Patient is under the guardianship of Swift County, and presented to the ED from his group home in Hennepin County. Patient got upset after being denied an outing, and went out to the road (not a busy road) and threatened suicide by getting hit by a car. Police were called, and patient was taken back to his group home where he made homicidal threats towards a neighbor. Group home staff then requested patient be seen by the emergency department. Patient has had multiple psychiatric hospitalizations. Patient reports frequent suicide attempts with methods unlikely to harm him, such as tying shoestrings around neck. Patient has a history of self-harm.
Recommended Service: Group Home
Group Homes are residential facilities where individuals, often children or adults with special needs, live in a group setting with support and supervision provided by trained staff.
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.
EH8D-F15-277
ASD, impulse control issues, DD, trauma history, pica, SIB, hits self, headbangs, nonverbal, putting foreign objects in body, smears feces, no family involvement, ward of Stearns County. No family involvement. Communicates w laptop, pictures. OT doing sensory work. Referral across MN, WI, ND, SD. Tennessee declines. Very difficult to place. 2 staff in day and 1 at night. Stearns trying to work on a home in their county. Came from her family care at age 4, to group home until 7, then another group home. She has struggled at her most recent group home. Lots of hands-on care. Willing to re-refer her to Grafton – was declined in July.
MHF-M15-1275
Pt is presented to the ED via EMS for erratic behavior. Pt has twice presented to the ED recently after altercations at his group home and his crisis respite program. Pt has been discharged from both of these programs due to aggressive behavior. Pt was returned home after being discharged recently and collateral reports that pt’s behaviors have increased. This ED visit was due to pt beginning to escalate, and was about to throw rocks at his friend’s windows. Pt’s mother’s boyfriend ran out and stopped him from doing so and told him “no” which is a trigger for pt. Pt then began to start banging on doors after he was stopped from throwing rocks. Pt has an injured elbow which was in jeopardy of being re-injured. Pt wouldn’t stop so mom called the police, and they brought EMS who brought him to the hospital. Pt has a diagnosis of Autism Spectrum D/O needing substantial support, Level 3, Unspecified type and suspected intellectual disability. Pt has a hx of agitation, aggressive behaviors with frequent visits to the ED. Pt’s mother and staff deny any suicidal ideation and attempts. Pt currently has a PCP, psychiatrist, case manager, and social worker. Pt has very limited verbal skills, and responds to questions with one- or two-word answers, and a thumbs up/thumbs down.
MCR-M14-1090
14 year old with significant trauma history, ward of Olmsted, previously residing in kinship foster placement but repeatedly eloped. Refuses to participate in therapy as an outpatient. Verbally defiant at times but no significant aggression toward caregivers; can have reactive physical fights with peers at school but not unprovoked. County has guardianship since November 2022, but he does have actively involved aunt/uncle who will be the targets for permanency planning.
MHF-M16-350
Patient presented from group home with aggression, breaking things. He has chronic aggressive behaviors. He was admitted to Hawthorn Center state hospital in 6/21-7/22. During his admission, patient’s mom passed away and he was placed in Beacon Crisis Residence. Patient had a prolonged stay in UMMC ED September 2022-October 2022 and was discharged to RTC in TN. Patient was discharged from the facility in TN due to concerns with the facility and was returned MN. He was brought from the airport to Children’s Hospital on 1/11/23-1/13/23 and was discharged and immediately brought to UMMC ED by parent and county worker. He was in UMMC ED 1/13/23-2/7/23 and was started on Zyprexa ODT due to cheeking medications. He was eventually discharged to crisis home. Patient then returned for further concerns of medication non adherance and exacerbation of psychotic symptoms. He had inpatient admission on Inpatient mental health at UMMC from 2/15/23-3/12/23. Patient was discharged to respite house with additional wrap around services. Patient has had 4 ED encounters since that time. Patient discharged to his group home on 5/1/23 and returned to ED on 5/2/23 due to aggressive behaviors. Patient is unable to return to group home.
MHF-M17-1182
Pt is presented to the ED via EMS. Pt resides at a residential treatment facility, where he has been for the past three months. While at the group home, pt reports he became upset by hallucinations and began banging his head. Pt states that he wanted to harm himself and possibly end his life. Pt has hx of baseline S/I and threats of suicide. Pt reports hx of physical and sexual abuse (does not provide further details.) Pt has hx of Borderline Personality Disorder, DMDD, PTSD, GAD and Unspecified Psychosis.
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
MHF-F13-251
History of Autism Spectrum Disorder, prenatal exposure to alcohol, cocaine, and heroin. Pt is cognitively delayed and has limited verbal skills. Recently attempted group home, assaulted staff after 1 day; guardian took patient home. Pt presented to ED after assaulting guardian in the home and guardian does not feel safe with patient returning to home, is planning to relinquish custody. In ED, patient is disrobing, throwing feces, assaulting staff, in seclusion. Behavior is chronic and has been seen at similar level historically. Prescribed Zyprexa, Abilify, Clonidine, Thorazine, Atarax, Trazadone.
4/7/23-4/13-23 – Discharged to home.
5/13/23-5/19/23 – Discharged to home.
5/23/23-5/26/23 – Discharged to home.
5/27/23-6/7/23 – Discharged to home.
HCMCH-16-1073
Patient is a ward of the State of MN, she has been unsuccessful in foster care placements the past 3 years. She attends a Level 4 school, Reach Academy. Patient in need of higher level of care, group home.
Patient discharged to kinship foster care 6/15/23 while Legal Guardian/Social Worker is still pursuing group home placement. Namia House, Willow Trails.