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-F13-6075

Youth came to our ED on 9/4/25 from a group home after reportedly ingesting extra medications. It’s unclear how she got the medications, but her custodian does not want her returning to the home at this time. IP was initially recommended however she was declined from multiple IP units due to feeling there would be no benefit from IPMH and due to her acuity. She has since stabilized while waiting in the ED, and is now being recommended for discharge. This is this youth’s 7th time boarding in Fairview EDs. There is a tentative placement set up for the 22nd, looking for potential interim plans.

PH-F17-6057

Recommending RTC/PRTF
17-year-old female who presents to PrairieCare Inpatient Hospital due to suicide attempt with increased SI and SIB.
This is her 2nd psychiatric hospitalization. She has engaged in PHP and outpatient psychiatric services.
For RTC – she will need funding through Ramsey County.

Discharge Plans as of 9/9/25:
RTC:
-Avanti (referral sent)
-Gerard (referral sent)
-PrairieCare Residential (accepted, on wait list)
-North Homes (not pursuing due to distance per guardians wishes)

PRTF:
-Nexus East Bethel (referral sent)
-Northwood (not pursuing due to distance per guardians wishes)

CH8SCH-F16-6006

Was in metro area with adoptive parents. Placed at Youth Shelter in St. Cloud. Came to hospital. Shelter d/c’d her and refused to pick her up. Ramsey probation and SW already involved. Adoptive parents want to relinquish any rights to patient as aggression is focused on mom.

PH-F10-5904

Pt is a 10 year-old female with historic diagnoses of anxiety, depression, ODD, specified neurodevelopmental disorder who presents today to address running away from home. Upon interview pt was observed to be easily distracted and appears to be guarded. Pt was resistant to the interview stating, “I don’t want to answer any questions.” After roughly 5 minutes pt refused the interview process leaving the room and forcefully pushing the door close with writer still in the room. Writer could hear pt yelling and laughing from the hallway “she’s locked in there” and “I locked her in there”.

Mother reports pt has been running away from home and putting herself in dangerous situation. Mother reports pt was sexually assaulted during one of her runaways. Mother reports pt’s motive for running away this time was to get on an airplane. Mother stated due to pt’s behaviors, pt has been hospitalized 3 times within one and a half weeks. Mother reports pt’s mental health is worsening. Mother reports pt struggles with authority figures and being held accountable. Mother states they use to have structure and routine in the home and is trying to incorporate it into the home again but when pt is held accountable, pt will threaten mother and think mother is “being mean.”

AH-M15-5556

Impression of Crisis Behavior (precipitants): Patient presented to the ED due to agitation and SI. The identified precipitant for this crisis is a verbal and physical argument with his mother and her boyfriend at the home. Patient was released from the JDC to home on 4/5/25.
Vulnerabilities: adolescent, ASD, h/o trauma, recently released from JDC, parent-child conflict, inadequate outpatient supports
Behaviors / Symptoms to address in the ED: deferred
Methods to increase desirable behaviors in the ED: meet basic needs, set behavioral boundaries/limits,
Barriers to Discharge include: At this time, patient is NOT felt to meet criteria for inpatient hospitalization. There are no new acute safety needs that warrant admission. His mental health concerns are chronic and environmental.

Mom is refusing to take him home, JDC won’t take him back as there are no new charges and he has no place to go. CPS is investigating allegations of abuse by parents and child but are not seeking placement. Mom does not consent to use of a shelter or Nexus YCT.

MHF-F13-5313

This pt has boarded with us multiple times in the past. 2/13/24-3/27/24 and 2/14/25-2/21/25. Came to us again 2/27/25 after self harm in the shelter setting where she had discharged to on 2/21. Shelter is unable to take her back. County has custodianship currently and is searching for additional shelter and foster placements, as well as waiver placements. (Was in foster prior to 2/14/25) Previously had residential treatment, in 2024. Is open to CADI waiver.

MCR-F8-5371

This 8 year old has been in two foster homes (skilled) that have been unable to keep her safe; no other foster homes available. Getting updated DA today. Has a YBH worker since 2022, in-home family therapy with family, in-home CTSS skills, individual therapy, medication management, partial hospitalization at PrairieCare Feb 2023 and March 2024, hospitalization Jan 2023; Level 3 at school.

Complex trauma (sex abuse, poor attachment, placement / moves); ongoing CPS case with pending charges. Parenting assessment indicates to cease parenting time

MHF-F13-5276

Kiddo came to our ED on 2/13/25 from a foster home. Foster parents are refusing to take back at this time. Has boarded in our ED in the past, 2/13/24-3/27/24. County has since taken over custodianship. Pt also has tribal involvement and has CADI waiver. Was previously in residential for a year and that is not the recommendation at this time, primarily searching for waiver paid placements. Not wanting to pursue hotel crisis. Nexus YCT has intake scheduled for their placement coordination.

MHF-M16-5234

Kiddo came to us on 2/2 following suicidal behaviors. Plan was originally for inpatient however while waiting for bed he stabilized in the ED and became a boarder on 2/10. Was in SUD residential treatment, but they are declining to have him return, explaining that his needs are more mental health based than what their program can provide. He has a tentative acceptance at a residential program, just waiting for them to process more paperwork and identify a discharge date. Currently under temp custodianship with Ramsey County but Mom is involved ongoing.

CH-F17-5216

Presents from home. Patient is known to our facility having previously boarded. Patient lives with aunt and uncle. There are issues with their relationship, and it has been increasingly difficult for aunt and uncle to manage, and they do not want patient to return home.