Pt is presented to the ED by police. Pt was adopted at age 2, and adoptive parents are now deceased. Pt lives with his sister/legal guardian, sister’s boyfriend, 2 year old cousin, and 15 year old brother. Pt had an altercation with his sister, where he tried to stab her, so she called the police. Pt was in the ED from 6/15 to 6/23 for a similar issue. Pt’s sister says aggressive behaviors are escalating, and he is said to have threated to kill everyone in home earlier this month. There is some concern that pt has been using weed and possibly other substances. Pt has PMH of AHHD, MDD and ODD.
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-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.
MHF-F6-1228
Pt presented to the ED via EMS after jumping out of her mother’s car into traffic, stating that she wanted to die. Pt lives with her mother and brother, who moved to MN from TX in December of 2022, to escape domestic violence and pervasive sexual trauma. Pt has a history of significant sexual abuse from their father, including sex trafficking. Pt has been screaming, kicking, and running outside, placing the family’s housing at risk.
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
GC8S-F14-863
14-year-old adolescent female with a history of ADHD, witnessed verbal and physical abuse, multi-substance use with significant behavioral issues at school. Pt was admitted to Gillette Children’s on 4-30-2023 with an acute hypoxic ischemic brain injury secondary to hanging herself in a suicide attempt. Pt has made significant improvements in her cognitive and motor functioning since her initial presentation. Pt does not have a previous history of suicide attempts but does have a history of non-lethal cutting behaviors. She has been involved with various mental health providers on an outpatient basis over the past several years. She has never been hospitalized for mental health issues. Pt is currently not suicidal. Pt currently presents with a flat affect and difficulty comprehending the gravity of her suicide attempt. Pt will be ready for discharge from a medical standpoint mid-next week and is expected to be independent in mobility and self-cares, although she will require supervision in the home setting. Pt has the endurance to complete a full day of activity. Please consider Pt for intensive mental health services and parental support as she transitions back to her home setting.
Update 5/18/23 from Mallory at PrairieCare: Amy and I messaged, this pt will DC from RU 5/24/23 and has not had any SI or SIB plans, means, or intent. Likely initially declined for Inpatient due to medical condition. Once medically cleared, discussed referral for PHP due to needing intensive therapeutic intervention, but not imminent danger to self. Amy plans to refer for PHP.
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.