC (referral placed)
Interim Plan:
Consider PCR (referral not made; insurance not accepted though possibility for a county contract- connecting county worker and PCR)
Continue Psychiatry at Nystrom and Associates
Continue Probation services at Goodhue County
Continue CMHCM at Fernbrook
Establish Family therapy at Nystrom and Associates.
Establish CADI worker at Goodhue County
update as of 6.22.23 – Denied acceptance at CRTC due to aggression and lack of buy in
MCR-F16-279
History of PTSD, RAD, ODD, mood issues, adopted at age 6, multiple foster placements prior. Struggling for many years, 4 suicide attempts fall 2021, placed in a shelter in St Paul and targeted by a sex trafficker and eloped for 2 weeks, repeatedly assaulted, given drugs. Admitted to SEY program at Heartland Girls Ranch March 2022, unsuccessfully discharged October 2022 after assaulting a peer. Receiving school-based CD services through ALC, but no mental health services. Case manager working on residential but no success. Admitted to hospital 1/23/23 after massive OD triggered by breakup. Medically cleared 1/27, declined by all inpatient psych because of assault history. Suicidality has resolved, no behavioral issues. She eloped from the peds floor on 3/16/23 and had to be brought back to the ED by law enforcement. Hospitalization not recommended; county looking at outside placement options.
MHF-M16-350
Patient presented from group home with aggression, breaking things. He has chronic aggressive behaviors. He was admitted to Hawthorn Center state hospital in 6/21-7/22. During his admission, patient’s mom passed away and he was placed in Beacon Crisis Residence. Patient had a prolonged stay in UMMC ED September 2022-October 2022 and was discharged to RTC in TN. Patient was discharged from the facility in TN due to concerns with the facility and was returned MN. He was brought from the airport to Children’s Hospital on 1/11/23-1/13/23 and was discharged and immediately brought to UMMC ED by parent and county worker. He was in UMMC ED 1/13/23-2/7/23 and was started on Zyprexa ODT due to cheeking medications. He was eventually discharged to crisis home. Patient then returned for further concerns of medication non adherance and exacerbation of psychotic symptoms. He had inpatient admission on Inpatient mental health at UMMC from 2/15/23-3/12/23. Patient was discharged to respite house with additional wrap around services. Patient has had 4 ED encounters since that time. Patient discharged to his group home on 5/1/23 and returned to ED on 5/2/23 due to aggressive behaviors. Patient is unable to return to group home.
CH-M8-901
Patient with a history of ADHD, DMDD, and trauma that presents after making verbal suicide threat and gesture of putting his hands around his neck. Has a history of suicide statements and self injury when angry. Does not require inpatient hospitalization though is unable to return to foster home. There is difficulty in finding an accepting foster placement.
D/C to new foster home on 6/2/23
MHF-F12-635
Patient presented to the ED from CRTC due to increased aggressive behaviors in the facility towards staff and was unable to return to the facility. Patient not safe to return home due to behaviors and case manager is pursuing residential treatment.
C8SM8M-M8-308
Presents with dysregulation, agitation, aggression, threats of SI/SIB. extensive mental health history. Sexual abuse at early age. In and out of residential treatment. He doesn’t meet inpatient requirement. Mom unable to meet his needs at this time. Mom working with county to find residential placement.
C8SM8SP-M14-474
ASD, Aggression, Deaf, PICA, Mood disorder