Archives: Cases

Post Type Description

MCHSRW-M12-5457

Patients mother shared that the patient has an extensive treatment history, but has continued to struggle with challenging behaviors and emotion dysregulation. Mom described that “over the last few days he’s just been a terror, despite our best efforts. He freaks out when we try to redirect him. Mom reported that the patient has “aggressive towards people, getting physical and violent, he’s been assaulting his younger brothers.” Mom described that on the day of admission the patient had been going into his brother’s bedroom “trying to annoy them,” and hitting them. Mom called her husband, the patient’s step-father, who is currently out of state for work. The patient’s step-father spoke to the patient over the phone and told him that he needs to change his behavior and reminded him that he has been through so many different programs and should be able to “put on the breaks” with his behavior. The patient began talking back and got confrontational with his step-father, asking “what are you going to do about it?” The patient’s step-father indicated that their would be consequences when he returned and urged the patient not to put his job at-risk by making him return home early to deal with his behaviors. The patient challenged his step-father further making statements such as “fuck you, why don’t you say that to my face?” and “bet, come home then and see what happens.” The patient further stated “I’ll shoot you in the fucking face, right through the eyes.” Mom reported that their is a gun in the home, however it is locked in a gun safe and the patient does not have access to this. Mom then asked the patient where he would get a gun from and the patient indicated that his friends at school have guns. Mom expressed “this has escalated so far beyond me. We are walking on eggshells from the time he gets home from school until he goes back the next day.” Mom reported that she did not feel safe bringing the patient back home. She reported that she had attempted to press charges on the patient today, however police had declined and brought him to the emergency department instead. The patient is uninsured, county is working on his application, but he does not have a county social worker. Has a contracted mental health case manager through Fernbrook.

CH-M15-4864

The patient is a 15 Y year-old male with a history of TBI, autism spectrum disorder, and is nonverbal who presented to the ER by EMS for agitation. Pt became upset after mom told him ‘no’ when he tried putting his hand in hot oil. He reportedly did put his fingers in the oil, however no injury observable. At home, he began to hit himself, slapping his wrist, pacing, kicking things. Mom tried to give him PRN hydroxyzine and haloperidol but he spit out some of them. Mom indicated the behavioral outbursts have started to occur more frequently and she is no longer to redirect or manage pt due to his size. Mom is attempting to find long term placement

MHF-F13-5435

Youth came to our ED 3/24 after altercation at home with Mom. Mom is refusing to pick her up. Has briefly boarded with us twice in the recent past, discharged home both times with WARM and FRSS services. Has contracted CMH CM. Mom is wanting RTC or PRTF. Reportedly County is working on switching her to operated CM to potentially access the screening team and those services.

MHF-F14-4898

Pt came to us 11/18/24 after an altercation at her ongoing GH in which she physically aggressed against another youth. Its reported that youth plans to press charges. She is not allowed to return to that GH, but that provider is working to see if they can set up a new setting for this pt, both temporary and ongoing. Team also has another GH they are looking into for her. This kiddo boarded with us previously, prior to discharge to her last GH, 9/24-11/1 of last year. Dakota County currently has custody. She is also open to CMH and waiver.

MHF-F13-5313

This pt has boarded with us multiple times in the past. 2/13/24-3/27/24 and 2/14/25-2/21/25. Came to us again 2/27/25 after self harm in the shelter setting where she had discharged to on 2/21. Shelter is unable to take her back. County has custodianship currently and is searching for additional shelter and foster placements, as well as waiver placements. (Was in foster prior to 2/14/25) Previously had residential treatment, in 2024. Is open to CADI waiver.

GC8S-F14-863

14-year-old adolescent female with a history of ADHD, witnessed verbal and physical abuse, multi-substance use with significant behavioral issues at school. Pt was admitted to Gillette Children’s on 4-30-2023 with an acute hypoxic ischemic brain injury secondary to hanging herself in a suicide attempt. Pt has made significant improvements in her cognitive and motor functioning since her initial presentation. Pt does not have a previous history of suicide attempts but does have a history of non-lethal cutting behaviors. She has been involved with various mental health providers on an outpatient basis over the past several years. She has never been hospitalized for mental health issues. Pt is currently not suicidal. Pt currently presents with a flat affect and difficulty comprehending the gravity of her suicide attempt. Pt will be ready for discharge from a medical standpoint mid-next week and is expected to be independent in mobility and self-cares, although she will require supervision in the home setting. Pt has the endurance to complete a full day of activity. Please consider Pt for intensive mental health services and parental support as she transitions back to her home setting.

Update 5/18/23 from Mallory at PrairieCare: Amy and I messaged, this pt will DC from RU 5/24/23 and has not had any SI or SIB plans, means, or intent. Likely initially declined for Inpatient due to medical condition. Once medically cleared, discussed referral for PHP due to needing intensive therapeutic intervention, but not imminent danger to self. Amy plans to refer for PHP.

MHF-M15-1275

Pt is presented to the ED via EMS for erratic behavior. Pt has twice presented to the ED recently after altercations at his group home and his crisis respite program. Pt has been discharged from both of these programs due to aggressive behavior. Pt was returned home after being discharged recently and collateral reports that pt’s behaviors have increased. This ED visit was due to pt beginning to escalate, and was about to throw rocks at his friend’s windows. Pt’s mother’s boyfriend ran out and stopped him from doing so and told him “no” which is a trigger for pt. Pt then began to start banging on doors after he was stopped from throwing rocks. Pt has an injured elbow which was in jeopardy of being re-injured. Pt wouldn’t stop so mom called the police, and they brought EMS who brought him to the hospital. Pt has a diagnosis of Autism Spectrum D/O needing substantial support, Level 3, Unspecified type and suspected intellectual disability. Pt has a hx of agitation, aggressive behaviors with frequent visits to the ED. Pt’s mother and staff deny any suicidal ideation and attempts. Pt currently has a PCP, psychiatrist, case manager, and social worker. Pt has very limited verbal skills, and responds to questions with one- or two-word answers, and a thumbs up/thumbs down.

C8SM8SP-F12-889

Patient was receiving residential services through Aspen House and sent to the ED following an altercation with another resident. Aspen House would not take Pt back. County is guardian and Patient has spent time in and out of foster care settings.

MHF-M14-1900

Patient presents to the ED via EMS after his group home called 911 due to patient’s aggression. Patient reports that he threw a stool at staff when they asked him to go to bed. Group home to determine whether they will take him back.
Patient has a previous mental health diagnosis of Mood Disorder, Intellectual Disability, Nocturnal Enuresis, Anxiety, ADHD and Autism Spectrum Disorder. Medical records indicate patient presented with similar behaviors to the ED, including defiance, a history of emotional and behavioral dysregulation, and acting out towards staff.
This is patient’s 6th visit in the ED in 2023 for behavioral and/or mental health.