Dewayne Lowe (DOB: 06/08/2010) is a 12-year-old African American right-handed male

who was admitted to Spring Grove Hospital Center (SGHC) on May 2022. He was

transferred from Charles H. Hickey, Jr. School (CHHJS), where he was admitted on May

2022, to SGHC pursuant to the court order from the Circuit Court for Baltimore County

Sitting as a Juvenile Court in May 2022 for a competency evaluation and in May 2022 for

emergency evaluation including psychiatric evaluation and medication reconciliation. The

court order stated: “The Respondent should return before the Circuit Court for Baltimore

County on June 2022.”

Dewayne has 12 counts of pending charges including Robbery with Dangerous Weapon;

Robbery; Assault-First Degree (x2); Assault-Second Degree (x2); Att-Dangerous Weapon-

Int/Injure; Dangerous Weapon: Conceal; Threat of Mass Violence; Theft: $100 To

Under $1,500; Malicious Destruction Of Property/Value Less Than $1,000; and Animal

Cruel Fail: Provide from an alleged incident that occurred in May 2022.




– SGHC records of Dewayne Lowe at SGHC, dated between May 2022 and June 2022.


– Phone interview with Dewayne Lowe's maternal aunt, Dianna Moore, on multiple occasions since Dewayne's admission to SGHC in May 2022. Partially reliable.

– Records from Charles H. Hickey, Jr. School including emails, dated in May 2022.


– Court orders from the Circuit Court for Baltimore County Sitting as a Juvenile Court, in May 2022. Reliable.

– State of Maryland Department of Health and Mental Hygiene Division of Vital Records, Certificate of Live Birth, Date issued was in 2010. Reliable.

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– Psychiatric Evaluation from Catholic Charities Baltimore by OMHC Baltimore City BARDS DSS team, dated in April 2022. Reliable.

– Psychiatric Evaluation completed in November 2017. Reliable.

– Baltimore City Public School records, dated between 2014 and 2019. Reliable.


Dewayne was upset when he arrived at SGHC. He expressed frustration about the length of

time he spent in a van while transported from CHHJS to SGHC. When he entered SGHC

after completing a COVID-19 rapid test, he continued to express his frustration. He became

upset when he was given a mask to wear. He also did not want to comply with admission

photography and covered his face with his hands. When he was redirected to wear a mask before

entering the unit, Day B, he started cursing at staff members and threw a mask on the floor. It

was picked up by a staff member and when he was offered a mask again, he started becoming

agitated. Dewayne cursed at staff members, clenched his fists and made verbal threats to hurt

staff members. Due to ongoing agitation, more security officers came on the scene.

Dewayne then opted to don a facemask, but he remained upset.

Upon arrival to the unit, Dewayne continued to show agitation, using profanity and making

threats that he would hurt others. Because of ongoing agitation, he was offered as-needed

(PRN) medications (lorazepam-anxiolytic and chlorpromazine-antipsychotic) which he initially

refused but eventually accepted encouragement. Within couple of minutes of taking the

medications, he displayed a change in his behavior. He was more calm and pleasant. In

addition, he stopped using profanity and making threats to others. Instead, he was saying “thank

you” when a security officer brought him some snacks after Dewayne reported feeling

hungry. The admission assessment continued until he started feeling sedated from the

medications and went to nap.

Dewayne reported “I worry about her (mother) a lot” after he heard from her that she

was diagnosed with breast cancer while he was at CHHJS. Later, I found out, his mother

was not diagnosed with breast cancer by his guardian, Dianna Moore, who told me: “He

(Dewayne) is lying.” Ms. Moore reported Dewayne has difficulty telling being truthful. For

example, Dewayne stated his date of birth is June 8, 2008 on his birth certificate, when his actual

birth date is June 8, 2010. Dewayne also said his cousin died two years ago, which Ms. Moore

said was untrue. She clarified that the last time any family member was shot was in 2011

when Dewayne was a year old. Dewayne also reported he was living with his brother, who is

four years younger than him, in the community, but Ms. Moore stated his younger brother

never lived with Dewayne. She described Dewayne's behavior as “he always lies… real bad

liar and manipulator.” Ms. Moore shared with me in November 2021, Dewayne reported her

boyfriend was trying to kill him with a gun, which she said, “none of that is true.”

