Archives: Cases

Post Type Description

CH-F6-2448

Patient was dropped off at a different ER by the parents of her 4th foster home placement where she was placed 3 days prior as the foster parents didn’t feel they could provide care for the patient due to hyperactivity, impulsivity, aggression, elopement, and sexualized behaviors. Her social workers picked her up from the outside ER and while in route to human services center to board until a new foster home was located, the patient was attempting to remove her seatbelt and she was brought to this ER where initially inpatient psychiatric hospitalization was recommended due to a lack of safety awareness, elopement, sexual behaviors, and need for medication assessment. She was trialed on guanfacine, developed hypotension and this was discontinued, and she was started on Concerta where her elopement attempts, impulsivity, and hyperactivity improved. She remains boarding in the ER while the county pursues foster home placement.

CH-M11-1984

Patient presents from PHP where he was discharged due to ongoing aggression and attempts to urinate on staff and floor. Patient currently struggling with family dynamics, limit setting, gender identity, disrobing, property destruction, and aggression.

CH-M13-2506

The patient is a 13 Y year-old male with a history of fetal alcohol syndrome, separation anxiety, ADHD, RAD, sensory processing difficulty, DMDD, conduct disorder, and ODD who presents to the ER on 12/2 via law enforcement for assessment of aggression, suicidal, and homicidal ideation after physically assaulting his adoptive mom and brother and threatening to use a knife or gun to hurt the family when they weren’t looking. The patient made threats to kill himself with a colored pencil. The patient has aggressive outbursts several times per day when he is told no.

The patient has a long history of psychiatric services including residential at Northwoods x3, inpatient hospitalization x1, group home placement, PHP and further outpatient services. The county is currently in the process of developing an individual home for him which is thought to be completed in January though still requires licensing.

HCMCH-F16-2188

Update: DC’d to Anthony Lewis 11/20.
16 y/o F with a significant opioid use disorder and passive SI. Self-presented to APS wanting CD tx. Hx of 3 serious overdoses.While in APS, She has been calm, cooperative, and engaged. Suboxone was started and is tolerating it well.

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.

MCR-F17-2442

Long history of trauma started ingesting non-edible items, batteries on 3 occasions. Waiting on County to help with disposition. Ward of state. No attempts at self-harm or ingesting since stay in ED. Last ingestion was day of admission. Surgically removed batteries then back to ED for MH care. Local school district working with her, tutoring. Turns 18 in May.

MCR-F14-2438

Ran away from home (resides with grandma) & stole from Scheels and air pods from a stranger Was tracked by air pods owner who confronted the patient at Red Lobster. Pt assaulted the mother of this individual. History of trauma & SA Kicked out of multiple schools brought gun to Willow creek & threatened to pistol whip classmate. Attempted treatment at Fountain Centers. Restraint chair multiple times.

Declined from Heartland Girls Ranch, Family/Foster Home is not an option due to behaviors, SERCC/Vonwald- patient has been to in the past and has either eloped or been kicked out of the program due to fighting. Trisha will follow up with PORT and Hunter’s Place. These are both sheltered care so similar to Vonwald but in a different geographic area. Neither of these are locked facilities which is also a concern.

Parents unwilling to take her home. Care conference with the county occurred after a week in the ED. Just starting the QRTP process.

MCR-F13-2434

This child was previously on the HUB as MCR-F13-2165.

Returned 3/21/23 to Mayo ED after discharging to home on 1/9/23. 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 its 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 days at Gerard in May, 3 ingestions and elopements while there, they had to dc him as couldnt 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.

Seeking ideas for other options for keeping him safe. Consider Gerard? Prairie Care? (have both turned him down). Jennifer Butler working on this case. suggestions to mitigating risk? clear all things from units, reintroducing slowly when able. Mayo has been able to mitigate risk with using paper crafts, crayons, etc. Haven’t had an ingestion for a few months – has a sitter a Mayo though as he’s on a medical unit. Functional behavior analysis? Hasn’t had one, due to instability. Hopefully he will have one soon. *** Discharged to home on 4/3/23 with 24/7 PCS care.

MCR-M17-2426

This child was previously on the HUB as MCR-M17-2128. Originally admitted 10/12/23, and discharged 11/17/22 to CD group home and eloped within 24hours. Brought back to ED after being found ODing on 12/4/22. Eloped on 12/30 and returned 1/6; attempted to elope again on 2/4 but successfully stopped.

Chemical dependency (fentanyl and meth), suicidal statements when intoxicated. On MI/CD Civil Commitment. Needs locked CD or dual diagnosis residential treatment. County Attorney pressing charges, which may help with JDC placement options.

MCR-M12-2422

Autism spectrum disorder and ODD, mother struggling with her own mental health issues and just started a day program. Multiple ED and SERCC presentations for physical aggression at home, typically triggered by conflict with mom. Completed PrairieCare PHP in September/October. SERCC declining due to lack of benefit and property destruction, Von Wald shelter has him on a wait list but no anticipated discharges. Only recently opened YBH case so in process of having worker assigned, no options for out of home placement. On wait list to start day treatment, perhaps week of 2/13, but he and mom can’t tolerate being in the same room together without escalating to yelling and throwing things. When not with mom, he is calm and engaged in crafts all day long. Care conference with mom and YBH intake 1/24 and 1/27 with a planned discharge 1/30 but mom refusing to take him home because of her concerns about his escalation in her care even in the hospital. Olmsted County CPS has screened out and does not have resources to offer.