12 yo male brought to Ridgeview Medical Center (RMC) via EMS after a verbal and physical outburst at home. Youth felt that his mother was “lying” about him to a visiting social worker and youth became aggressive, throwing dishes on the floor in the kitchen. Youth “pushed” his brother, who then pushed youth. No h/o violence or aggression at school or with individuals outside of his home. Most aggression is shown verbally towards his mother. Mother is not allowing youth back into her home right now. Carver Co. Crisis and COPE have assessed youth and are recommending psychotherapy and/or psychiatry/medication management.
Recommended Service: County Management
County Management refers to administrative and managerial services provided at the county level to oversee and coordinate various social and human services, ensuring efficient delivery of resources to individuals and communities.
AH-M13-4588
Pt per chart presented 9/15/2024 d/t sent from JAF facility after agitation episode during which pt expressed self-harm ideation via electric outlets. Of note this is a behavior for which he has been sent to ED multiple times and regulates in ED and has been sent back. However, currently facility is not agreeing to take pt back and apparently for the past 5 days since last visit, there has been a plan to discharge pt if there was 1 more ED visit, which is current visit.
CH-M10-4290
Patient presented via law enforcement to the St. Cloud ETC after eloping from mother’s home and found wandering on Highway 10. Initially aggressive/combative with law enforcement. Patient was cleared for discharge but refused to go with mom, because combative and required PRN to calm down. Was kept overnight. Patient’s mom refused to pick patient up once cleared for discharge due to his ongoing aggressive behaviors. CPS is involved and a new report was filed.
Police hold initiated 7/9/24 and CHIPs petition is being pursued. County CPS worker is seeking foster care placement.
Update (7/18)- Court hearing for CHIPs petition. County CPS case worker is continuing to look for foster care placement. Patient will have twice weekly phone calls with his mother.
CH-F16-3194
Update 5/16/24: Still on Empath. Cancelled follow up visit/pursuit of ChildServe due to county not being able to provide out of state funding. Starting over with contacting facilities in MN. Enriched living extensive waitlist, Beacon sent referral for long term crisis placement, Dragon fly still reviewing, JD homes reviewing, REM reviewing.
Update 5/9/24: Still on Empath unit. Being reviewed by ChildServe for potential placement out of state. County also pursuing waiver for adult group home.
Update 4/15/24: Still on the Empath unit and continues to do well. MN Choice Assessment completed last week. Referral made to ChildServe in Iowa.
Update 3/21/24: Still on Empath unit, doing well. Stearns county has guardianship, still working on CADI waiver. Referral made to Dragonfly.
Update:3/7/24: On Empath unit, used for assessments and stabilization. 48 hour stay. Doesn’t need hospital. Needs to be assigned a social worker. On a chips hold. Going to need a CADI waiver.
Patient is diagnosed with Soto’s syndrome and is non-verbal with significant developmental delay and suspected cognitive functioning of a toddler. Dad dropped her off at the ER with reports that he is not willing to bring her back home as he and mom are aging and are unable to manage her any longer as they have other disabled children in the home and mom has health issues. Patient has a chronic history of slapping herself, biting herself and others, and pulling hair. Patient is incontinent of bowel and bladder and requires significant assistance with ADL’s including toileting, bathing, dressing, and eating. Family currently has no supportive services in place with the exception of psychiatry. CPS report was filed with court scheduled Monday morning. Not aggressive or violent since in ER. Compliant. 1:1 since she’s on an adult unit.
HCMCECC-M13-3482
**Contact department: HCMC Acute Psychiatric Services (APS) 612-873-9300
13 y.o. male boarding in ED. Brought in by adoptive mother after running away from home 3 times. Multiple suspensions from school (including currently) for fighting. Mother unwilling to bring patient home. Physically assaulted mother after he was brought back home. Went to Uncle’s house and left via window. Has been making passive comments indicating suicidal ideation and not having any sense of danger- getting into cars with strangers. Significant increase in challenges since he began going through puberty about 6 months back.
Copied from ED note:
“Collateral from mother and family:
Foster mother took in his sister first, took him as well at 16 months old. States that when he first came to live with her he would eat out of the trash, and from bowls on the floor like a dog. Took several months to correct this. Patient was then returned to his paternal grandmother in chicago, but was only there for two months. Foster system asked mother to adopt him and keep him with his sister. Some school issues, briefly on IEP. Mother was kindergarten teacher.
In the past 6 months, since hitting puberty and undergoing a growth spurt, patients behaviors have been worsening. In Nov of 23 patient attempted to start a fire in his bedroom. He has been in a plethora of fights at school. Is currently suspended. Believes that everyone hates him. Since January he has been making comments to family about ending his life. Reportedly had knife in his room at one point. 3x running away from home. 1st time was not far and he came home quickly. 2nd he made his way from north Minneapolis to S St. Paul, and was with a complete stranger for approximately 9 hours. Family reports that patient refuses to speak about this time. Was acting strangely after he returned. 3rd was yesterday after he became angry and physically assaulted mother. Was found by police (allegedly engaging in burglary?) Was brought to uncles house per request of mother, as he had been quite belligerent with her earlier. Patient normally behaves well with uncles, but today he waited until he was unsupervised and climbed out of a ground floor window to run away again.”
Not appropriate for inpatient pediatric medical floor. Boarding in HCMC Emergency Department. HCMC Acute Psychiatric Services do not feel patient needs an inpatient psychiatric admission. Family and NEXXUS advocate not comfortable with discharge unless plan for significantly increased outpatient support. No formal diagnoses. Has been completely compliant and appropriately behaved since presenting to the ED 32+ hours prior.
NMH8R0MGH-F14-3413
Presents from home after altercation with mother and sister. Family does not feel safe with patient returning home.
C8SM8M-M8-3342
Pt presents with behavioral escalations from out of home placement. Pt currently in hospital with no d/c plan at this time coordinated by county. Pt has a history of trauma and sexualized behaviors.
C8SM8M-M10-3146
Patient presents to ED for behavior escalation from foster setting. Guardianship lies within county.
C8SM8M-M11-3149
Patient presented to hospital from group home with escalated bx, unable to return. County retains guardianship.
AH-M16-2327
Patient was in Prairie Lake JDC and his ‘time was served’. County did not have a place for him and reported a judge ordered for a sheriff to drive him from there to ANW for acute MH care. He does not need IP MH care, Crow Wing County does not have a place for him. They are connected with Solutions, working on group home placement.
Patient placed at Crisis respite hotel.