Patient is presented to the ED by EMS after getting into an altercation with his mother. Patient threatened mother, and ran away from home. Police found the patient three hours later and was brought to the hospital. Patient has a history of mental health issues, aggression, and is currently on probation for making terroristic threats at his school.
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.
MCR-M16-378
16 year old, county ward, who has been at Gerard Academy for 1.5 months and had escalating SI in the context of conflict with peers at Gerard and then ultimately learning that father’s parental rights were terminated. Long previous history of neglect and possible abuse, multiple family members with substance use disorders. At Gerard was leaving the facility and finding sharps to potentially harm himself with. Initially was recommended for inpatient psychiatric care, but declined by all facilities due to history of aggression or behavioral issues in those facilities previously. Eventually acute SI resolved while boarding in the ED, but as plans have been made to work on return to Gerard, he has repeatedly stated he does not want to go back there and will hurt himself or others if he does. His case manager reports that similar statements have arisen repeatedly in the past as placement facilties start to challenge him and seem to serve the function of avoiding difficult emotions. Currently trying to work with Gerard staff and case manager to help him safety plan for a return to Gerard.