Pt is presented to the ED via EMS due to possible ingestion of cold medications. Pt’s father had called 911, reporting patient’s presentation as being confused and “high” on drugs. Pt admitted to taking pills (unclear about the number of pills) in order to get high. He denies that this was a suicide attempt, and currently denies any suicidal ideation. Pt denies recent self-harm, but has a hx of self-harm over one year ago. Pt lives with his father during the week, and mother on the weekends. Medical records indicate the following history: He has a history of major depressive disorder, generalized anxiety disorder, and substance use disorder. He had been evaluated in the ED for close monitoring in the setting of altered mental status secondary to presumed toxic ingestion of unknown substances, and has a history of multiple inpatient psychiatric admissions. Most recently admitted in March 2023 due to “ingestion/inhalation of multiple substances, including dextromethorphan and benadryl”. Pt has a history of residential treatment, and has a hx of substance abuse for several years and participating in both inpatient and outpatient treatment.
Risk Factor: Elopement risk
Elopement risk indicates the potential for individuals, often children or individuals with cognitive impairments, to run away or leave without supervision, which can lead to safety concerns.
MHF-F6-1228
Pt presented to the ED via EMS after jumping out of her mother’s car into traffic, stating that she wanted to die. Pt lives with her mother and brother, who moved to MN from TX in December of 2022, to escape domestic violence and pervasive sexual trauma. Pt has a history of significant sexual abuse from their father, including sex trafficking. Pt has been screaming, kicking, and running outside, placing the family’s housing at risk.
MHF-F13-251
History of Autism Spectrum Disorder, prenatal exposure to alcohol, cocaine, and heroin. Pt is cognitively delayed and has limited verbal skills. Recently attempted group home, assaulted staff after 1 day; guardian took patient home. Pt presented to ED after assaulting guardian in the home and guardian does not feel safe with patient returning to home, is planning to relinquish custody. In ED, patient is disrobing, throwing feces, assaulting staff, in seclusion. Behavior is chronic and has been seen at similar level historically. Prescribed Zyprexa, Abilify, Clonidine, Thorazine, Atarax, Trazadone.
4/7/23-4/13-23 – Discharged to home.
5/13/23-5/19/23 – Discharged to home.
5/23/23-5/26/23 – Discharged to home.
5/27/23-6/7/23 – Discharged to home.
MHF-F18-995
Patient is presented to the ED by EMS from an RTC facility. Patient assaulted another resident and staff members, and attempted to elope from the facility. Patient is under guardianship of Martin County, and is considered a vulnerable adult. Patient has a significant history of abuse, and suicidal ideation. Patient is supposed to follow a low sugar and fat diet due to pancreatitis.
MCR-F12-255
12 year old with trauma history, in-utero cocaine exposure, long history of behavioral outbursts with adoptive parents, participating in CIBS since November and moved to Phase 2 at Gerard in early January, but struggled and was sent to the ED within 48 hours due to severe outburst at Gerard. Appears to have mild autism spectrum disorder (difficulty with transitions, sensory sensitivity, communication struggles), and likely PTSD related to attempted kidnapping and multiple sexual assaults spring 2022. Has started Vyvanse, Prazosin, and Fluoxetine while boarding, and she has had much less extreme behavioral outbursts, has not needed IM or restraint in weeks. Oppositional, but generally can be verbally redirected. Outbursts tend to be tied to her difficulty with flexibility – eg when meals or medications arrive at slightly different times, or one nurse implements different TV rules than another – will start swearing, sometimes escalating to head-banging, but generally is able to calm on her own when given space (intervening/talking/etc once she is starting to dysregulate tends to escalate rather than de-escalate her). Has loving parents and want her in their home, but fear they cannot keep her safe right now. Regarding running – hasn’t tried to elope from peds floor. Sometimes ran from school or home when upset, walks around neighborhood and comes back. Issues at school have been more blowing up and headbanging. Update as of 4/11 still in ED
MHF-F13-1114
Pt is presented to the ED by the police after running away from home approximately two weeks ago. Pt had gotten into an argument with her mother and no longer felt safe there. Pt reports being physically abused at her mother’s house. Pt had been staying at a man’s house since running away from home, has been having unprotected sexual intercourse with him, and has a history of being sexually exploited for money. Pt is also on probation for unknown reasons.
MHF-M15-999
Patient is reported to be under the guardianship of Hennepin County. Patient presents to ED with his social worker for a mental health evaluation after having “mental breakdowns” while under the care of his mother, who kicked him out and told him not to return. Patient has a hx of autism spectrum disorder. Patient has hx of abandonment from both parents, and has a foster placement with his aunt, but is refusing to return to her care, stating that he will kill her if he has to go back.
MHF-F37-787
Patient presents to ED via EMS for aggressive behaviors and agitation at her foster home. Patient has diagnosis of MDD, GAD, and Intellectual Delay. Foster caregivers report that the patient has had increased agitation over the past 4-5 days, is throwing things, crying most of the day, trying to run away from the setting multiple times a day, is uncooperative, destroying property, hitting caregivers in the face and stomach, and is now trying to self-harm by dumping a dresser over on herself. Patient does have contact with her birth mother but there are apparently issues with that, and foster care believes that birth mother is influencing the patient to act out so mom can get custody returned to her.
C8SM8SP-F14-885
Patient has previous mental health history and does not want to return home to live with her parents. Patient makes efforts to elope from their care and will escalate her behaviors to ensure she does not return home. Patient has grabbed the steering wheel from mom in an effort elope from the car.
MHF-M6-779
Patient is presented to the Peds ED from his elementary school, where he became physically aggressive towards staff and students, and eloped from his school. Patient was placed in the care of paternal aunt about two years ago, but removed a couple of months ago due to alleged abuse toward patient. Patient’s mother and aunt are allowed supervised visits. Patient has been in four foster home placements in the last six weeks. Patient’s most current foster placement refuses to take him back. Patient has hypersexual behavior and sexual knowledge not appropriate for his age. There are concerns for sexual abuse