This patient was brought to the hospital by police for aggression and dysregulation exhibited at the group home. He was charged with 5th degree assault after injuring staff members at his group home. His behavior has persisted despite medication adjustments and behavioral plans. He struggles in settings where there is too much sensory input and lack of structure. He has been destroying property and presenting with escalating aggressive, dangerous behaviors, homicidal threats and sexualized behaviors. Despite his impulsive behaviors and subsequent harm to staff members, he displays no remorse, though some question of whether he is able to adequately engage in reality testing possibly related to intellectual disability.
He is a ward of the state. He was placed in foster care at age 6 after suffering from neglect by his biological family. Their rights have been terminated.
County: Saint Louis
PH-F16-4123
Recommendation is for level 6 RTC/PRTF – patient is currently inpatient.
16-year-old Female from RTC level 5. Patient admitted to inpatient after struggling with self-regulation shortly after arriving to RTC. Patient has had several other inpatient hospitalizations and has admitted to RTC twice, discharging both times to inpatient. In alignment with CMHCM, seeking RTC level of care. At this time pt is under temporary guardianship of the county. Referrals have been sent to Nexus East Bethel, Bar None Haven, and PrairieCare.
Patient insured by Medicaid.
Pt has the following outpatient supports:
County guardian/CPS worker
CMHCM
Guardian ad Litem
MHF-F12-4051
This pt arrived in Ridges ED on 5/31 after behaviors at her Grandma’s house. St Louis County has temporary guardianship. Grandma is refusing to let her return to her home. Made suicidal statements at home and was verbally escalated. County is exploring Heartland Girls Ranch and 35 day assessment programs. Referral is being completed to Nexus YCT.
MHF-F16-3864
Update: Discharged to Aspen House but was having suicidal ideation so returned to ED 5/25. County working with Prairie Care Residential for potential placement.
Pt came to ED on 5/10 via foster care parent due to suicidal ideation. Foster parent refusing to take back due to these behaviors. Was previously in North Homes residential and was in inpatient with us from 2/5-2/13. County reports they are exploring residential and PRTF, waiting for DA to come back with recommendation. Completing referral for Nexus YCT. Pt’s mental health is being negatively impacted by boarding, she has been continuously sobbing in our ED about being here.
MHF-M14-3589
Pt came to ED after ongoing behavioral concerns at home with guardian/grandmother, physical and verbal aggression, and threats. Previously discharged from CADI GH for physical aggression, went to JDC for that but was released after a rule 20. Declined by North Homes, Northwoods, and CABHH. A CADI home in Duluth that may be an option.
MHF-F13-3515
Patient presented from North Homes due to suicidal ideation and aggressive behaviors. Patient was initially recommended for IPMH however stabilized in ED and no longer required admission. Patient has been discharged from North Homes and is in need of long-term placement as she cannot return to guardian’s home. Case manager will be working on referrals for RTC and out of home placements.
MHF-F14-2469
Patient is presenting to the ED for the following concerns: suicidal ideation, depression. Patient reports he tried to kill himself last night by stabbing himself with a dull pencil. Patient reports suicidal and homicidal thoughts that have increased in last two weeks. He has been at North Homes for three months. He was discharged to North Homes after a hospital stay at UMMC in September for SI. At North Homes, the patient escalated and told staff he was suicidal. He took the batteries out of a remote and tried to swallow them. He also tried to stab self with dull pencil. He became combative and needed to be restrained and then kicked staff in chest and tried to kick another staff. Patient then stated he would find each clients personal info and then take pictures of other clients after he killed them and send to parents. Patient told staff he would kill other clients and himself.
Patient reports long history of MH including PTSD, MDD and GAD. Patient has been hospitalized 2 x in past 6 months. Patient reports history of trauma. Patient states he has history of SIB.
EH8D-M19-2375
ASD, aggression, DD, language impairment
EH8D-M15-2103
ASD, Aggression, DD, language impairment. Has failed at 2 group homes since being on this list.
PH-F13-1646
UPDATE 9/7/23: Pending potential foster/emergency beds.
UPDATE 8/31/23: Possible emergency foster bed open 9/5, emergent SMRT application in process. Still waiting living placement.
13 y/o female with a history of PTSD, depression, ADHD, mild CD concerns. Patient has a history of previous psychiatric hospitalizations related to increase in SI, SIB, and/or suicide attempts. Patient currently has an outpatient therapist and children’s mental health case manager; treatment history includes outpatient therapy and psychiatric hospitalizations as well as one prior placement at Northwoods crisis stabilization program. Patient is in foster care under guardianship of St. Louis County. Patient was in a foster home prior to inpatient hospitalization but is unable to return to that placement after discharge. Patient has Ucare PMAP insurance.
Discharge Recommendations:
Continue individual therapy established provider
Continue CMHCM with established provider
Continue primary care/medication management with established provider
Establish psychiatry (SW to refer/follow up with outpatient team RE: pending referral)
Estimated length of stay:
Until placement is established by the County (Patient is medically ready for discharge as of 08/16/23)