Update 3/14: Planning for DC back to home 3/15. Provided mom with resources for group home placement
Patient presented to the ER via law enforcement for suicidal ideation after getting into an argument with his brother and attempted to jump out of a 3rd story window and the vehicle. Mom does not feel safe with him at home due to ongoing aggression. Patient has ABA therapy and social worker.
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.
PCMC-M14-3346
Pt arrived to ER with law enforcement after Aggressive agitated episode with stated suicidal and homicidal thoughts in a young 14-year-old with serious past psychiatric history. Patient is currently in a moderately agitated state but no need for chemical restraints at this time. Patient did agree to laboratory evaluation per protocol suggest in light of the absence of concern of overdose that we will defer to behavioral health evaluation before doing a blood draw. Will attempt to get a urine for drug screen. Behavioral health consult placed unclear if he will cooperate with evaluation. Patient is on one-to-one observation.14 year old male with oppositional defiant disorder, sensory integration dysfunction and ADHD with hyperactive impulsive type presented to Hosptial after disturbing events at school this morning. We know some sort of electronic gadget was taken away from Ethan. He became agitated and apparently attempted to roam the halls looking for his father who is also a teacher at the school making threats against the stepfather. Statements of suicidal ideation were made. Father is reportedly in support of a behavioral health stay due to to the level of aggression that has not been witnessed for a while. During his period of upset he tore off a piece of trim from the school that had nails in it and was swinging it at staff.
C8SM8M-M8-3342
Pt presents with behavioral escalations from out of home placement. Pt currently in hospital with no d/c plan at this time coordinated by county. Pt has a history of trauma and sexualized behaviors.
MHF-F14-3262
Patient brought in to ED by case manager after her group home discharged her due to ongoing behaviors and aggression. Case manager did not have alternate placement and therefore patient now boarding in ED until new placement can be found. Patient in need of shelter or crisis respite placement while longer term placement is found. Awaiting funding.
M8SAS-14-3322
Elopement from family home. HI towards mom, could be safely planned. Child has insight, and doesn’t want to harm mom. CPS notified, meeting with the family. Family ok with group home but county isn’t.
PH-F16-2714
Updated 3/7/224: Admission scheduled for 3/12, discharge from hospital will occur same day
Updated 3/1/24: SW was informed the admission date was moved to March 12th. Scheduled admission to Nexus East bethel for March 12th
Updated 2/28/24: East Bethel Accepted- Admission scheduled for March 7th time TBD, pt remains on the inpatient unit.
Updated 2/15/24- East Bethel Accepted- Opening now first week of March, pt remains on the inpatient unit.
Updated 2/1/24: East Bethel Accepted- Opening mid February
Updated 1/25/24: East Bethel tentatively accepted- opening mid February
Updated 1/11/24: East Bethel will review, if accepted- admission in a few weeks.
Update 1/9/24: Patient has been declined to Grafton PRTF due to her behaviors not being appropriate for current milieu and identified as it would not be therapeutic.
Discharge Plans: PRTF is medically recommended by inpatient treatment team
PRTF: Nexus East Bethel (Referral sent & under review, will likely hear about acceptance decision in January 2024)
PRTF: Grafton (declined on 1/9 due to behaviors not appropriate fit for current milieu)
-(DHS eligibility form for PRTF sent and approved)
Referrals to RTC’s made previously by the county:
-LSS, Sioux Falls: Couldn’t meet pt’s needs, low cognitive function, and FAS diagnosis
-Gerard: Couldn’t meet pt’s needs and FAS diagnosis
-North Homes: CMHCM referred for 35 day evaluation, still working on an acceptance
-Avanti: Pt’s legal guardian did not consent due to distance away from home
-Boys Town, Nebraska: Declined due to FAS diagnosis
Continue with established outpatient providers:
-CMHCM: Des Moines Valley Health and Human Services
-Medication Management: Windom Hospital
-Individual Therapist: Greater MN
This is patient’s 5th psychiatric inpatient hospitalization. Patient’s current admission is due to increased suicidal ideation, behavioral dysregulation, and homicidal threats towards staff and peers at school. Patient has utilized outpatient mental health supports such as psychotherapy, medication management, children’s mental health case management, children’s therapeutic support services, vocational rehabilitation skills, as well as group home and respite care. Patient has engaged in partial hospitalization program twice.
CH-F16-3295
Patient presented to the ER with concerns for SI. The patient has had multiple residential and inpatient hospitalizations and reports they will not be safe if they return home. The patient was discharged from a 13 month stay in residential in January and was discharged from a 2 week inpatient stay in February.
PH-F10-2765
Update 2/22/224- Admission to Grafton tentatively scheduled 2/28/24, can discharge interim pending availability.
Update 2/15/24- waiting admission to Grafton end of Feb- date pending- can discharge home interim, pending availability.
Pt is medically cleared for discharge- parents informed county they need to pursue crisis respite for patient.
Discharge Plan:
Residential treatment referrals-
Grafton PRTF (Accepted, next opening tentative end of February)
Northwood Children’s (Referral not sent d/t insurance)
Nexus-East Bethel (Denied d/t not in 6th grade)
Nexus-Gerard (Denied d/t functioning for programming)
Avanti Center (Referral not sent d/t patient’s age)
VOA-Bar None (Referral not sent d/t patient’s age)
Heartland Girls’ Ranch (Referral not sent d/t patient’s age)
Nexus-Mille Lacs (Referral not sent d/t male only programming)
North Homes (Referral not sent d/t patient’s age)
Newport Academy (Referral not sent d/t patient’s age and insurance)
PrairieCare Residential (Referral not sent d/t insurance)
Village Ranch (Referral not sent d/t patient’s age)
Northwest Passage (Referral not sent d/t patient’s age)
Dakota Boys & Girls Ranch (Referral not sent d/t not ND resident)
Rogers Behavioral Health (Referral not sent d/t insurance)
Plan to bridge until residential availability:
Cradle of Love (Accepted, pending county funding)
Northwood Children’s Shelter (CM placing referral)
Kindred Care (CM placing referral)
MCCP Crisis Respite (CADI CM placing referral)
Trauma focused/attachment therapy (Referrals to be placed by CM)
Continue with established outpatient providers:
Ramsey County CADI- (Shakir Consulting Services)
Ramsey County CMHCM- B
PCP- (Entira Vadnais Heights)
OT- Fairview
CTSS- (Nystrom & Associates)
PCA/companion care 3x/week
MHF-F14-3259
Patient arrived from Divine Institue due to aggressive behaviors towards a peer, unable to return to facility. County working on shelter referrals and long term placement options.
MHF-M17-3191
Presented from home following an episode of aggressive behaviors. History of FAS, parents do not feel safe with patient returning to their home. Seeking crisis respite or shelter placement for patient. Has been calm and cooperative in the ED.