13-year-old female with a history of autism spectrum disorder, oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), major depressive disorder (MDD), and traumatic brain injury (TBI).
On 4/23/25 according to EMS, the patient had an argument with her mother around 5:00 PM today and subsequently left the home abruptly.
This is her second time boarding in APS; she was admitted two weeks ago and remained for two weeks while in-home services were being arranged. She was discharged but returned due to elopement and aggressive behavior toward her mother.
During her previous admission, she was referred to CABHH but placed on the waiting list. She has also been referred to Beacon for respite care and has been on the waiting list at Grafton for over a year.
Youth came into our ED on 5/6 from the Bridge for Youth shelter. Shelter refusing to take her back. She has boarded with us before for a short time last June. Currently has CADI and CMH, both through contracted agencies. Unable to access County screening team due to contracted CM, so MH GH and residential are not options currently. MCCP referral is in, also have referral to CABHHS and Grafton- awaiting approval from Arkansas Foundation and for acceptance at the program.
Youth came into our ED on 5/6 from the Bridge for Youth after an altercation there. They will not allow him to return. He currently has a CMH Case Manager through Fernbrook with Goodhue Co. They last screening him for in home care/services but Mom is refusing to have him go home. Looking at shelters, group homes and residential. Also has CADI, so crisis respite and CRS would be options as well. Denied by North Homes.
Patient is a 15-year-old female, currently at PrairieCare Inpatient Hospital.
Recommendation is for level 6 PRTF.
Patient has had five previous inpatient hospitalizations through Abbott Northwestern and PrairieCare since April of 2022. Patient has had two admissions to PrairieCare partial hospitalization programming, and one admission to Anthony Louis Center RTC.
Establish PRTF:
-Nexus East Bethel (CMHCM sent referral, PC also sent a referral, declined for admission 04/16 due to believing PT needs a higher level of care- CABHH)
-Northwoods (Not a viable option due to insurance and 2 year waitlist)
-Grafton (Not a viable option due to patient not meeting admission criteria)
-Leo Hoffmann Center (Not a viable option due to patient not meeting admission criteria- only accept biological males)
Impression of Crisis Behavior (precipitants): Patient presented to the ED due to agitation and SI. The identified precipitant for this crisis is a verbal and physical argument with his mother and her boyfriend at the home. Patient was released from the JDC to home on 4/5/25.
Vulnerabilities: adolescent, ASD, h/o trauma, recently released from JDC, parent-child conflict, inadequate outpatient supports
Behaviors / Symptoms to address in the ED: deferred
Methods to increase desirable behaviors in the ED: meet basic needs, set behavioral boundaries/limits,
Barriers to Discharge include: At this time, patient is NOT felt to meet criteria for inpatient hospitalization. There are no new acute safety needs that warrant admission. His mental health concerns are chronic and environmental.
Mom is refusing to take him home, JDC won’t take him back as there are no new charges and he has no place to go. CPS is investigating allegations of abuse by parents and child but are not seeking placement. Mom does not consent to use of a shelter or Nexus YCT.
Pt presented to the FV Riverside ED on 3/17/25 from school for agitation and aggression in the context of being questioned by school security about misusing her medications (which was reported to school by her guardian). She has remained in the ED boarding awaiting placement at a residential facility as guardian/aunt has not felt safe to have her return home. In the ED, she has had multiple behavioral codes, has been aggressive to staff, and has self injured. Given her out of control behaviors and the ED’s inability to manage her, she was admitted to UMMC unit 7ITC on 4/11/25 as a boarder while she awaits placement. Significant symptoms on the initial presentation include irritability, aggression, out of control behaviors, impulsivity, and SIB. Was previously admitted to Nexus-East Bethel but assaulted staff so unable to return.
Came to our ED on 4/10 only because the County had no where else to bring him. Mille Lacs County has custody. He just left the lino lakes juvenile detention center. Has been to many juvenile detention placements, but is no longer required to be there. Has some history of substance use, but most SUD treatments have denied him due to aggression. Has been sober for 2 months now as he was at JDC and now the hospital. County is exploring out of state MH treatment facilities, as well as in state MH group homes, shelters, evaluation programs. Working on getting a recommendation for PRTF through a psychologist who had seen him for civil commitment. Working on SMRT and MNchoices for waiver placement options.
Recommending Level 5 RTC/QRTP
15-year-old female who presented to PrairieCare Inpatient Hospital due to a conflict with her mother leading to an increase in SI.
She was living in a group home for 2 years until approximately January 2025 when she returned home to her adoptive mother.
The JST through Faribault County occurred on 4/16/25. The county did not make a determination whether they support or deny QRTP for this youth at the conclusion of the meeting and discussed they would like to keep this determination open. The county is wanting to pursue shelter and corporate foster care for this youth.
This youth does have a scheduled admission to Nexus Gerard Academy RTC on 4/19/25 pending approval of county funding.
This youth was also accepted to Avanti Center for Girls RTC pending approval of county funding.
Youth came to our ED 3/30 after an altercation in the car with his foster care provider. Foster Care provider is not willing to accept him back. Has permanent custodianship through the County. Open to waiver and looking at crisis respite, getting updated DA for treatment placement information, and is on the list for foster care/shelters.
This youth came into our ED 3/31 after a behavioral altercation at his group home. They have issued a suspension notice. Parent is refusing to take home. He has both CMH CM and is open to CADI. CMH is making the CADI referrals currently, for crisis respite and CRS. The current DA does not recommend treatment placement however CMH is working with OP therapist to try and update the DA.
