Psychiatric Diagnosis: Trauma and Stressor Related Disorders

Trauma and Stressor Related Disorders are a group of psychiatric diagnoses that result from exposure to traumatic or stressful events, such as acute stress disorder and adjustment disorders.

PH-F10-1534

UPDATE 8/31/23: Discharge to family with wraparound services planned for 8/31/23 at 1300 while waiting next Gerard admission (tentative late September) as QRTP pre placement screening has now approved.
UPDATE 8/24/23: Pt remains accepted to Gerard, next admission now late September. QRTP pre placement screening team approved 60 days RTC as of 8/24/23. We will discharge home with wraparound services while waiting RTC admission.
UPDATE 8/8/23: Pt is accepted to Gerard and can admit tentative 8/21- pending preplacement screening/QRTP approval from Hennepin County.

10- year-old female with a history of anxiety, depression, social difficulties, anger and trauma. Aggressive behaviors and increase in suicidal ideations. Has participated in PHP, individual therapy, and psychiatry. Insured by BCBS PMAP.

DISCHARGE PLANNING EFFORTS:
Primary Recommendation: Residential Treatment.

Patient recommended to return to home/community with wraparound services while waiting for Residential. Discharges have been attempted, patient threatened grandmother. (Patient cannot return to mother or to grandmothers- CPS involved)

Wraparound:
Establish CMHCM (Referral to be made internally from CPS case worker)
Establish CTSS (Referral completed to Summer Counseling, reviewing; Referral completed to MN CarePartner, on waitlist, 2-3 months)
Establish FT (Referral completed to Family Attachment Center and Empower)
Continue Individual Therapy with Rachel at ELEOS Psychology Center
Continue Psychiatry with Catherine McCormick-Deaton, DO at Allina Health-St. Paul
Continue PCP at Allina Health-Maple Grove

Residential, when available due to waitlists*:
Consider Nexus-Gerard RTC (Declined due to aggression, being re-reviewed currently)
Consider Northwood Children’s RTC (Referral sent, waitlist 6-9 months)

*Juvenile Treatment Screening with Hennepin County needed to request funding for QRTP/RTC level of care. CPS worker aware of request.

Estimated length of stay:
Patient is medically ready for discharge as of 6/30/23

EH8D-M15-414

15 year old male with a history of ASD, ADHD, trauma, and multiple prior psychiatric hospitalizations and residential placements. He was admitted to the hospital after becoming aggressive and self-injurious while at crisis stabilization home. Patient has a history of making significant threats of violence and has been repeatedly sexually inappropriate. He was removed from his home after having molested a younger cousin. Patient will, at times, express remorse for his behaviors while at other times appearing grandiose and narcissistic, with violence perpetrated in response to narcissistic injury.

MHF-M11-1283

Pt is presented to the ED via EMS by his adoptive mother/aunt for aggressive behavior. Pt got angry after his family arrived home, after a parade, without any candy for him. Pt began to punch holes in the wall, beat his adoptive mother with shoes, throw things at family members, and threaten to kill them. Pt currently lives with his aunt and uncle who are also his adoptive parents. There are five other children in the home. Pt’s birth mother’s parental rights were terminated in 2020 due to child neglect. Pt carries current diagnoses of ADHD, other specified trauma and stressor related disorder, and other specified neurodevelopmental disorder. There is a strong suspicion of fetal alcohol spectrum disorder, although a diagnosis has not been given due to inability to confirm maternal alcohol use during pregnancy. There is genetic loading for mood disorders and substance use. Pt was most recently in a residential treatment facility for six months, and discharged home about a week ago. Pt has a history of inpatient hospitalizations for his aggression with his last hospitalization taking place from 10/26-11/09/2022.

SMCF-F12-1160

Patient was brought to the Emergency Dept. after having a violent outburst at a residential facility in Fargo, ND. Concern for physical aggression and property damage. Patient reportedly was involved in a verbal altercation with another resident who was calling him by the wrong pronouns. He has now been discharged from the residential facility with no alternative residential facilities available. Otter Tail County (MN) is the guardian. Guardian has exhausted all options. He has been calm and cooperative in the ED with no outbursts. He is medically cleared and he is not meeting criteria for inpatient psychiatric hospitalization.

MHF-F14-674

Patient presented to the ED from PHP for making homicidal threats towards foster mother and other children in the home, during a family meeting. Foster mother doesn’t feel safe bringing the patient home.

MHF-M6-779

Patient is presented to the Peds ED from his elementary school, where he became physically aggressive towards staff and students, and eloped from his school. Patient was placed in the care of paternal aunt about two years ago, but removed a couple of months ago due to alleged abuse toward patient. Patient’s mother and aunt are allowed supervised visits. Patient has been in four foster home placements in the last six weeks. Patient’s most current foster placement refuses to take him back. Patient has hypersexual behavior and sexual knowledge not appropriate for his age. There are concerns for sexual abuse