16-year-old Caucasian male with disregulated behaviors and suicidal ideation. Patient was brought into the hospital by EMS from school. Patient punched a wall, made suicidal statements and began banging his head in response to a conflict with another student and teacher. Mother of child states “ramping up” behaviors at home recently. Patient carries a current diagnosis of ADHD, OCD, Autism, and Bipolar Disorder. Patient lives at home with his mother, father, and younger sister. Patient has has a history of mental health hospitalizations: at age 11 (Prairie St. Johns) and age 8 (Fairview Ridges).
Recommended Service: Crisis Stabilization
Crisis stabilization services are mental health services, provided after crisis intervention, to help the member return his or her functioning to the level it was before the crisis.
MHF-M16-1797
Patient is presenting to the ED for the following concerns: physical aggression. Patient has prior diagnosis of ASD, ADHD, Intellectual Disability, and Mood Disorder. Patient has prior presentations for behavioral issues and outbursts at United, Mercy, and Abbott. Patient lives with his mother and 5 other siblings. Patient and his family were outside, when he says his sister started mocking him. Patient hit his sister twice, and then his brother. Patient then came up behind his mother, as if to hit her, and his brother stepped in. Patient’s mother is refusing to pick him up.
Patient’s family is moving this week, and he does not want to move.
SMCF-M14-1785
14yr old male who presents to Emergency Dept with homicidal ideations with dad from school. He denies making statements of a homicidal nature but per report he threatened to kill his school paraprofessional and “shoot up the school.” Patient has access to means and at the time reported intent. He also make threats to hospital staff when angry and has made several comments about owning a gun. He has a history of acting violently and notes when he is angry he could do something to harm others. He missed several days of his psychiatric medications which may be contributing to this escalating behavior. Medication was restarted two days ago but he needs a safe secure environment to restart medication and to further evaluated his risk of threat to others. Patient is perseverative in this thinking, restless, and with disorganized thinking which may be in part due to not receiving his ADHD prior to this assessment but also deserves further assessment.
MHF-F11-1552
UPDATE: Accepted to Gerard Pending date next week.
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, anxiety, worsening psychosocial stress. Patient was threatening to attack kids in her neighborhood with a knife, and threatened to stab her grandfather when he attempted to intervene. Patient’s grandfather locked her out of the house, so she wasn’t able to get anything else to hurt someone with, and patient kicked the lock off of the door.
Patient recently lived in a youth shelter/transitional home called Dignity House for 1.5 weeks until 8/3/2023. She was then sent to the ED for aggression. She had a warrant for arrest due to an assault and threatening homicide to family members. She was taken to JDC on 8/3/2023, had court, and then she was sent to the Bridge for Youth Shelter. Patient got into a physical altercation at The Bridge and was sent back to the ED on 8/8/2023. While in the ED, patient physically assaulted a nurse and was picked up by her grandfather.
Within this year, the patient has had approximately 13 ED visits due to concerns including runaway, aggression, abuse/neglect, and altercations with family members.
AH-F15-484
Diabetic, needing crisis respite or group home
Discharged to Meridian Crisis Respite in Golden Valley on 9/15/22.
PH-F13-1646
UPDATE 9/7/23: Pending potential foster/emergency beds.
UPDATE 8/31/23: Possible emergency foster bed open 9/5, emergent SMRT application in process. Still waiting living placement.
13 y/o female with a history of PTSD, depression, ADHD, mild CD concerns. Patient has a history of previous psychiatric hospitalizations related to increase in SI, SIB, and/or suicide attempts. Patient currently has an outpatient therapist and children’s mental health case manager; treatment history includes outpatient therapy and psychiatric hospitalizations as well as one prior placement at Northwoods crisis stabilization program. Patient is in foster care under guardianship of St. Louis County. Patient was in a foster home prior to inpatient hospitalization but is unable to return to that placement after discharge. Patient has Ucare PMAP insurance.
Discharge Recommendations:
Continue individual therapy established provider
Continue CMHCM with established provider
Continue primary care/medication management with established provider
Establish psychiatry (SW to refer/follow up with outpatient team RE: pending referral)
Estimated length of stay:
Until placement is established by the County (Patient is medically ready for discharge as of 08/16/23)
MHF-F14-1493
UPDATE: as of 8/24/23 she has been accepted to a residential facility in Georgia, and the family is waiting for some pieces from their insurance company. Transportation is ready to go once insurance is approved – hopefully end of this week or early next.
Pt is presented to the ED via EMS for the following concerns: verbal agitation, physical aggression, significant behavioral change, and anxiety. Pt has been in a residential treatment center for approximately 5 weeks, and had been in a “crisis state” all day, on day of admission. Pt was requiring frequent restraints, supervision and redirection for up to 8 hours. She was non-compliant with treatment activities, frequently trying to run away from program activities, and into the street. Pt kept searching for sharp objects to self-harm, and assaulted staff when they tried to take objects from her.
These are chronic behaviors for pt. Pt is currently in a 3rd residential treatment program (secure), with a hx of one prior group home placement. Pt has a hx of several mental health hospitalizations, with most recent in October 2022. Patient has a hx of refusing medications.
Residential facility stating that pt has been discharged, however there is no discharge paperwork available. From North Dakota. No case mgr or services in place. Her parents were able to get her into the residential treatment center she was at. Able to DC but nowhere to go at this point.
C8SM8M-M11-881
Patient is an 11-year-old male presenting to Children’s Emergency Department due to increasing behavioral escalations at home. Patient has a history of trauma. Patient has not had stable housing and has been in several different placements within this last year.
Patient does not meet inpatient mental health criteria due to no ongoing or current suicidal ideation, thoughts of self-harm, or thoughts to harm others and was recommended to discharge home to his foster home with his grandmother.
MHF-M15-1498
Pt is presenting to the ED for the following concerns: verbal agitation, physical aggression, significant behavioral change. Pt had not been taking his medication, and had been awake for several days on his computer. Pt began waving a knife and scissors around the house, and refused to give them back to his mother. Pt’s mother was concerned that he was going to hurt her, so she called the police.
Pt seems to have limited potential to regulate his emotions and can be erratic without considering the consequences for his impulsive behaviors. Pt was discharged from inpatient treatment in July of this year, for a similar presentation.
AH-F15-1322
came to ED with suicidal and homicidal threats after an upsetting conversation with former foster provider – currently denies HI/SI to staff, unable to be placed with former foster provider, difficulty at group home – arguments with staff and other residents and they have said she is unable to return, CPS worker is guardian and looking for placement,
Nexus -FACTS
– youth has been accepted at Nexus FACTS for assistance with Placement Coordination Services.