Patient presents from group home. Patient is known to our ER and previously boarded 12/3/24-1/7/25. Patient presents after engaging in aggressive behavior that reportedly included verbal threats and chasing them with a shovel. She has had episodes of aggression with staff in the ER and has been targeting another patient that is boarding. The group home has provided a suspension of services and plans to submit a termination of services. County case worker has been making referrals and looking for crisis respite placement. She will likely need a home created for her.
County: Sherburne
NMH8R0MGH-M25-5508
Presents to the ER with Guardian, passive suicidal ideation, feels misunderstood with regard to gender and cultural identity, adopted as a child. Adoptive parents not an option for living. Borderline Intellectual Functioning/Possible Fetal Alcohol Syndrome. Per DD Case Manager, they have tried At Home Living, no openings, Genesis homes has not openings and not able to put patient on a wait list. Patient needs a placement that can accommodate transgender, and she has had inappropriate contact with others in prior GH settings. VOA is assessing.
CH-M15-5352
Patient presented via law enforcement after jumping in front of a vehicle in an attempt to end his life with additional thoughts to jump off of the bridge he was standing on until law enforcement intervened. Patient reports a 3 year history of auditory hallucinations that tell him to harm himself or others which occurs when he is alone or stressed. (hallucinations appear consistent with audible thoughts). This is his 4th inpatient hospitalization for suicide attempts and he has had multiple ER visits. While here, he attempted to assault a younger peer and was assaulted by a different patient. He was placed in the BICU where he has attempted to “snap” his neck on multiple occasions, head bangs, ingested hygiene supplies x1, and tied towel around his neck x1. Suicidal thoughts are perseverative when they occur and can be difficult to redirect.
CH-F13-4941
Patient presents via law enforcement for increased aggression and outbursts, threatened to hurt self and staff with a knife, recently broke a staff members nose. Facility next door to group home is a day care and Pt threatened to slit the kids throats (has a history of aggression towards small children). She was seen by psychiatry who felt behaviors were chronic in nature and would not improve with inpatient hospitalization and return to group home was recommended. Each attempt and returning to her group home resulting in her assaulting staff and need for restraints and IM. Group home has since suspended services.
CH-F13-4577
Pt presents from school after high level of aggression, homicidal threats, and property destruction resulting in multiple hours of restraints. Patient has longstanding history of aggression and impulsivity with recent increase and daily occurrence consistent with starting new school. Pt newly to a group home from home placement as of May 2024. Now discharged from level 4 school due to behavior leading to presentation. Looking for IP for medication adjustments, though making changes in the ER in the interim. Difficult placement given neurological functioning, level of aggression, and acuity.
PH-F15-3876
Recommendation is for Level 5 Residential Treatment; patient is currently inpatient.
Patient presented to inpatient from the ED due to an increase in SI and risky behaviors. Patient has had two previous psychiatric inpatient hospitalization, has attempted PHP, and engaged in outpatient mental health services.
Discharge Plan:
RTC: (JST Thursday 5/30 at 1030 to approve funding for RTC)
Avanti (ACCEPTED – opening 6/11, pending county funding support)
Gerard (referral sent & received – under review, tentative openings August)
North Homes (referral resent & received – under review)
PCR (accepted – insurance OON, county unable to support county contract for funding)
PRTF:
Grafton (referral sent & received – under review)
DHS PRTF eligibility (approved 5/13)
CMHCM: Sherburne County
Continue with established outpatient providers:
-Individual Therapy: Nystrom & Associates
-Family Therapy: Nystrom & Associates
-Medication Management: Allina Health Clinic Cambridge
CH-M8-3464
Update 4.18.24 – on wait list for Northwoods, admission wouldn’t be until summer. Looking for a foster family until residential.
update 4/15/24: The patient is medically stable and has been doing very well here on the unit. Has not shown aggression towards others. One minor episode of head banging when frustrated. Medications are providing therapeutic benefit.
Patient with a past history of RAD, PTSD, ODD and questionable FASD that presented to the ER with foster parents of 4.5 months for concerns of aggression, suicidal ideation, and sexually inappropriate behaviors towards others and pets. He has been in several foster/kinship homes since age 5 with significant trauma prior to this including witnessing mom overdosing on several occasions, witnessing the overdose and death of housemate, sexual abuse by bio father, homelessness, sister attempting to suffocate and strangle him on multiple occasions, and physical abuse by caretakers. He was recently found on video touching the house dog sexually and physically inappropriate and has been threatening and pushing his foster mom. Foster providers are unable to accept him back in their home.
PH-F16-3524
Update 4/3/24- funding in place, waiting available RTC- accepted at Gerard and North Homes. Waiting to hear back from Avanti and East Bethel.
Case Description: Patient is a 16 y/o individual w/ hx MDD, GAD, ADHD, multiple previous hospitalizations, currently presenting due to SI. Patient went to foster care after discharge in previous hospitalization at PC ( october 2023) and returned to mothers home end of Dec after 1 month. Patient was hospitalized at Prairie St Johns for 1 week ( discharged 3/8) due to intrusive SI . Patient feels she was discharged earlier than she should have been because she was still struggling w/ “feeling safe”. Patient indicated that depression /anxiety and intrusive SI improved significantly in foster care. Patient indicated during the time in foster care, patient worked on her relationship w/ mother and feels it was “helpful. Patient transitioned to mothers home and feels that overall relationship has improved and does not know why depression/SI has escalated again.
Discharge Plan: RTC (county funding approved for RTC)
-Avanti (Referral done, waiting to hear back)
-Gerard (Referral done, Accepted)
-North Homes (Referral done, Accepted, currently on waitlist, openings anticipated in June)
PRTF:
-Nexus East Bethel (Referral in progress)
Existing outpatient providers:
-CMHCM at Sherburne County
-Individual therapy Main Street Family Services-Elk River (Appt scheduled 3/27)
-Family therapy at Main Street Family Services-Elk River
-Primary care at Stellis Health-Monticello
-Psychiatry s at Nystrom & Associates
-In-home skills
NMH8R0MGH-F14-3413
Presents from home after altercation with mother and sister. Family does not feel safe with patient returning home.
MHF-F12-680
Patient presented to the hospital by police for suicidal ideation, homicidal ideation, and physical and verbal aggression towards her family after lowering a dose of patient’s medication. Patient’s mother doesn’t feel safe with her returning home.
5/3/23 discharged to home