Risk Factor: Self harm

This term refers to instances of isolated, non-repetitive aggressive behavior, such as a single incident of physical aggression or verbal aggression.

MHF-F16-1094

Patient is presenting to the ED via EMS for suicidal statements and self-harm. Patient returned to her group home from school, and entered the bathroom to self-harm with a paperclip. Patient was told the group home would have to remove some of her possessions, so patient left the home. Patient threatened staff, and threatened to jump off of a bridge. Patient has been inpatient for mental health, at least six times, and has had many ED encounters (6 times in the past month) for similar symptom presentation in the past.

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-F14-893

Pt’s parents recently lost custody. Patient was residing at Brittney’s Place and engaged in SIB by cutting superficially. Pt was evaluated and cleared for discharge however Brittney’s Place with not take Pt back.

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.

MCR-M16-378

16 year old, county ward, who has been at Gerard Academy for 1.5 months and had escalating SI in the context of conflict with peers at Gerard and then ultimately learning that father’s parental rights were terminated. Long previous history of neglect and possible abuse, multiple family members with substance use disorders. At Gerard was leaving the facility and finding sharps to potentially harm himself with. Initially was recommended for inpatient psychiatric care, but declined by all facilities due to history of aggression or behavioral issues in those facilities previously. Eventually acute SI resolved while boarding in the ED, but as plans have been made to work on return to Gerard, he has repeatedly stated he does not want to go back there and will hurt himself or others if he does. His case manager reports that similar statements have arisen repeatedly in the past as placement facilties start to challenge him and seem to serve the function of avoiding difficult emotions. Currently trying to work with Gerard staff and case manager to help him safety plan for a return to Gerard.