Dewayne denied feeling depressed or having issues with sleep or appetite. Ms. Moore, however,

feels he has been showing some signs of sadness after his maternal grandmother, who lived with

Dewayne since age seven months, passed away when Dewayne was three years old. She pointed

out Dewayne has difficulty regulating his mood as he gets quickly angry and acts

aggressively. He previously reported to an evaluator at Catholic Charities Baltimore that he

struggles with anger.

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While Dewayne was at CHHJS, there were four restraints documented. In May 11, 2022,

Dewayne reported he felt “lied [to] and said COVID was over and it wasn’t” and he was

“becoming an imminent threat while in Douglas Hall.” He was subsequently placed in

restraint. On May 14, 2022, Dewayne “took their (staff) keys” and was restrained “due to

becoming an imminent threat to self and or others.” On May 17, 2022, Dewayne was restrained

“due to an imminent threat.” On May 18, 2022, Dewayne made an allegation toward DJS

staff and also was restrained “for becoming an imminent threat to self and/ or [sic] others.”

On May 21, 2022, Dewayne was not restrained but he “broke the Television on Douglas Hall

while youths [sic] were having leisure time.”

Psychiatric evaluation completed April 2022 noted “A certificate of need was provided in Feb

2022; however, DSS was unable to find the recommended placement.” Dewayne “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.” When he is out of

home, he tends to engage in risky behavior such as “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.” It was noted that Dewayne incurred several more theft charges

since the grocery store incident. In March 2022 he ran away from home and was not located until

April 2022 when Dewayne asked his DSS worker to pick him up in Hagerstown. He was placed

back with his aunt but ran away again a few days later. It was noted Dewayne “was placed on

punishment and smashed her car window with bricks. Following this event, he was caught on

camera stealing [a] package off of a friend’s porch.” In April 2022, he injured his shoulder while

he was trying to forcefully enter his aunt’s home by running into a door and self-presented to an

emergency room.

Dewayne's aunt, Ms. Moore, reported he frequently ran away overnight from home and at times

went missing for days to weeks since age 10. Ms. Moore told me when Dewayne does not have a

place to go, he goes to a hospital emergency room, police station or “any type of

building.” There are about 20 to 30 police reports filed due to him running away from home.

One time, Dewayne went to Johns Hopkins Hospital emergency room and told a staff member

there that his aunt was parking a car and he had back pain. He was given Motrin and got

treated for it. Then, child protective service (CPS) was contacted as his aunt was not showing

up, as she was not there and she did not know about this. Ms. Moore stated Dewayne was

also asking “random people to see if he could stay” with them.


Previous diagnoses: Dewayne was previously diagnosed with Attention-Deficit/

Hyperactivity disorder, Predominantly inattentive presentation; Unspecified Trauma- and

Stressor-Related Disorder; Oppositional Defiant Disorder.

Previous admission: Available record indicated in March 2022, Dewayne was hospitalized

at Johns Hopkins Hospital Bayview for 10 days after endorsing suicidal ideation. Dewayne's aunt stated, “I don’t exactly know what happened.”

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Previous suicide attempt: Dewayne never attempted suicide in the past.

Previous non-suicidal self-injurious behavior: Dewayne denied previous self-injurious

behavior and his aunt reported “I never seeing that myself.” Available records indicated in

March 2022, Dewayne was hospitalized at Johns Hopkins Hospital Bayview for 10 days after

endorsing suicidal ideation. Dewayne's aunt stated, “I don’t exactly know what happened.”

