Came to the ED on 8/27 after behaviors at home of head banging and screaming. Mom has refused to pick pt up thus far, wanting medications prescribed before she is willing to do so. Our psychiatrist has been trying to work with Mom on potential medication changes, but there has not been an agreement thus far. CPS has opened a case and is investigating, and Nexus YCT intake was yesterday. Patient is primarily non-verbal. Mom is reporting he needs residential treatment, but there is no professional recommendation for that at this time and due to age and autism diagnosis, options would be very limited. Mom has connected with Chelida in WI. Pt has DD waiver with in-home services, as well as Washburn ready to come out at discharge.
Risk Factor: Aggression (other)
Other forms of aggression that do not fit into the specific categories listed.
MHF-F16-4455
Kiddo came to GICH ED on 7/31 from Little Sand GH after an altercation there. Pt had verbally and physically aggressed toward peer and staff, and had self harm/head banging. According to the team this was her first incident of physical aggression, she has not been violent in the past. Does have history of self harm and verbal aggression. Little Sand is recommending a higher level of care. Team would like PRTF placement and have made referral to Nexus East Bethel. Exploring VOA Bar None for interim plan, has not been accepted anywhere yet.
CH-F11-3461
Update 6/26/24: Patient doing well and has made improvement with emotional dysregulation. No longer recommending PRTF level of care. Interview with Divine House occurred last week.
Update-5/30/24- Patient has had severe decompensation in part due to child protection concerns along with prolonged hospitalization and has been in the BICU for aggression, self harm, and seeking/securing items to self harm with. It is now recommended that she be placed in a PRTF.
11 year old presented to the ER after discharging from residential for concerns of running away, recent sexual perpetration to 6 year old brother, and homicidal ideation towards current guardian. Active CPS investigation over the last 1.5 years and is unable to return to her mother’s care or a home with younger children. This patient struggles with low insight, poor boundaries, antagonizing behavior, and justifies her behaviors. We attempted to obtain psychological testing though patient was not cooperative and refused. Medications are stable. She continues to display oppositional behaviors at times.
MHF-F14-3744
Discharging today 6/20 to group home
Came to our ED solely due to not having another placement. Has boarded in our ED in the past. Was previously at Bar None Shelter plus where she assaulted others and was taken to JDC. Was in JDC for a week when a judge ordered her to be removed, so CPS brought her to the ED as they had no other place to go. CPS is searching for group home placement as that is what the County’s juvenile screening team deemed the appropriate level of care.
PH-F16-4145
Recommendation is for dual diagnosis residential programming (ASAM 3.5)
Patient arrived at Inpatient from ED due to increased suicidal ideation. This is his 5th psychiatric inpatient hospitalization in the past few years. He has done RTC through Northwest Passages, PC PHP, and began programming at Options day tx before it closed. He does have a history of aggression towards school peers although aggression has not been a concern while in programming or hospitalized.
Discharge Plan:
Dual Diagnosis RTC:
Dual Diagnosis RTC:
-Newport (patient declined due to impulsivity and aggression concerns)
-MHealth Fairview, Maplewood (declined due to acuity of MH and aggression)
-Hazelden (in network benefits approved – initial phone screen complete, awaiting decision for setting up next assessment)
-Wings (pt declined due to physical aggression in previous six months)
-Rogers BH (Referral sent – guardian to complete phone screening and then pt screening will be scheduled)
-Lakeside Academy (Christian based program – patient declines referral due to this)
-Bar None Omegon (unable to refer – only accepts biological males)
-Anthony Louis Center (unable to refer – will not accept those needing dimension 3 ratings or above)
CH-M8-3464
Update 4.18.24 – on wait list for Northwoods, admission wouldn’t be until summer. Looking for a foster family until residential.
update 4/15/24: The patient is medically stable and has been doing very well here on the unit. Has not shown aggression towards others. One minor episode of head banging when frustrated. Medications are providing therapeutic benefit.
Patient with a past history of RAD, PTSD, ODD and questionable FASD that presented to the ER with foster parents of 4.5 months for concerns of aggression, suicidal ideation, and sexually inappropriate behaviors towards others and pets. He has been in several foster/kinship homes since age 5 with significant trauma prior to this including witnessing mom overdosing on several occasions, witnessing the overdose and death of housemate, sexual abuse by bio father, homelessness, sister attempting to suffocate and strangle him on multiple occasions, and physical abuse by caretakers. He was recently found on video touching the house dog sexually and physically inappropriate and has been threatening and pushing his foster mom. Foster providers are unable to accept him back in their home.
RMC-M17-3365
This patient presented to Ridgeview Medical Center via P.D. after running from his home. He was found in the woods nearby his home with a knife (patient has an ankle monitoring device). Patient reportedly desires out-of-home placement and verbalized plans to use the knife to harm kids who bully him at school. Patient has a significant history of running away from home with more than 30 reported incidents. Patient maintains a desire not to return home at this time. Carver Co. holds temporary decision making authority over patient, by court order.
C8SM8M-M8-3342
Pt presents with behavioral escalations from out of home placement. Pt currently in hospital with no d/c plan at this time coordinated by county. Pt has a history of trauma and sexualized behaviors.
ADYC-M14-1768
Update: 1/19/24 Pt. still looking for placement.
15-year-old male looking for a group home and residential program. Children’s Mental Health Case Manager has tried everything, and doors are being shut. Client has a physical aggression, verbal aggression, history of PTSD and sexual abuse. Client has experienced abuse from biological father who is in still in the home, and sexual assault that happened possibility of more than one with an older cousin sister. Client mother is giving up on hope on trying to help her child. Client is struggling at home, school, and community. Children’s Mental Health Case Manager has been trying everything to find a placement for him. He’s been going in and out of the ER like every two months now. Children’s Mental Health Case Manager still trying to offer support the way she can by being there every hospital stay, seeing client like twice a month, and having mom keep her on speed dial to talk to client.
Because of experiences, client is chemical dependent on marijuana, perks, and opioids.
C8SM8SP-F13-2687
Patient presented to ED due to concerns of sexual abuse. Patient has extensive history of eloping from home to meet up with adult men she met online and have sex with them. Mom does not feel she can keep her safe at home due to her risky behaviors.