Patient arrived via EMS due to her mother calling 911 after the patient made suicidal comments at home and conflict with her mother. Patient was engaging in sexual behavior with a strange, in exchange for drugs. Patient went home and told her mother what she did, passively stating she wanted to kill herself.
The patient has a history of risky sexual behavior, self-harm, and suicidal ideation. Patient also has a history of physical and verbal altercations with others including family and EMS / hospital / treatment staff, and has a history of 3 suicide attempts, most recent attempt was 1 year ago by ingesting bleach.
Patient has a past psychiatric history of ASD, ADHD, MDD, GAD, and Cannabis Use disorder.
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.
SMCF-M14-1785
14yr old male who presents to Emergency Dept with homicidal ideations with dad from school. He denies making statements of a homicidal nature but per report he threatened to kill his school paraprofessional and “shoot up the school.” Patient has access to means and at the time reported intent. He also make threats to hospital staff when angry and has made several comments about owning a gun. He has a history of acting violently and notes when he is angry he could do something to harm others. He missed several days of his psychiatric medications which may be contributing to this escalating behavior. Medication was restarted two days ago but he needs a safe secure environment to restart medication and to further evaluated his risk of threat to others. Patient is perseverative in this thinking, restless, and with disorganized thinking which may be in part due to not receiving his ADHD prior to this assessment but also deserves further assessment.
MCR-M16-382
Update 7/27 Genesis Group Homes is pursuing an intake to potentially utilize crisis services.
16 year old adopted from Ecuador at age 8 (with twin brother with similar difficulties, as well as 2 other siblings without similar struggles), with ASD and intellectual disability, associated with a microduplication at chromosome 8p23.1, likely in-utero substance exposure, as well as early life neglect (living in an orphanage for much of his young life). Significant aggression difficulties that are becoming more unmanageable by family as he grows larger; unsuccessfully discharged from Chileda in November 2022. Family have financial resources and have purchased a second home for the boys and hired private caregivers in the evenings, but their income limits eligibility for MA and state-funded services. New behavior analyst started working with the family in March. May be on the MSOCS wait list. Currently on the wait list for inpatient care at Kennedy Krieger near Baltimore (brother previously had a good experience there).