Risk Factor: Aggression (chronic/ongoing)

This term describes a pattern of repeated and persistent aggressive behaviors, such as chronic physical or verbal aggression.

MHF-F14-2469

Patient is presenting to the ED for the following concerns: suicidal ideation, depression. Patient reports he tried to kill himself last night by stabbing himself with a dull pencil. Patient reports suicidal and homicidal thoughts that have increased in last two weeks. He has been at North Homes for three months. He was discharged to North Homes after a hospital stay at UMMC in September for SI. At North Homes, the patient escalated and told staff he was suicidal. He took the batteries out of a remote and tried to swallow them. He also tried to stab self with dull pencil. He became combative and needed to be restrained and then kicked staff in chest and tried to kick another staff. Patient then stated he would find each clients personal info and then take pictures of other clients after he killed them and send to parents. Patient told staff he would kill other clients and himself.
Patient reports long history of MH including PTSD, MDD and GAD. Patient has been hospitalized 2 x in past 6 months. Patient reports history of trauma. Patient states he has history of SIB.

PH-F10-2551

Discharge Plan:
-Gerard (PT denied d/t documented IQ, requested reconsideration as new testing shows IQ as 78, pending)
-Northwoods (Waitlist is 1+ years long)
-North Homes (Pt denied d/t age)
-Acadia Out of State RTC network (Referral sent, pending)
-CABHH (Referral sent, pending)

10 yr old female admitting from Windom Area Health emergency department for suicidal ideation and homicidal ideation. Pt eloped from school and attempted to run into traffic and was brought to the ED via the police. Nobles County is Legal Guardian.

Existing services:
-Psychiatry through Southwest Mental Health Center
-New therapist starting in December through Healing Path in Levurne
-Previous therapist through Greater MN Family Services
-Neuropsych done with Surdy Psychological Mankato
-Nobles County guardian and CMHCM
-Nobles County guardian and CPS

MCR-M12-2422

Autism spectrum disorder and ODD, mother struggling with her own mental health issues and just started a day program. Multiple ED and SERCC presentations for physical aggression at home, typically triggered by conflict with mom. Completed PrairieCare PHP in September/October. SERCC declining due to lack of benefit and property destruction, Von Wald shelter has him on a wait list but no anticipated discharges. Only recently opened YBH case so in process of having worker assigned, no options for out of home placement. On wait list to start day treatment, perhaps week of 2/13, but he and mom can’t tolerate being in the same room together without escalating to yelling and throwing things. When not with mom, he is calm and engaged in crafts all day long. Care conference with mom and YBH intake 1/24 and 1/27 with a planned discharge 1/30 but mom refusing to take him home because of her concerns about his escalation in her care even in the hospital. Olmsted County CPS has screened out and does not have resources to offer.

MHF-F15-687

Patient is presenting to the ED for the following concerns: substance use, intoxication, anxiety. Patient was at WINGS treatment center for substance abuse/mental health from 10/17/23-10/28/23, before eloping. Patient was living on the streets, and staying with friends, before going to her aunt’s house. Patient was then picked up by her guardian/grandmother and brought to the ED.
Patient has a history of elopement and substance abuse.
Patient attended Prairie Care’s PHP program in June 2022, but was discharged due to behavioral problems.
Patient was in FV inpatient unit from 3/10/23-3/16/23 when she eloped while being transported to FV residential treatment program.
Patient was readmitted to the inpatient unit on 3/17/23 where she remained until admission to FV residential treatment could be arranged.
Patient was discharged from treatment due to behaviors and ran away from home, when she was found and brought back to FV ED on 4/24. where she remained until eloping on 5/28.
Patient has been accepted to Oshki Manidoo treatment center, and will admit once a bed opens up.

RH-F15-2367

1 week prior to ED pt was found tied up in her home by her parents. She was taken to Children’s and placed into foster care. Mother didn’t believe in Western Medicine and was using THC and tying her up to treat pt’s agitation in the home. Pt presented to Regions ED from the foster home due to increase agitation and needing more staff support, pt has severe ASD, DD. Hx of violence towards self and others. She can’t eat without someone holding her hands because she hits everything away. She is mostly nonverbal, only knows a few words.
Has been in the ED for over 165 hours, she has been started on medications and we have seen a decrease in her level of agitation. She has been more cooperative with ADLs, takes medications, and eating meals w/ assist and staff have been able to redirect her before a code needs to be called. Pt has been declined by all inpatient facilities at this time. CPS in Anoka is current guardian. Has DD waiver. Regions providing sensory support, weighted blankets, stuffed animals, music. Needs 24/7 support.
Mom currently in custody.

AH-M14-2363

Came from Bar None. Sig family trauma, sex trafficked by parents who are incarcerated. Some drug use, but sober now (benzos and opiates). been behaving ok so far. Responding well to limit setting in ED. At Omegon was doing ok aside from relationship issues. Grandmother had custody but has been terminated.

Several referrals – denied due to chemical use/abuse. Shelters denied d/t aggression. High risk for placement. Check into returning to Bar None Omegon? Youth Villages in TN – they can take more aggressive behaviors. ***Discharged to Hotel Care with crisis staffing. The Hennepin County CM/guardian arranged for the placement after 30 days in the ED.

C8SM8M-F11-2346

History of trauma, sexually exploited youth, aggression, ODD, multiple placements, adjustment disorder. Had an Intake with FV PHP program, was accepted, but nowhere to place her to do the program. Meeting today with county to discuss the case. Looking at intensive therapy services, shelters.
Patient been accepted to Fairview’s PHP, pt has a foster mom who is only willing to take pt home after completing PHP, county seeking residential. 3/23 update: transferring 3/24 @ 10:15 am to DIVINE.

C8SM8SP-F16-2330

Asked to leave shelter as she was being aggressive toward staff. Has history of being sex trafficked. Parents have open voluntary CPS involvement but maintain guardianship.

AH-F17-2276

attachment difficulties, inappropriate sexual stories and behaviors. Rec level 6. Has a father and step mother who are involved.