This youth came into our ED 3/31 after a behavioral altercation at his group home. They have issued a suspension notice. Parent is refusing to take home. He has both CMH CM and is open to CADI. CMH is making the CADI referrals currently, for crisis respite and CRS. The current DA does not recommend treatment placement however CMH is working with OP therapist to try and update the DA.
Risk Factor: Aggression (chronic/ongoing)
This term describes a pattern of repeated and persistent aggressive behaviors, such as chronic physical or verbal aggression.
MCHSRW-M12-5457
Patients mother shared that the patient has an extensive treatment history, but has continued to struggle with challenging behaviors and emotion dysregulation. Mom described that “over the last few days he’s just been a terror, despite our best efforts. He freaks out when we try to redirect him. Mom reported that the patient has “aggressive towards people, getting physical and violent, he’s been assaulting his younger brothers.” Mom described that on the day of admission the patient had been going into his brother’s bedroom “trying to annoy them,” and hitting them. Mom called her husband, the patient’s step-father, who is currently out of state for work. The patient’s step-father spoke to the patient over the phone and told him that he needs to change his behavior and reminded him that he has been through so many different programs and should be able to “put on the breaks” with his behavior. The patient began talking back and got confrontational with his step-father, asking “what are you going to do about it?” The patient’s step-father indicated that their would be consequences when he returned and urged the patient not to put his job at-risk by making him return home early to deal with his behaviors. The patient challenged his step-father further making statements such as “fuck you, why don’t you say that to my face?” and “bet, come home then and see what happens.” The patient further stated “I’ll shoot you in the fucking face, right through the eyes.” Mom reported that their is a gun in the home, however it is locked in a gun safe and the patient does not have access to this. Mom then asked the patient where he would get a gun from and the patient indicated that his friends at school have guns. Mom expressed “this has escalated so far beyond me. We are walking on eggshells from the time he gets home from school until he goes back the next day.” Mom reported that she did not feel safe bringing the patient back home. She reported that she had attempted to press charges on the patient today, however police had declined and brought him to the emergency department instead. The patient is uninsured, county is working on his application, but he does not have a county social worker. Has a contracted mental health case manager through Fernbrook.
MHF-F14-4898
Pt came to us 11/18/24 after an altercation at her ongoing GH in which she physically aggressed against another youth. Its reported that youth plans to press charges. She is not allowed to return to that GH, but that provider is working to see if they can set up a new setting for this pt, both temporary and ongoing. Team also has another GH they are looking into for her. This kiddo boarded with us previously, prior to discharge to her last GH, 9/24-11/1 of last year. Dakota County currently has custody. She is also open to CMH and waiver.
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.
MHF-M14-1900
Patient presents to the ED via EMS after his group home called 911 due to patient’s aggression. Patient reports that he threw a stool at staff when they asked him to go to bed. Group home to determine whether they will take him back.
Patient has a previous mental health diagnosis of Mood Disorder, Intellectual Disability, Nocturnal Enuresis, Anxiety, ADHD and Autism Spectrum Disorder. Medical records indicate patient presented with similar behaviors to the ED, including defiance, a history of emotional and behavioral dysregulation, and acting out towards staff.
This is patient’s 6th visit in the ED in 2023 for behavioral and/or mental health.
MHF-F13-5331
Kiddo was brought to our ED 3/4 by Mom. Had discharged from our ED hours prior, but returned after another altercation at home regarding pts phone. Mom is trying to get a DA from ongoing therapist, reports one was completed, to get CMH CM. Does not have any ongoing County CMs at this time. Our team tried to make parent-referral shelter referrals however Mom reports she is unwilling to agree to the terms of those programs, which include that Mom will need to pick up if pt becomes dysregulated. No waiver or CMH worker involved to approve any alternative placements at this time. CPS just opened today 3/5. Care Conference taking place 3/6 to gather further information.
MCR-F12-5376
Adopted at age 8 from private agency (so ineligible for MA). Comes in with Homicidal ideation and threats to kill sister and burn down house. Family not willing to bring her home for safety. Have tried many services but terminated them about 2 years ago and now are trying to re-engage. No approval for placement at this time.
MCR-F8-5371
This 8 year old has been in two foster homes (skilled) that have been unable to keep her safe; no other foster homes available. Getting updated DA today. Has a YBH worker since 2022, in-home family therapy with family, in-home CTSS skills, individual therapy, medication management, partial hospitalization at PrairieCare Feb 2023 and March 2024, hospitalization Jan 2023; Level 3 at school.
Complex trauma (sex abuse, poor attachment, placement / moves); ongoing CPS case with pending charges. Parenting assessment indicates to cease parenting time
MHF-M14-5362
Kiddo was just boarding with us 1/30/25 – 2/18/25, and returned to our ED 3/9/25 after aggression in the hotel crisis setting and they are not allowing him to return. Has also boarded on our IP unit for extensive time in the end of 2024. There was a GH set up originally for 3/14 however they are having staffing shortages and so admit date was pushed back to an unknown time. CM is continuing to look for additional placement options.
MHF-F17-5334
Kiddo came to our ED 3/4 from Aspen House, where she has been discharged from after an altercation there involving verbal and physical aggression. She has boarded with us multiple times in the past, 2/21/25-2/25/25, 1/3/25-1/10/25, and 1/19/24 – 2/2/24. She is just a few weeks from turning 18. PRTFs were being explored, but so far denied. Just had MNchoices yesterday 3/4 to re-start waiver, looking into waiver CRS placement. Previously was at NW Passages. Has had Nexus YCT involvement ongoing, since our team made the referral in January.