Update: DC’d to Anthony Lewis 11/20.
16 y/o F with a significant opioid use disorder and passive SI. Self-presented to APS wanting CD tx. Hx of 3 serious overdoses.While in APS, She has been calm, cooperative, and engaged. Suboxone was started and is tolerating it well.
Update: DIfficult to place, haven’t been successful at contact w family
Patient is presenting to the ED for the following concerns: physical aggression, significant behavioral change. Patient has Autism, is non-verbal, has a developmental delay, speech delay, PICA and behavioral issues at home that have been increasingly difficult for the family to manage. Patient was seen her earlier this month after ingesting a battery. Patient reportedly has been accepted for a residential treatment facility in Missouri – Lake Mary Center, though they currently do not have a funding source and intake is not until the end of December. Family has been working with Aurora Behavioral Services, as well as psychiatry and PCA services.
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.
This child was previously on the HUB as MCR-F13-2165.
Returned 3/21/23 to Mayo ED after discharging to home on 1/9/23. Was at SERCC, brought to ED for ingestion of metallic items there. Had been in ED > 24hrs now admitted to inpatient unit to monitor his GI. Was in Fernbrook Day treatment. Transitioning to male. ED more related to PICA ingesting nonfood items regularly – batteries, tacks, chargers, etc. 1:1 support for keeping from self-harm. is at home with mom when not in day treatment program. Needs more than day tx support, needs 24 hr. Concern for medication mgt. Absence of psychiatric support. Has been in Prairie Care twice summer 2022 – dc’d for noncompliance. He describes a strong compulsion for ingesting things. He doesn’t claim it to be self harm. when he goes to Mayo, he claims that its a suicidal attempt. Was at Gerard in May and struggled, then inpatient at Children’s in summer. Then came back to Fernbrook. over 30 presentations to ED at Mayo and Metro for self-harm and ingestion. Some are SI. Ingested batteries, screws, chargers, needing med tx/attn. Spent 12 days at Gerard in May, 3 ingestions and elopements while there, they had to dc him as couldnt meet his needs. Just gotten a CADII waiver to help mom supervise at home. Case conf. yesterday – the hope would be that he could be in a residential settings with the understanding that he will ingest things. Licensure issues. He has been declined as he fits everyone’s exclusion criteria. When he is out of crisis, he’s lovely. bright, intelligent.
Seeking ideas for other options for keeping him safe. Consider Gerard? Prairie Care? (have both turned him down). Jennifer Butler working on this case. suggestions to mitigating risk? clear all things from units, reintroducing slowly when able. Mayo has been able to mitigate risk with using paper crafts, crayons, etc. Haven’t had an ingestion for a few months – has a sitter a Mayo though as he’s on a medical unit. Functional behavior analysis? Hasn’t had one, due to instability. Hopefully he will have one soon. *** Discharged to home on 4/3/23 with 24/7 PCS care.
This child was previously on the HUB as MCR-M17-2128. Originally admitted 10/12/23, and discharged 11/17/22 to CD group home and eloped within 24hours. Brought back to ED after being found ODing on 12/4/22. Eloped on 12/30 and returned 1/6; attempted to elope again on 2/4 but successfully stopped.
Chemical dependency (fentanyl and meth), suicidal statements when intoxicated. On MI/CD Civil Commitment. Needs locked CD or dual diagnosis residential treatment. County Attorney pressing charges, which may help with JDC placement options.
Came after being found in the street by a passerby who administered Narcan. Was incoherent, EMS brought her in to HCMC ED. Long history of trauma. Sexually abused in preschool by her father, who is incarcerated currently. Has been vulnerable to sexual exploitation. Her engagement with anyone in the community is a pathway to a friendship. Dakota County financial responsibility. Working with DaK. case mgr. Had an incident at school (interaction with the principal and had some sort of physical contact with him, charged with assault), so now has a probation officer. No aggression noted at hospital. Wonderful family support. Had been living with aunt. Will just walk out and engage with strangers who do not have her best interest in mind. When DA is complete will be looking for placement for her. community placement. Has been at CRTC and VOA. Working on getting all the info to understand her full picture. DRug screen was negative. Unsure if chemical abuse is dependent? She will use substances if someone offers it to her, socially.
Brought to the emergency department by police due to concerns for sexual exploitation. She was admitted with opioid withdrawal and need for safe discharge plan. In need of substance use treatment and mental health. Has history of running. not aggressive. Very collaborative and asking for treatment. Substance use tied to sexual exploitation. Wonderful partnership with HCMC CPS. Will be placed at Provo Canon in Springville UT tomorrow. Had to go way up the chain to get approval for out of state. Very high-risk youth. Still very collaborative and wanting treatment. Mom and dad have come to see her and brought things to take with her.
History of trauma, sexual exploitation, concurring with MH and substance use. Co-managed by psychology and addiction medicine in the hospital. Community PCP has been established who can also monitor suboxone. Patient in need of short-term placement. Has been referred to Heartland Girl’s Ranch.
Patient ran away from Aspen House shelter with three other people. The car that patient and others had taken was stolen, and they crashed into a sign. Patient drove the vehicle to another girl’s house, where the police came. Patient had written a note that implied she was suicidal, and was brought to the ED.
Patient has a history of anxiety, depression, ADHD, PTSD. She has had numerous ED visits and hospitalizations. Patient has had 4 ED admissions in the past 6 months. Pt was most recently at Prairie Care from 4/9/23-4/27/23. She is currently seeing an individual therapist, a SIBS in home family therapist, and has a Dakota County case manager.
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.