Previous medication trials: Methylphenidate (Ritalin), Methylphenidate extended-release


Previous outpatient treatment: Dewayne started receiving mental health services from

Baltimore Child & Adolescent Response System (BCARS) then moved to Villa Maria

school-based service. After the COVID-19 pandemic hit, he could no longer get

medications; thus, his pediatrician started prescribing methylphenidate extended-release

(Concerta, stimulant) 36 milligrams in the morning. Available records indicated Dewayne was in BCARS three times in 2021. He was last admitted to BCARS in February 2022 and

received in-school therapy in fifth grade. When Dewayne was six years old, the school

recommended he see a mental health professional as he did “basically everything that [a]

child with ADHD did.” He was diagnosed with Attention-Deficit/Hyperactivity Disorder

(ADHD) and prescribed methylphenidate (stimulant). He initially had no behavioral issues

at home but at age 10 he started running away from home and “missing for weeks.” Ms. Moore reported Dewayne never told her where he was staying.

Previous community placement: Dewayne was placed in the home of family members and

an unlocked residential treatment center (RTC). He has a history of eloping from the RTC

and leaving his family’s home without permission.


Previous physical, sexual, emotional abuse or neglect: Dewayne reported he does not like

people. He said his 16-year-old cousin was killed in 2020 after a gang member shot him

when “I was around a corner” from the incident. He noted feeling guilty as he feels “I wish I

was there.” He also noted witnessing a “shoot out” about four years ago when he was on his way


Symptoms of trauma: Dewayne reported feeling hypervigilant and negative alteration of his

mood and cognition along with difficulty controlling his anger.

When I asked his aunt, Ms. Moore, about those incidents, she stated “never heard that before,

more than likely [a] lie.” She told me Dewayne struggles with telling the truth to others.


Dewayne reported using marijuana and tobacco products since age eight. He reported

marijuana products make him feel “happy.” He also reported drinking hard liquors.

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Current medical concerns: None. Available records indicated Dewayne has a history of

eczema, dry skin and increased blood lead level. Dewayne was circumcised at age four.

History of traumatic brain injury: Dewayne does not have a history of traumatic brain

injury according to his legal guardian, Ms. Moore.

History of seizure: none.


Medication allergies: none.

Other allergies: none.

Medication or food intolerances: none.

Medications at the time of admission: none.


Birth and early development: Certificate of live birth indicated Dewayne was born with the

full name, Dewayne Allen Lowe Jr., on June 8, 2010 at 11:30pm from Jessica Olivia Rand (mother) and Dewayne Allen Lowe (father). Mother’s age was 13 and father’s age was 19

when they gave birth to Dewayne.

Family dynamics: Dewayne was born and raised in Baltimore City. His aunt, Dianna Moore, voiced concern that there is community violence and Dewayne is a follower and he

is easily influenced by others. Ms. Moore works as a manager at McDonald’s and she is

looking into transferring her job to North Carolina as this would be a better environment to raise


Education: Dewayne was attending Commodore John Rodgers as a sixth grader. He has 504

for “behavior” issues but no individualized education program (IEP). He has been having more

days missing school than attending recently as he has been frequently running away from

home. When he was attending school consistently, he was getting average grades (Bs and Cs).

Records indicated he was suspended “’a lot’ for fighting peers, accidentally hit a teacher once.”

He also was suspended for threatening school staff and telling administrator he wished he

were dead. Dewayne reported he threw a boot at a school staff member’s head and was


Social: Dewayne was living with his maternal aunt (mother’s maternal half-sister) in

the community. Dewayne stated he can obtain firearms in the community. Dewayne has two

younger siblings.


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Dewayne's mother (bipolar disorder, ADHD, schizophrenia) and maternal

grandmother (depression, substance use) have mental health issues. Ms. Moore informed

that Dewayne's maternal grandmother had “a lot of mental issues.” Available record indicated

there is a family history of cancer and high blood pressure.


