This session is being provided through home-based telehealth with verbal consent. The location was verified, and the phone number was confirmed in case of a technical issue. No other parties except the client and/or guardian were present.
Patient presents today accompanied by DSS worker, Mr. Purple, for evaluation for a certificate of need. A certificate of need was provided by this author in Feb 2022; however, DSS was unable to find the recommended placement. Since last seen by this author, patient has eloped from a treatment foster care placement as well as from his aunt’s home. There have been countless incidents where he has been AWOL in the past few months. Mr. Purple reports that patient tends to engage in risky behaviors when AWOL. He will engage in sexual activity, smoke cannabis, and has attempted robbery. He has two active charges in Baltimore County for first degree assault and armed robbery for an incident in which patient went into a grocery store with a bebe gun with intent to rob them. He has incurred several more theft charges since then, the last of which occurred in March 2022. That same day, patient ran away and was not located until April 2022. He called his DSS worker from Hagerstown asking to be picked up. He was placed back with his aunt at that time. He did well for a few days and then left without permission overnight. He got upset when he was placed on punishment and smashed her car window with bricks. Following this event, he was caught on camera stealing package off of a friend’s porch. Patient’s latest episode of dangerous behavior occurred yesterday during which he injured his shoulder trying to forcibly enter his aunt’s home. He self-presented to the ED after this event.
During interview today, patient alleges he injured his shoulder by carelessly running into a door. He reports his mood has been “good”. Admits to struggle with anger but states “I’m good” when asked for further detail. Denies any suicidal or homicidal ideation. He has been doing “ok, not ok”. Denies any anxiety symptoms. Reports focusing well. Patient was irritable and impatient during session. He was guarded and in a rush to complete the appointment as he wanted to go to lacrosse practice. Provided few details when asked for updates on how he has been doing in the past few months. He has been off of medication and out of treatment since last seen by this author due to multiple unsuccessful attempts to maintain him in any one placement in the community. Patient was evaluated in the Johns Hopkins emergency room at Bayview. He was recommended for residential treatment placement; however, he eloped from the interview from a unlocked RTC facility in which DSS was hoping to place him.