Update 5/15: Referral madeEmbark (out of state PRTF) and other 2 PRTF out-of-state referrals, as well as Bar None Haven.
The patient is 14 y/o female with a PMH dx to include DMDD,, ADHD, PTSD, and FASD. The patient has presented to ED for SI, attempts elopement and aggression. The patient has significant hx of MH IP hospital admissions. She was recently d/c Dungarvan after 2.5 years.
Hx of sexual abuse and neglect. She ward of the state. Her extensive trauma history and attachment issues, which hinder her ability to form relationships.
Patient was placed at Passageways shelter for 1 month. Near the end of that time, patient became upset that time was ending and would transition back to home. Is not recommended for IP MH care and needs a d/c plan from the ED. Several referrals to shelters have been made.
Update 4/29/24: Patient discharged from Inpatient on 04/19/24 to wraparound outpatient mental health services while continuing to pursue RTC options.
Patient admitted to PrairieCare Inpatient Hospital 3/19/24 from the ED following increased thoughts of suicide with a plan. Pt has had previous IP stays at PrairieCare, Mayo Clinic, Riverside and Prairie St. John’s. Pt had a previous residential stay at Gerard. RTC has been pursued and funding has been approved through Dakota County although currently pt has been declined by viable in-state options. Level 6/PRTF programming is also being explored.
Referral is currently pending at Bar None Haven. Referral also made to Acadia to explore out of state options. Referral will be made to Nexus East Bethel PRTF as CMHCM is willing to help pt switch to straight MA if Nexus is able to accept. Patient is medically ready for discharge and is pursuing an interim plan of dcing home with wrap around services while awaiting placement.
RTC (CASII LEVEL 5) (funding approved, in QI process):
-Acadia (referral sent to explore out of state options)
-Avanti (declined)
-PCR (declined)
-North Homes (declined)
-Gerard (declined)
-Northwoods (waitlist 2+ years, so not a viable option)
-Newport (Insurance not accepted, so not a viable option)
-Nexus Mille Lacs (only accepts biologically male patients, so not a viable option)
PRTF/CASII LEVEL 6
-Bar None Haven (referral pending)
-Nexus East Bethel (referral to be sent, CMHCM able to help switch to straight MA if accepted)
-Grafton (requires ID dx)
-Leo Hoffman (only accepts biologically male patients)
-Northwoods (2+ year WL)
Patient presented from Prairie Care PHP due to aggression and dysregulated behaviors. PHP unwilling to accept patient back, mother unwilling to take home at this time and cites need for RTC. No RTC referrals made currently. Patient needs support in short term placement while outpatient team supports long term plan and placement. Has been in the ED 4 other times. Back and forth from ED to home. No letter of rec. for residential at the moment. Working on it. There is a case mgr, working on a care conference currently.
1/18/24. No placement at this time. Waiting for a waiver to open up more funding sources. Denied at respite/shelter due to behaviors
Patient presented from Aspen House shelter due to aggressive behavior and property destruction. Patient is unable to return to shelter. Mother refusing to discharge home. County looking into shelter options and foster care placement
Patient presented to ED due to concerns of sexual abuse. Patient has extensive history of eloping from home to meet up with adult men she met online and have sex with them. Mom does not feel she can keep her safe at home due to her risky behaviors.
Came after being found in the street by a passerby who administered Narcan. Was incoherent, EMS brought her in to HCMC ED. Long history of trauma. Sexually abused in preschool by her father, who is incarcerated currently. Has been vulnerable to sexual exploitation. Her engagement with anyone in the community is a pathway to a friendship. Dakota County financial responsibility. Working with DaK. case mgr. Had an incident at school (interaction with the principal and had some sort of physical contact with him, charged with assault), so now has a probation officer. No aggression noted at hospital. Wonderful family support. Had been living with aunt. Will just walk out and engage with strangers who do not have her best interest in mind. When DA is complete will be looking for placement for her. community placement. Has been at CRTC and VOA. Working on getting all the info to understand her full picture. DRug screen was negative. Unsure if chemical abuse is dependent? She will use substances if someone offers it to her, socially.
Patient has had several disrupted placements over the past year including shelters and foster homes. Patient has extensive trauma history and was most recently at a shelter where they engaged in self harm by cutting and expressed passive SI. Patient was sent to the ED and was not allowed back to the shelter.
Aggression, Child looks difficult on paper.
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, and significant behavioral change. Per patient’s mom, patient has been struggling for several years with anger and aggression, but this past month things have been escalating. Patient got upset at home, threw things, and punched his mom in the face. Patient’s mother called the police. Patient was in Riverside’s inpatient unit 3x in 2020. Patient was referred to PHP, and attended a 3-week PHP at Children’s Hospital. At the completion of the 3-week PHP, patient was recommended for additional treatment in a residential/inpatient setting. Patient has previous mental health diagnosis of PTSD, ADHD, DMDD, anxiety, and depression. Patient has a mental health CM and a psychiatrist.
