Psychiatric Diagnosis: Oppositional Defiant Disorder

Oppositional Defiant Disorder is a psychiatric diagnosis typically diagnosed in children or adolescents who display a pattern of defiant, hostile, and disobedient behavior toward authority figures.

MHF-M17-3467

Pt came to ED 3/25 after being on the run for a few weeks. Was previously at hotel crisis respite prior to being on the run, damaged property there and can not return. County is current guardian, though patient turns 18 very shortly and will be his own guardian at that time. History of behaviors, verbal and physical aggression and property destruction. Has been denied from shelters due to behaviors and previously denied from RTCs in and out of state, though due to age would no longer be an option. Refuses all mental health services and has not had a DA since 2020. Is on CADI waiver. Recommendation on weekly call to discuss benefits of IRTS program/treatment with him.

RMC-M17-3365

This patient presented to Ridgeview Medical Center via P.D. after running from his home. He was found in the woods nearby his home with a knife (patient has an ankle monitoring device). Patient reportedly desires out-of-home placement and verbalized plans to use the knife to harm kids who bully him at school. Patient has a significant history of running away from home with more than 30 reported incidents. Patient maintains a desire not to return home at this time. Carver Co. holds temporary decision making authority over patient, by court order.

MHF-F12-3097

Patient presented from Prairie Care PHP due to aggression and dysregulated behaviors. PHP unwilling to accept patient back, mother unwilling to take home at this time and cites need for RTC. No RTC referrals made currently. Patient needs support in short term placement while outpatient team supports long term plan and placement. Has been in the ED 4 other times. Back and forth from ED to home. No letter of rec. for residential at the moment. Working on it. There is a case mgr, working on a care conference currently.

SBHC-M10-2773

Behavioral issues, parent takes him on a leash when taking him out of the home. Physically and verbally aggressive to parent(s) and others (peers and staff). Throws items, pulls fire alarms, attempts to elope. Receives CTSS services and has demonstrated significant behaviors within those services. Had been in homebound school program, attempted re-entry into school setting and on first day back, damaged property and assaulted staff as well as directing violence towards peers, resulting in transfer to ER for placement. Treatment team questioning consistency of receiving medications appropriately in the home setting and are recommending residential treatment or a shelter bed until residential treatment can be secured.

C8SM8SP-F13-2687

Patient presented to ED due to concerns of sexual abuse. Patient has extensive history of eloping from home to meet up with adult men she met online and have sex with them. Mom does not feel she can keep her safe at home due to her risky behaviors.

SMCTRF-M10-2621

Significant behavioral issues, Parent takes him on a lease when taking him out of the home. Physically and verbally aggressive to parent(s) and others (peers and staff) throws items, pulls fire alarms. Attempts to elope.

MHF-F12-2607

Arrived to ED due to dysregulation at home, which is baseline. Patient’s mother does not feel safe with patient coming home without more intensive outpatient services in place. County not supporting residential at this time, reports need for PHP/day treatment.

RMC-M11-2238

Ward of the state-currently under Wright County Guardianship. Parental rights have been terminated. History of aggressive behavior with homicidal and suicidal comments towards multiple people/on multiple occasions. On 11/15/23, patient was sent to a “calming room” at his school due to throwing a ball at another students face. This caused him to miss out on an outdoor activity that he wanted to attend. Patient was upset and punched one of his teachers (mental health support services personnel) in the nose, causing a broken nose. Had been living with bio-grandparents prior to this incident. He has been removed from foster homes in the past due to homicidal threats to the foster parents/others in the home.

C8SM8M-F11-2346

History of trauma, sexually exploited youth, aggression, ODD, multiple placements, adjustment disorder. Had an Intake with FV PHP program, was accepted, but nowhere to place her to do the program. Meeting today with county to discuss the case. Looking at intensive therapy services, shelters.
Patient been accepted to Fairview’s PHP, pt has a foster mom who is only willing to take pt home after completing PHP, county seeking residential. 3/23 update: transferring 3/24 @ 10:15 am to DIVINE.

C8SM8M-M9-2342

ADHD, adjustment disorder, anxiety, Developmental delay, ODD, aggression, sexualized behavior. FAmily was living in shelter. Disregulated episode- tried to strangle self, to ED for assessment. Initially rec for inpt, then decided he did’nt need inpt. Family leaving shelter soon, so not able to take him back at this time. Mom says addicted to porn. Became disregulated once but otherwise has been stable, no SI. Henn county won’t get involved- saying it’s not abandonment, doesn’t have a county case mgr. Some services thru Dakota county. Level 4 school setting. Looking into other shelters. Family thinks he needs tx. Referrals to nexus, Prairie Care, Henn County Peace offering made. Gap in services. 7/21 was at Prairie Care. Mom open to foster home, he doesn’t necessarily need residential. Mom isn’t visiting bec she is scared he will be sent home with her.
Previously attended IP MH at PC in July 2021, no current acute SI, safety concerns in hospital, pt and his family are homeless, got kicked out of shelter due to aggression, pt currently does not have any county supports. Patient’s family moved from St. Cloud. Due to pt’s age, history of aggression, and sexualized behavior (watching porn, taking photos of privates, exposing himself to siblings) mom has been unable to find a shelter that will accept them. referral for services was put in with Hennepin county. DC’d to home with mom.