The patient presented to HCMC emergency department on 11/13/24 with police after running away from home. He is still currently in HCMCs emergency department. He was found on a metro transit bus where he became agitated, fighting and fleeing from officers, making suicidal comments. When in the emergency department the patient significantly agitated, pacing room, yelling. He began destroying hospital property and was physically restrained by security and placed in pediatric violent restraints. He repeatedly shouted, “just kill me” and threatening harm to self and staff. He has been angry and agitated about his situation at home. When he doesn’t get his way with his mother, he acts out, runs away from home, and he places himself in danger as he is impulsive and does things that place himself at risk. The patient was given sedatives for the agitation and heightened state on two different occasions so far.

Presented to the emergency department at HCMC on 11/9/24 for suicidal ideation. The patient ran away from home two hours prior to arrival at the ED. He was encountered by police and was very upset, refusing to go home because he did not like it there. Made suicidal comments, prompting PD to bring patient to the ED. Patient currently is adamantly denying any suicidal attempts this evening. He endorses self-harming in the past by punching himself in the head, no self-harm tonight. He reports that he feels safe at home, but that he does not want to be there because it is boring.

He was at an inpatient psychiatric from 9/6/24-9/24/24, which was his first inpatient hospitalization. The patient was brought in by ambulance from school after an aggressive outburst. Patient was verbalizing suicidal thoughts. He was aggressive in school and required ketamine and restraints during transport. Patient presenting with episodic episodes of dysregulation of such magnitude that he requires multiple psychotropic medications as well as physical restraints to calm him down for his safety and that of others.