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
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-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.
CH-M17-4047
Pt brought in because they locked themself in their room and wouldn’t come out. Police involvement encouraged patient to come in to see a therapist. Dad refused to take patient home fearing that patient would become aggressive. Patient has historically been violent in times of parents taking away electronics. CPS report made. CPS did not feel patient should be forced to go home with dad because patient was threatening dad while in the ER that they were going to notify police that dad and roommate forced them to take marijuana edibles. Referral made to 180 degree shelter, who declined.
NMH8R0MGH-M19-3995
19 year old left his adoptive home for a walk, then stopped at a private home and requested that 911 be called due to having suicidal thoughts. Patient is in high school. 4 visit to the ER in two weeks.
EH8D-F10-3962
Pt has been living in the Residential Services-Jewel Group home for over a year. They gave a 60 day termination of service due to their inability to manage her escalating behaviors (last day of services 6/25/24). They have 2:1 staffing for her. These behaviors include harm to self, or others, striking out, choking herself, throwing things and threatening to kill herself and others. She had been attending TSA day treatment until March after an altercation with a peer. She is currently at a 4th grade level and has an IEP. She was brought to the Welia Mora ED on 5/9 and 5/10 as well as Children’s ED on 5/14 looking for “other placement” and was discharged due to not meeting criteria for inpatient hospitalization.
HCMCH-F14-3794
Update 5/15: Referral madeEmbark (out of state PRTF) and other 2 PRTF out-of-state referrals, as well as Bar None Haven.
The patient is 14 y/o female with a PMH dx to include DMDD,, ADHD, PTSD, and FASD. The patient has presented to ED for SI, attempts elopement and aggression. The patient has significant hx of MH IP hospital admissions. She was recently d/c Dungarvan after 2.5 years.
Hx of sexual abuse and neglect. She ward of the state. Her extensive trauma history and attachment issues, which hinder her ability to form relationships.