MFIUP-F14-5242

Presented to ED for verbal agitation, physical aggression, significant behavior chance, suicidal ideation. Patient has also been engaging in SIB. Aggression has been ongoing for over a year and has intensified. Aggression comes on suddenly/does not seem to be predictable. Mom feels she has no control. Has an IEP for low IQ and learning difficulties. Refuses medications. Strained relationships with mother, father, and older siblings. Patient reports not having many close friends. Has engaged in lots of community and outpatient treatment options including individual therapy, family therapy, case management, school counseling, child protection, primary care, psychiatric medication management, day treatment. Has been hospitalized before at PrairieCare.

CH-F11-5026

Pt presented from home, adopted parents, for aggressive behaviors. Third ER visit this month, unable to take pt back home due to frequency and intensity of behaviors as well as 4 other children in the home. Pt initially recommended IP hospitalization, however unable to find placement due to acuity, no beds, or declined due to IQ (56) and inability to participate in programming. Medications adjusted in ER. No violence since medication increase. Family/CADI worker have been looking for more support for several years and pt seems to fall through the cracks due to IQ and aggression.

GC8S-M10-4890

Patient was at school when he began having hallucinations, pulled his hood over his face, then ran into a concrete wall. He was admitted to Gillette for medical management of his bleed needing surgery to repair. Initially he was calm and not demonstrating behaviors then once he was fully off all sedation, he began showing his behaviors. He verbalized thinking everything is poison so he wouldn’t eat or drink, hearing and seeing things that are not there, extremely anxious and afraid. He needed physical holding for safety this am due to behaviors that put him at risk for his safety and others in the room. Patient has a history of this behavior prior to this incident. Strong family history of schizophrenia, this is currently in question for patient. Have connected with Children’s, Abbott and Prairie Care for possibly inpatient psych placement and med management.

PH-F17-4728

Patient is needing an out-of-home, secure, placement, due to ongoing, chronic, safety concerns, that are unable to be managed at home. Patient is recommended to attend Residential Treatment or enter into a supportive living environment.

Patient has a significant psychiatric history including:

Psychiatric hospitalizations
-Mayo Clinic Generose 08/2019
-PrairieCare 10/29-11/11/2022
-PrairieCare 08/30-9/7/2023
-Mayo Clinic Generose 09/2023
-PrairieCare 11/8-11/20/2023
-Mayo Clinic Generose 12/2023
-Mayo Clinic Generose 04/2024
-PrairieCare 06/25-7/11/2024
-PrairieCare 07/25-8/14/2024

Residential Treatment:
-North Homes for a 35-day evaluation
-Gerard 08/2020-06/2021
-Gerard 12/2022-06/2023

Day Treatment:
-Fernbrook Family Center

Partial Hospitalization:
-Mayo Clinic November 2021, June 2022; Prairie St. John’s February 2022 and July 2022
-PrairieCare Rochester 11/16-12/21/2022
-PrairieCare Rochester 09/11-9/15/2023
-PrairieCare Rochester 09/19-10/11/2023

History of self-harm by cutting (recently daily), with one prior reported suicide attempt (by overdose, 6/2024), who re-presents to PrairieCare inpatient due to safety concerns related to self-harm by cutting, with increasing suicidal ideation and intention, with an inability to contract for safety, in the context of stressors related to school re-starting.

PH-F8-4701

Recommendation is for QRTP or PRTF – either could potentially meet the needs of this patient and limited treatment centers available due to patient’s age. Patient is currently in psychiatric inpatient hospitalization.
Patient is an 8-year-old female. Patient presented to inpatient from the ED due to increase in unsafe and risk-taking behaviors. This is her fourth inpatient hospitalization; one in 2022 and three in 2024. Patient has attended day treatment twice and participated in outpatient psychotherapy and medication management.

Discharge Plan:
PRTF/QRTP: (county funding approved for QRTP)
– Grafton (declined due to not meeting criteria)
– Northwood (referrals submitted 9/9, on waitlist 9/23 – awaiting update on admission timelines)
– Gerard (unable to accept due to age)
– Avanti (unable to accept due to age)
– Bar None Haven (unable to accept due to age)
– North Homes (unable to accept due to age)
– Heartland Girls Ranch (unable to accept due to age

Continue with following outside providers:
– Therapy/Therapist: Solutions Behavioral Healthcare Professionals
– Primary Care Provider: Sanford Health
– Medication Management: Solutions Behavioral Healthcare Professionals
– Case Management: Solutions Behavioral Healthcare Professionals
– Occupational Therapy: Beyond Boundaries Therapy and Wellness

RMC-M12-4515

12 yo male brought to Ridgeview Medical Center (RMC) via EMS after a verbal and physical outburst at home. Youth felt that his mother was “lying” about him to a visiting social worker and youth became aggressive, throwing dishes on the floor in the kitchen. Youth “pushed” his brother, who then pushed youth. No h/o violence or aggression at school or with individuals outside of his home. Most aggression is shown verbally towards his mother. Mother is not allowing youth back into her home right now. Carver Co. Crisis and COPE have assessed youth and are recommending psychotherapy and/or psychiatry/medication management.

CH-M11-4380

Patient endorses homicidal ideation towards his sibling. Increasing behaviors at home. PHP (Clara’s House) attempted and will be discharged with recommendation of high level of care (residential). Patient has significant trauma after extensive physical abuse from biological mother and likely operates at a much younger age. Patient was removed from his mother’s custody by Ramsey County CPS in May 2024. Aunt is foster care provider.

RMC-F16-4041

16 year old female who was brought in by EMS in 4-point restraints after being restrained by PD trying to enter river to “drown herself”. Patient argued with her mother just before she threatened to “drown herself in the river;” destruction of house/property per mother’s report. Patient admits to past similar behaviors and has multiple MH hospitalizations on record.

PH-F11-3982

The patient presented after expressing homicidal thoughts (threats of aggression) toward her grandmother with whom she lives. Patient was on her way home from school when she pulled her school lvan driver’s arm to the back of the van as she did not want to return home. Patient was then returned to her school where her grandmother picked her up and eventually brought her to the Emergency Department. Since her presentation to the Emergency Department, the patient has not displayed any aggressive behavior. Patient has irritability and emotional outbursts with grandparent(s) and has displayed these behaviors at school as well. Has mostly been pleasant and cooperative in the Emergency Department. Has some attention seeking behaviors when the Emergency Department is busy.

RMC-M15-3979

Suspended (5/17) for bringing a knife to school. Went to school on 5/20 with uncle to search locker (items were missing from home-guns, knives, etc.). Pt became agitated and began banging his head on the wall. He also punched his uncle.