HCMCH-M17-2004

Update: Accepted by PrairieCare but waiting on funding. looking for respite while waiting.

A 17 year old, African American, assigned male at birth. He identifies with “both” genders (boy and girl) equally. Alternates between male and female persona. Medically stable and boarding on Pediatrics while awaiting placement disposition. History of being bullied.
Approaching his cluster of symptoms from the lens of comorbid autism spectrum disorder and mild intellectual developmental disorder is likely to lead to better treatment adherence and response to intervention.
Given his intellectual concerns and history of emotional dysregulation, the patient would benefit from residential treatment. Such a treatment facility should have access to mental health resources, independent living skills training, and regular recreational and social-emotional supports.

MHF-M15-2183

Patient is presenting to the ED for the following concerns: self-harm. Patient has a history of self-harm, through primarily biting his arm, punching other things or scraping himself with a tack. Mom reported that today was the first time he self-harmed with a blade. Mom reporting increased aggression in the home and at school and feels that patient needs inpatient. Mom explained the patient is in a level 4 school setting. He recently did PHP at Prairie Care and was discharged after three days due to concerns about aggression and inappropriate sexual comments. Mom shared the patient has made comments about wanting to strangle others.
Mom explained that patient may already be on the waitlist for the Village Ranch residential treatment in Cokato. They are also exploring North Home in Bemidji. Mom reported that patient has been diagnosed with ADHD, ODD, PTSD and ASD. She also wonders about FASD due to his biological mothers, drug and alcohol use. Patient was adopted at age 7 by his adopted mom and adopted dad. Mom was his PCA in his last foster home for one year before adoption.

MHF-M7-2180

Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression. Patient currently lives with foster mom and dad, mother will soon be entering IRTS but intends to take son back afterward. Patient has been not been taking his medications and engaging in behavior that puts himself and others around him in danger. Patient has high sensory needs that if not attuned to will begin to hurt self and others. Patient was last admitted on 10/20/23 and was inpatient until stabilization. Patient has been attempting to “scratch out” his eyes and turn off devices of his fellow foster care children. Pt is diagnosed with Autism Spectrum Disorder and significant early childhood trauma. Collateral reports that when pt takes meds, he can calm down. Patient is non-verbal.

MCR-F17-2173

Ingesting items. Several ED trips to have items removed. Was at Gerard, couldn’t keep her safe. Significant sexual abuse history. Several referrals with denials due to the ingesting. looking at Group homes. takes responsibility for her actions. Parental rights terminated. Barriers are not being able to keep her safe (ingesting). medical issue with pancreas – very specific diet, ex. places don’t have medical staff on site. Turns 18 in May

MCR-F13-2165

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 it’s 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 ays at Gerard in May, 3 ingestions and elopements while there, they had to dc him as couldn’t 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.

MCR-M16-2136

Twin brother adopted from Ecuador at age 11. DD, operate at about 5-6 year old. No MA or waiver due to parent income. County case manager referred to MSOCS and CSS. Mom working with Kennedy Krieger. Barriers: no MA, waiver or declined due to DD or aggression. DC from Chileda due to behaviors.

MCR-M16-2149

Twin brother adopted from Ecuador at age 11. DD, operate at about a 5-6 year level. No MA or waiver due to parent income. County case manager referred to MSOCS and CSS. Mom working with Kennedy Krieger. Barriers; no MA, waiver or declined due to DD or aggression. Discharged from Chileda due to behaviors. The family wants to keep him at home, but is intimidated by how big and aggressive he’s become.

C8SM8SP-F13-1993

Patient has had several disrupted placements over the past year including shelters and foster homes. Patient has extensive trauma history and was most recently at a shelter where they engaged in self harm by cutting and expressed passive SI. Patient was sent to the ED and was not allowed back to the shelter.