Dewayne reported his first legal contact was at age 10 for “credit card fraud, assault, possession

of fire arm.” Available records indicated Dewayne has two active charges in Baltimore

County for first degree assault and armed robbery for an incident in which he went into a grocery

store with a bebe gun with intent to rob them.

Dewayne was admitted to SGHC court ordered with 12 counts of pending charges

including Robbery with Dangerous Weapon; Robbery; Assault-First Degree (x2); Assault-

Second Degree (x2); Att-Dangerous Weapon-Int/Injure; Dangerous Weapon: Conceal; Threat of

Mass Violence; Theft: $100 To Under $1,500; Malicious Destruction Of Property/Value Less

Than $1,000; and Animal Cruel Fail: Provide from an incident that happened on 5/9/2022.


Dewayne was admitted to the SGHC Adolescent Unit in May 2022 and he is going through

evaluations from the following disciplines: psychiatry, psychology, somatic medicine, nursing,

social work, recreational therapy, and occupational therapy.

Mental status on admission:

Dewayne was awake and alert during the interview process. He was oriented to place, time,

and person based on his ability to correctly state today’s month, today’s year, the name of

“crazy hospital” and his DOB.

He was wearing detention-issued clothes and shoes. He had fair personal hygiene and grooming.

He appeared younger than his biological age based on his short stature and slim body. His gait

was stable and he did not appear having any abnormal muscle movement (AIMS was

zero). Initially, Dewayne was oppositional by refusing to comply with wearing a mask, using

profanity at security officers and glaring at staff members. However, after receiving as-

needed (PRN) medication for agitation, he started engaging in the interview properly and his

demeanor was calm with intermittent eye contact.

Dewayne's speech was regular rate and rhythm without any difficulties with articulation.

His thought process was goal directed and linear without any disorganization. He

denied experiencing any thoughts to harm self or others (Suicide Behaviors Questionnaire-

Revised Plus 2, SBQR-2 was 3). He denied paranoia or ideas of reference. However, he

exhibited behavior that would indicate hypervigilance based on him constantly assessing any

threats around him and not liking to have anyone where his back is facing. He did not appear

having any perceptual disturbances and denied experiencing any hallucination.

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Dewayne had an intact ability to register for three objects (penny, table, cat), which indicates

his immediate memory was intact. He exhibited deficient short-term memory based on his ability

to only recall one out of three objects (penny) in five minutes. His long-term memory

appeared intact as he was able to recall the names of a couple of past presidents: “Donald

Trump” and “Barack Obama.” He was able to tell me the name of the current president.

Dewayne's judgment was poor based on his answer (“I’m gonna pick it up and see if money

in there”) when I asked him “What would you do if you find a stamped, addressed and

sealed envelope on a sidewalk?” His insight appeared poor as he did not seem to understand

reasons for his admission to SGHC.

Dewayne did not answer when I asked him how he feels (just glaring at me). His affect was

angry and upset, but this improved after he was given with PRN medications. He was not

able to perform serial 7s (subtracting 7 from 100 and keeps subtracting 7 from the previous

answer) as his answer was “ninety something” when he subtracted seven from 100. He was

able to spell ‘WORLD’ forward but not backward (he spelled it DLORW). His abstraction

ability was not able to be tested as he started feeling sedated from PRN medications given to



Upon admission, Dewayne was placed on one-to-one staff observation for COVID-19

admission quarantine and threat to hurt others. The day after he was admitted, SGHC

received an email from his DJS worker that his COVID-19 PCR testing, which was performed

in May 2022, came back positive. Thus, Dewayne was placed on quarantine. Dewayne struggled wearing a mask properly over his nose and maintaining distance from other peers.

After he completed with COVID-19 admission quarantine, he continued on one-to-one

staff observation for making threats to hurt others.

