Children’s Mental Health Targeted Case Management – Mental Health Collaboration Hub

NFH8EB-F13-6881

Youth experiences emotional and behavioral dysregulation that impairs functioning across settings. Dysregulation looks like verbal aggression, suicidal comments or gestures, self-harm, eloping. Youth demonstrates poor impulse control and has low frustration tolerance. Youth experiences cognitive rigidity and has limited insight which often contributes to interpersonal conflict. Youth has participated in a 35 day assessment program and other residential treatment services. Youth was administratively discharged from her previous residential placement due to persistent dysregulation with limited progress.

EH-M16-6874

Report by psychiatrist
This is a 16-year-old male with a prior history of mild intellectual disability with a full-scale IQ in the 50s but apparent better verbal functioning, bipolar disorder, reactive attachment disorder, autism spectrum disorder and ADHD. Patient was brought in the emergency on 4/27/2026 by law enforcement. He had been making threats at school of stabbing others with a pencil had been attempting to elope. On 4/26/2026 he severely assaulted group home staff causing facial fractures requiring facial surgery. He tells myself “I was mad at the group home made up that stuff I never said I was going to go in there and set the other roommates deck “. Mother states that perhaps he was upset that the other client came out and put the his hand on staff and patient may have been jealous of this. It was a fairly severe sleep assault. Group home and previously given a 60-day notice. However when I talk to group home staff they state that they would have taken him back if he was stabilized. Case manager and mother sent an email on 5/5/2026 terminating their stay with that group home with mother telling me that group home said that they would take the client back but did not want the mothers involved any further. Patient does have some insight in this states he wants to avoid juvenile detention and states he knows what he did was wrong. He also describes knowing it was wrong to assault his mother and apparently another client in their foster home when he previously lived at home and went to juvenile detention. He appears very motivated to avoid juvenile detention.

Overall he has done reasonably well in the emergency room. He is slightly unkempt at times and needs redirection and can be somewhat irritable with this but has not had any physical aggression. In regards to his anger he states “I have bipolar disorder “. He is worried about charges being pressed for his recent actions but does not believe that they have been pressed.

Patient’s mother describes what sounds like perhaps manic episodes which can last for up to 5 days. She notes that the first hallmark is decreased need for sleep with excessive energy he seems to fixate on certain things and may have delusions with her state that he gets out of touch with reality. He has grandiose ideas and is overall very pleasant. He also becomes more hypersexual at these times and may attempt to touch staff. She feels that getting on top of the poor sleep with Zyprexa early on has been helpful.

There is been some concerns about depressive lows at times when he is more irritable and can and will risk of acting out. Patient denies this currently states he enjoys fishing, playing games and cooking. His sleep and appetite are fairly good. He apparently is been making comments to his mother about not wanting to live or being shot by law enforcement. When staff of asked him about this he states “I was just mad and saying that “. He denies current suicidal thoughts of myself. Apparently at age 8 he had placed a cord around his neck.

Patient has a long history of being very impulsive and rapidly fluctuating moods. I did not review symptoms of ADHD in detail with him. There is no current clear psychosis and no clear obsessions or compulsions. There were no clear recent stressors which triggered his change in behavior recently. I do wonder if the group home giving the 60-day termination notice in mid April as part of what triggered some these behaviors.

PH-M15-6840

Recommending RTC/PRTF.
15 year old male who presented to PrairieCare Inpatient due to an increase in suicidal ideation with a plan to overdose.
Patient has a history of other inpatient hospitalizations, PHP, and CD RTC. QRTP funding was denied.

PH-M15-6144

Recommending PRTF/RTC/ CADI placement with supports
15 year old male who presents to PrairieCare Inpatient Hospital due to suicide attempt with increased SI and SIB.
He has a history of several inpatient stays, has engaged in PHP, individual therapy, family therapy, and RTC at Gerard
Funding is in place for RTC with Polk County, has waiver

CH8SCH-M12-6493

Patient presents to ER with mom for concern for suicidal ideation, fights at school, along with problematic sexual behaviors towards females. Mom is fearful of the safety of other children including 3-year-old daughter within the home. Patient does not have any active services.

CH8SCH-F14-6487

Patient presented from local residential facility after getting into an argument with staff where she tied rubber bands around her neck in an attempt to end her life resulting in staff needing to remove the bands and discoloration of her face. She was able to hide and sneak in additional items to self harm with into the ER and inpatient unit where she again placed something around her neck. Residential unable to accept her for return as they feel they are not able to keep her safe and that she needs a higher level of care.

CH8SCH-F16-6368

Patient was at Heartland Girls Ranch and reports that she tried to run from the facility, scratching her arm and hitting her head on the wall. Patient reported suicidal ideations with a plan. County is guardian of patient due to past abuse. County feels like patient needs PRTF level of care. On the waitlist at CABHH.

SBMC-F15-6411

Patient presented to the ED with her father after ingesting a screw while at school. EGD completed to remove the screw and she returned to the ED. Mental health team met with patient and father making the recommendation for acute inpatient MH placement. Patient denied ingestion to kill self and denied SI. She has a history of swallowing 2 AA batteries in Dec as well as another episode of swallowing a button batter a couple days prior. After those interactions she spent 11 on our medical floor waiting for a discharge plan. She was finally placed at an acute inpatient unit only to return home in a week with no additional supports in place. The original recommendation was for a long term residential placement but that was changed to discharging to home.

SBMC-F15-6326

Patient presented to the ED after ingesting a button battery. Surgical intervention was needed to remove the battery. Safety plan competed to allow patient to return home with father. While at school the next day, she hid in the bathroom and broke open a calculator to swallow 2 AA batteries. Hospital admission needed until batteries passed the next day. Acute inpatient MH options explored with no accepting facilities. Remains admitted awaiting residential placement at this time. Father does not feel he can keep her safe at home due to the increased risk of swallowing objects.