Risk Factor: Aggression (highly acute/risk to others)

Highly acute aggression refers to aggressive behaviors that pose a significant risk to the safety of others.

NMH8R0MGH-M18-4738

Patient with autism and agitation sent from his new group home awaiting placement options. pt’s DD CM Deqa (612-472-2572) to gather more information regarding the Exception Bed Referral. Deqa shared that she was told that she can either refer for the Exception Bed or MFOC but not both. She is moving forward with the MFOC referral, as it would be a long term placement which would be better for the pt in the long run. She has made it known that the referral to MFOC is urgent. If the MFOC referral is denied, Deqa plans to either push on DHS as they have had an opening for 1 year and have not filled it, and/or pursue the Exception Bed. Deqa said she submitted for the Minnesota State- Operated Community Services (MSOCS) referral on 10/15. DHS Complex Transitions Team referral made on 10/15/24.

CH-F13-4577

Pt presents from school after high level of aggression, homicidal threats, and property destruction resulting in multiple hours of restraints. Patient has longstanding history of aggression and impulsivity with recent increase and daily occurrence consistent with starting new school. Pt newly to a group home from home placement as of May 2024. Now discharged from level 4 school due to behavior leading to presentation. Looking for IP for medication adjustments, though making changes in the ER in the interim. Difficult placement given neurological functioning, level of aggression, and acuity.

AH-M15-4368

Under Hennepin County custody. Came to the hospital after assaulting a peer and staff at crisis respite. Has been in multiple placements (residential, group homes, foster care and shelters) and has been terminated from them due to aggression. There were concerns for psychosis prior to admission but symptoms have stabilized with medication.

AH-F16-4271

Adopted at birth with in utero meth exposure. Several inpatient, residential and outpatient avenues explored both instate and out of state. Patient is declined or asked to leave to due aggression to peers. Juvenile system has discharged back to mental health. Engages in self harm, significant aggression, stealing and fraud, fire setting, etc.

PH-F12-3422

Update 4/15/24: Patient discharged from inpatient on 4/15/24 to home with outpatient services while awaiting level 6 RTC/PRTF placement.

Update 4/3/24: Bar None Haven (Referral submitted, Denied 3.22.24), Northwood Children’s (Referral submitted, On waitlist), Grafton (Referral submitted), Nexus East Bethel (Referral submitted). County also working on referral for MITH program (MN Intensive Therapeutic Homes). MN Choice Assessment done.

12-year-old female with DMDD and RAD presenting to PrairieCare Inpatient Hospital. Patient has had multiple psychiatric hospitalizations, 2 RTC placements and 2 JDC placements.

Discharge Plan:
Locked Level 6 RTC – Bar None Haven (Referral submitted)

Current Providers:
CMCHM at Beltrami County
Individual Therapy
Medication Management
Wavier Case Management Services through Beltrami County (In process)

SMCTRF-M10-2621

Significant behavioral issues, Parent takes him on a lease when taking him out of the home. Physically and verbally aggressive to parent(s) and others (peers and staff) throws items, pulls fire alarms. Attempts to elope.

CH-M11-2520

Patient was adopted 2 years prior from Bulgaria. Initially, patient had very odd behaviors. For example, he would like his adoptive dad to be present in the bathroom when he went to the bathroom and showered. Parents state his behaviors have escalated. He has tried to masturbate the dog. He draws pictures of men with erections. He has exposed his genitals to his siblings. Purposefully incontinent of stool at tines. He has killed a Chinchilla and possibly several cats. He has tried to strangle the dog. They found sharp objects including a razor and sharp screwdriver under the bed. He did cut the top of his left hand but states this was an accident. Adoptive mom states they have a special needs child and patient has tried to harm this child. Parents are worried about safety within the home and are unable to bring him home at this time.

RMC-M11-2238

Ward of the state-currently under Wright County Guardianship. Parental rights have been terminated. History of aggressive behavior with homicidal and suicidal comments towards multiple people/on multiple occasions. On 11/15/23, patient was sent to a “calming room” at his school due to throwing a ball at another students face. This caused him to miss out on an outdoor activity that he wanted to attend. Patient was upset and punched one of his teachers (mental health support services personnel) in the nose, causing a broken nose. Had been living with bio-grandparents prior to this incident. He has been removed from foster homes in the past due to homicidal threats to the foster parents/others in the home.

MCR-F14-2438

Ran away from home (resides with grandma) & stole from Scheels and air pods from a stranger Was tracked by air pods owner who confronted the patient at Red Lobster. Pt assaulted the mother of this individual. History of trauma & SA Kicked out of multiple schools brought gun to Willow creek & threatened to pistol whip classmate. Attempted treatment at Fountain Centers. Restraint chair multiple times.

Declined from Heartland Girls Ranch, Family/Foster Home is not an option due to behaviors, SERCC/Vonwald- patient has been to in the past and has either eloped or been kicked out of the program due to fighting. Trisha will follow up with PORT and Hunter’s Place. These are both sheltered care so similar to Vonwald but in a different geographic area. Neither of these are locked facilities which is also a concern.

Parents unwilling to take her home. Care conference with the county occurred after a week in the ED. Just starting the QRTP process.