Dewayne's behavior was described as “oppositional, defiant, rude and disrespectful to staff for

the most part of the shift. He was rude during rehab group, cursed staff walked back to the unit.”

His interaction with other peers was “negative” as he was “cursing and rude to staff.”

Dewayne gets upset when redirected. He was also making a gun gesture with his hand at a

charge nurse. When he was redirected for such behavior “patient became verbally and

physically aggressive posturing in manner to attack staff.”

Dewayne was restrained six times since his admission to SGHC: May 27, May 28, May 29,

May 31, June 5 and June 8. On May 27, he became very agitated and refused to

follow any redirections along with not complying with mask wearing. On May 28, Dewayne was agitated and not complying with wearing a mask. On May 29, he was not following

redirections and wanted to stay in the hallway and did not comply with mask wearing (he was

COVID-19 positive) and was close to another peer, cursing at staff members and made a

threat to “fuck them (staff members) up.” On May 31, Dewayne became upset when staff

could not locate a movie. He kicked trash, threw a food tray, broke a pay phone and threatened

to hit staff. On June 8, he was restrained after throwing a plastic chair, posturing at a staff

member and making threats to hurt

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staff. He received oral as needed medications including lorazepam 1mg, olanzapine 5mg, and

diphenhydramine 50mg.

Medication history:

Dewayne was not prescribed any medications while at the detention center. Upon admission

to SGHC, he was not prescribed any medication to assess his clinical symptoms. When he was

seen in milieu, he was struggling with ADHD symptoms including inattention,

hyperactivity and impulsivity. Verbal consent was obtained from his guardian and

Methylphenidate 5 milligram was initiated. Dewayne has been verbalizing not wanting to

take his medications stating his mother would not want him on any medications. When I

called his guardian, she told me there was no conversation with Dewayne about his

medication and she would like Dewayne to take his medications as she feels medications do

help him with his behaviors. He was observed once to spit out his medication; thus he was

ordered to have a mouth checks with each medication administration.



Disruptive Mood Dysregulation Disorder (DMDD)

Attention-Deficit/Hyperactivity Disorder, combined presentation (ADHD)

Posttraumatic Stress Disorder (PTSD)

Conduct Disorder, Childhood onset




Cannabis Use Disorder

Tobacco Use Disorder

Alcohol Use Disorder


History of elevated blood lead level

History of dry skin

History of Eczema


1.Dewayne has primary psychiatric diagnoses of Disruptive Mood Dysregulation Disorder (DMDD); Attention-Deficit/Hyperactivity Disorder, combined presentation (ADHD);

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Conduct Disorder, Childhood onset; Posttraumatic Stress Disorder (PTSD); Cannabis

Use Disorder; Tobacco Use Disorder; and Alcohol Use Disorder.

2. In light of available aftercare options and in considering the least restrictive clinically-

appropriate option, Dewayne should be released to the care of a residential treatment

center (RTC) where he would receive intensive mental health care services

including medication management. The program should emphasize anger management,

treatment of oppositional behaviors, and have a substance abuse treatment component.

Considering his PTSD diagnosis, individual trauma therapy is recommended. Family

therapy would be appropriate to provide Dewayne's guardian with resources and

education to provide structure and discipline at home once he is released into the


3. Dewayne should meet with a psychiatrist on a regular basis. He is currently

prescribed methylphenidate 5 milligrams in the morning and methylphenidate 5

milligrams at 1pm.

4. Dewayne should see a primary care provider for regular monitoring of his

physical wellness and prior history of elevated blood lead level, dry skin and

eczema. While Dewayne was at SGHC, he did not require any medications for somatic


5. Dewayne should return to his grade appropriate education. Dewayne was

attending Commodore John Rodgers as a sixth grader. He has 504 for “behavior” issues.

6. Dewayne would benefit from male mentor who can guide him to healthier ways to

manage his anger and encourage him to engage in prosocial behaviors.