Pt is presented to the ED via EMS. Pt resides at a residential treatment facility, where he has been for the past three months. While at the group home, pt reports he became upset by hallucinations and began banging his head. Pt states that he wanted to harm himself and possibly end his life. Pt has hx of baseline S/I and threats of suicide. Pt reports hx of physical and sexual abuse (does not provide further details.) Pt has hx of Borderline Personality Disorder, DMDD, PTSD, GAD and Unspecified Psychosis.
Psychiatric Diagnosis: PTSD
PTSD is a psychiatric diagnosis that results from exposure to a traumatic event or series of events. It is characterized by symptoms such as flashbacks, nightmares, and severe anxiety, often resulting in impaired daily functioning.
SD8SC-M8-1067
Client in process of completing DA through our Assessment Team so not all information is complete at this time. The system has not been helpful to this family for a long time and they are struggling to maintain his adoption. He has low IQ, largely non-verbal with few receptive language skills (communicates by pulling people to things), approved for residential treatment over 3 years ago – not accepted to any placement so far, has a DD case manager and “unlimited” waiver. Historical diagnosis include: ASD, PTSD, GDD, and ADHD. He has significant behaviors including hitting, pushing, stomping and fecal smearing when told “no” or denied access to something even with a body suit. Behaviors of some kind occur multiple times daily. He is aggressive toward all family members but the fecal smearing happens more in response to mother. He has been declined services at over 20 PCA agencies, is not successful attending outpatient therapy services or medical appointments (aggressive to providers and engages in behaviors), no respite providers will accept him, and he has been declined admission to psychiatric hospitalization and most outpatient providers declined him for services as his needs are “too great”. The family includes 4 other children many with special needs, and 2 are medically fragile. The family is to the point where parents are considering having one parent live with this child and the other 4 with the other parent for safety reasons.
6-23-23 client is now linked to Fraser and LSS for possible additional in-home wavier paid supports/services to decrease the likelihood of a boarding or out of home placement
HCMCH-16-1073
Patient is a ward of the State of MN, she has been unsuccessful in foster care placements the past 3 years. She attends a Level 4 school, Reach Academy. Patient in need of higher level of care, group home.
Patient discharged to kinship foster care 6/15/23 while Legal Guardian/Social Worker is still pursuing group home placement. Namia House, Willow Trails.
MHF-F18-995
Patient is presented to the ED by EMS from an RTC facility. Patient assaulted another resident and staff members, and attempted to elope from the facility. Patient is under guardianship of Martin County, and is considered a vulnerable adult. Patient has a significant history of abuse, and suicidal ideation. Patient is supposed to follow a low sugar and fat diet due to pancreatitis.
MCR-F12-255
12 year old with trauma history, in-utero cocaine exposure, long history of behavioral outbursts with adoptive parents, participating in CIBS since November and moved to Phase 2 at Gerard in early January, but struggled and was sent to the ED within 48 hours due to severe outburst at Gerard. Appears to have mild autism spectrum disorder (difficulty with transitions, sensory sensitivity, communication struggles), and likely PTSD related to attempted kidnapping and multiple sexual assaults spring 2022. Has started Vyvanse, Prazosin, and Fluoxetine while boarding, and she has had much less extreme behavioral outbursts, has not needed IM or restraint in weeks. Oppositional, but generally can be verbally redirected. Outbursts tend to be tied to her difficulty with flexibility – eg when meals or medications arrive at slightly different times, or one nurse implements different TV rules than another – will start swearing, sometimes escalating to head-banging, but generally is able to calm on her own when given space (intervening/talking/etc once she is starting to dysregulate tends to escalate rather than de-escalate her). Has loving parents and want her in their home, but fear they cannot keep her safe right now. Regarding running – hasn’t tried to elope from peds floor. Sometimes ran from school or home when upset, walks around neighborhood and comes back. Issues at school have been more blowing up and headbanging. Update as of 4/11 still in ED
MHF-F13-1114
Pt is presented to the ED by the police after running away from home approximately two weeks ago. Pt had gotten into an argument with her mother and no longer felt safe there. Pt reports being physically abused at her mother’s house. Pt had been staying at a man’s house since running away from home, has been having unprotected sexual intercourse with him, and has a history of being sexually exploited for money. Pt is also on probation for unknown reasons.
MHF-F8-348
Pt has been residing in foster homes since she was a few days old. Pt has lived in approximately 9 residences, some were with biological family members. She has been in her current foster home since October 2022. Pt is under guardianship through Hennepin County ICWA program with a Hennepin County Case Manager. According to her guardian, pt has been subjected to significant trauma from her previous placements, including physical/emotional/sexual abuse and neglect. Pt’s biological parents’ parental rights were terminated before pt was 1 year old. Pt is now enrolled in school through the MPLS public school, attending while boarding in the ED. She has frequent, chronic aggression in the community. Generally no concerns in the hospital.
MHF-F16-987
Patient is a 16 year old female presenting to the UMMC West Bank Adult ED for the following concerns: parent-child conflict. Patient has most recently been to Prairie Care inpatient facility. Patient’s mother reports patient has been skipping school and running away, so she locked her out of their apartment. Patient’s mother won’t accept patient back into her home.
MHF-F12-655
Patient presented after RTC in Nevada abruptly closed that patient was residing at; patient was flown home to MN and brought directly to the ED due to lack of placement following RTC closing. Patient is under guardianship of Otter Tail county. History of aggressive behaviors in community and placements however has been calm throughout ED stay.
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.