12 yo male brought to Ridgeview Medical Center (RMC) via EMS after a verbal and physical outburst at home. Youth felt that his mother was “lying” about him to a visiting social worker and youth became aggressive, throwing dishes on the floor in the kitchen. Youth “pushed” his brother, who then pushed youth. No h/o violence or aggression at school or with individuals outside of his home. Most aggression is shown verbally towards his mother. Mother is not allowing youth back into her home right now. Carver Co. Crisis and COPE have assessed youth and are recommending psychotherapy and/or psychiatry/medication management.
Psychiatric Diagnosis: Oppositional Defiant Disorder
Oppositional Defiant Disorder is a psychiatric diagnosis typically diagnosed in children or adolescents who display a pattern of defiant, hostile, and disobedient behavior toward authority figures.
MHF-M13-4494
Pt came to our ED on 8/9 from parents home after an altercation. Parents are refusing to pick pt up. They report pt is involved in some gang activity and verbal and physical aggression toward them at home. Has been to 3 residential programs, and multiple placements Northwoods, Gerard and Bar None. He continues to exhibit behaviors in all settings. County does not feel another residential would be beneficial as the last 3 haven’t improved behaviors. Therapist is currently working on IQ testing but unsure if that can be completed in the hospital. Team is looking at starting MNchoices process to get waiver options.
EH8D-M14-4364
This patient was brought to the hospital by police for aggression and dysregulation exhibited at the group home. He was charged with 5th degree assault after injuring staff members at his group home. His behavior has persisted despite medication adjustments and behavioral plans. He struggles in settings where there is too much sensory input and lack of structure. He has been destroying property and presenting with escalating aggressive, dangerous behaviors, homicidal threats and sexualized behaviors. Despite his impulsive behaviors and subsequent harm to staff members, he displays no remorse, though some question of whether he is able to adequately engage in reality testing possibly related to intellectual disability.
He is a ward of the state. He was placed in foster care at age 6 after suffering from neglect by his biological family. Their rights have been terminated.
MHF-M12-4418
Came to us 7/22 via EMT after aggression and property destruction at hotel crisis respite, provider wont take pt back. Previously boarding in our ED 4/5 to 4/25, with somewhat frequent ED visits between. Has previously been to VOA Bar None. Hennepin County has custody and our team was struggling with reaching the CPS worker yesterday/this morning- going to continue reaching out for further plan/details.
PH-M14-4088
Recommendation is for level 5 RTC – patient is currently inpatient.
14-year-old Male from ED. Patient got in a fight with their father and ran away from home. Patient has had several other inpatient hospitalizations and has completed a partial hospitalization program with PrairieCare. In alignment with CMHCM, seeking RTC level of care. At this time parents do not feel they can have the child return home. Referrals have been sent to Gerard Academy and Nexus Mille Lacs.
Patient insured by UCARE MA PMAP.
Pt has the following outpatient supports:
Individual Therapy
Psychiatry
PCP
CMHCM
MHF-M14-4476
Pt came to our ED via EMT on 8/5/24 after an altercation at home. He has a history of multiple inpatient stays, done PHP and day treatment, been to Gerard, Newport, and JDC. There have been 2 rule 20 evals that have deemed him incompetent, one just finalized on 8/7. Dad currently has custody and is refusing to pick up, reporting that he wants more help. Pt has history of abuse from both parents. CPS is petitioning for temp custody and placement is at a stand still while we wait for that to go through.
RMC-M15-4330
On 7/8/24, patient was told he would be spending time with his mother, to which patient had a negative response, causing patient to assault his father and run away. Police located patient at a local middle school just before patient ran across a highway and had to be sedated by EMS due to safety concerns.
Pt has dx that include: reactive attachment d.o., disruptive mood dysregulation disorder, PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections), ADHD, ODD, OCD, pervasive social communication d.o., with low non-verbal skills, high verbal skills, low memory skills, and average IQ.
MHF-M15-4172
Pt came to ED from North Homes, after increase in physical/verbal aggression and 30 day notice was given and lapsed without another placement found. Was boarding in our ED in Nov 2023 prior to admit to North Homes. Planning to connect with parent/County about re-involving Nexus YCT. Some sexual inappropriate behavior making him difficult to place.
MHF-F16-4103
Came to ED on 6/2 after a fight with her guardian, Grandma. Grandma reported she has run away in the past and had made comments related to SI. Grandma refused to pick up and then flew to another state, notifying us she did not know when she would return. We tried to refer to shelter programs, but struggled due to Grandma’s unwillingness to work on reunification post shelter placement. CPS has now opened and will be pursuing temp custody, once they have that they will pursue placement options.
RMC-F16-4041
16 year old female who was brought in by EMS in 4-point restraints after being restrained by PD trying to enter river to “drown herself”. Patient argued with her mother just before she threatened to “drown herself in the river;” destruction of house/property per mother’s report. Patient admits to past similar behaviors and has multiple MH hospitalizations on record.