Post Type Description
Patient with a history of ADHD, DMDD, and trauma that presents after making verbal suicide threat and gesture of putting his hands around his neck. Has a history of suicide statements and self injury when angry. Does not require inpatient hospitalization though is unable to return to foster home. There is difficulty in finding an accepting foster placement.
D/C to new foster home on 6/2/23
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.
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.
Pt has been residing in foster homes since she was a few days old. Pt has lived in approximately 9 residences, some were with biological family members. She has been in her current foster home since October 2022. Pt is under guardianship through Hennepin County ICWA program with a Hennepin County Case Manager. According to her guardian, pt has been subjected to significant trauma from her previous placements, including physical/emotional/sexual abuse and neglect. Pt’s biological parents’ parental rights were terminated before pt was 1 year old. Pt is now enrolled in school through the MPLS public school, attending while boarding in the ED. She has frequent, chronic aggression in the community. Generally no concerns in the hospital.
DIAGNOSIS
1. Suicidal ideation
2. At risk for intentional self-harm
ASSESSMENT/PLAN/DECISION MAKING:
Patient referred observation for suicidal ideation, patient has had prior ER visit earlier this week, unable to place and patient, mother, decided to trial home with safety plan and close follow-up, unfortunately, patient presents back to ER tonight. Referred observation. Will continue to assess for placement options, consider crisis team evaluation in AM as they had recommended her present to the ER tonight. Patient had labs done on 5/22/23, did not repeat at this time as only home for 24hr otherwise has been under hospital care, will obtain if requested by facilities
15-year-old female who was recently discharged from this ER on 5/24/2023 at 1730, presents back after being home with her mom for 24 hours with actions of intentional harm, statements of hurting herself by throwing herself down a flight of stairs, stating that she will find a way to hurt herself if she is discharged back home. Crisis team had instructed her to come to the ER, not called at this time. Patient will be referred observation while assessing placement options. Patient is difficult to place due to her acuity level and also her need for long-term placement, will be in contact with her case manager tomorrow morning. She is on wait list for multiple behavioral health long-term placement options, however, these wait lists are 3 to 6 months long before her case would be reviewed. Patient is greatly triggered by her home atmosphere. Patient was released from juvenile detention on 5/19/2023, spent the night at her mom’s house but then went to a cousin’s house for 2 days before returning to her mom’s house on 5/22/2023 where she presented to the ER within 8 hours of being back home. Patient had discharge from this facility last evening to her mother’s houses there was not another option for her at that time, a safety plan had been discussed with patient and she did follow that safety plan by calling the crisis team, unfortunately returns to the ER tonight.
Placement options are limited, however, will reach out to behavioral health options for patient this evening and tomorrow, again will discuss with case manager for assistance. Consider contacting crisis team tomorrow once patient has calm down for reevaluation is finding an acute placement for this patient has proven difficult in the past several months and may need to develop a safe plan with the crisis team assistance.
Patient states that her siblings are mean to her and tell her to kill herself, due to the disruption she causes at home.
Patient is a 16 year old female presenting to the UMMC West Bank Adult ED for the following concerns: parent-child conflict. Patient has most recently been to Prairie Care inpatient facility. Patient’s mother reports patient has been skipping school and running away, so she locked her out of their apartment. Patient’s mother won’t accept patient back into her home.
Patient presented after RTC in Nevada abruptly closed that patient was residing at; patient was flown home to MN and brought directly to the ED due to lack of placement following RTC closing. Patient is under guardianship of Otter Tail county. History of aggressive behaviors in community and placements however has been calm throughout ED stay.
Patient presented to the ED from CRTC due to increased aggressive behaviors in the facility towards staff and was unable to return to the facility. Patient not safe to return home due to behaviors and case manager is pursuing residential treatment.
Patient presented to the ED from PHP for making homicidal threats towards foster mother and other children in the home, during a family meeting. Foster mother doesn’t feel safe bringing the patient home.
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.
Mental Health Collaboration Hub