Psychiatric Diagnosis: ADHD

ADHD is a psychiatric diagnosis characterized by persistent patterns of inattention, hyperactivity, and impulsivity that can significantly affect a person’s daily functioning, especially in academic and occupational settings.

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

PH-F17-3785

Recommendation is for level 5 Residential Treatment; patient is currently inpatient.

Patient is a 17-year-old individual who identifies as non-binary and uses they/them pronouns. They admitted to PrairieCare Inpatient Hosptial via ED due to an increase in suicidal ideation. This is their 3rd psychiatric inpatient hospitalization, they have done PHP, and engaged in outpatient mental health therapy and psychiatry. County funding has been approved for RTC on 4/25/24.

Discharge Plan:
RTC: (county funding approved on 4/25)
-Avanti (ACCEPTED, scheduled admission Tuesday 6/4/24)
-Gerard (Referral sent & received, awaiting secondary review)
-North Homes (accepted with immediate opening – county and guardian declined placement)

Continue with established outpatient providers:
-Individual therapy: South Central Human Relations-Owatonna
-CMHCM: MN Prairie County Alliance

CH-M17-4047

Pt brought in because they locked themself in their room and wouldn’t come out. Police involvement encouraged patient to come in to see a therapist. Dad refused to take patient home fearing that patient would become aggressive. Patient has historically been violent in times of parents taking away electronics. CPS report made. CPS did not feel patient should be forced to go home with dad because patient was threatening dad while in the ER that they were going to notify police that dad and roommate forced them to take marijuana edibles. Referral made to 180 degree shelter, who declined.

AH-F15-4044

Patient is under guardianship of Scott County; most recently residing at JAF who is not allowing her back. Foster family cannot take back.

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.

EH8D-F15-4024

Pt is a 15 year old female with a history of unstable placements after having been removed from family care due to physical abuse. She has a history of irritability, impulsivity and mood instability which have led to outbursts, self-harm, aggression and property destruction. She was admitted to the hospital after being discharged from her residential treatment facility due to these behaviors. Patient is requesting medication management for the above listed symptoms while we work with her Hennepin County case manager on placement. She has not had any significant behavioral issues over the past 2 weeks while in the hospital.

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.

MHF-M10-3883

Update 5/23/24: Needs psycho-sexual eval, but there is no place to send him to have it done as it can’t be done in the hospital.
Pt was brought into ED on 5/11 by mother due to allegations of abuse. Mother resides in DV shelter and shelter is not allowing pt to return there due to pt behaviors (bangs his head, kicks walls, makes threats, aggression toward mother.) Mother is trying to find new housing so that pt can return to her. County referrals made to Northwoods, North Homes, Village Ranch and Mille Lacs Academy- programs thus far are months out. Barrier to many programs is pt age. County JST is meeting today at 10:30am to discuss further options. Planning to refer for Nexus YCT once discussed with all team members and ROI is received.

EH8D-F10-3962

Pt has been living in the Residential Services-Jewel Group home for over a year. They gave a 60 day termination of service due to their inability to manage her escalating behaviors (last day of services 6/25/24). They have 2:1 staffing for her. These behaviors include harm to self, or others, striking out, choking herself, throwing things and threatening to kill herself and others. She had been attending TSA day treatment until March after an altercation with a peer. She is currently at a 4th grade level and has an IEP. She was brought to the Welia Mora ED on 5/9 and 5/10 as well as Children’s ED on 5/14 looking for “other placement” and was discharged due to not meeting criteria for inpatient hospitalization.

PH-F14-3891

Update 5/23/24: Patient accepted to Heartland Girls Ranch with scheduled admission Wednesday 5/29 – county funding was approved.

Patient presents to inpatient from the ED due to an increase in SI. This is her third psychiatric inpatient hospitalization. She has done PHP twice and engaged in outpatient mental health services.

Discharge Plans –
RTC: (JST funding meeting on 5/17)
-Avanti Center for Girls (referral under review)
-Nexus Gerard (referral under secondary review)
-North Homes (pt is on waitlist – 4-6 weeks out)
-Village Ranch- Annandale (pt is on waitlist – end of June)
-Heartland Girls Ranch (referral under review)

Continue with established outpatient providers:
– Therapist: Mayo Clinic Health Systems Austin
– Family Therapist: Albert Lea
– Medication Management: Mayo Clinic Austin
– Case Management: Freeborn County
– Occupational Therapist: Mayo Clinic Rochester