Update 9/28/23: Has potential placement. Awaiting.
Patient was brought in by medics after she was physically aggressive with a staff member at The Aspen House, where she has been living for two months.
Patient has adoptive parents and adoptive siblings. She was adopted when she was two years old, and has recently reconnected with bio-dad.
Patient had prior diagnoses of depression, ADHD combined type, anxiety, neurocognitive disorder related to maternal meth abuse while patient was in utero, and learning disability. She’s been in M Health FV IOP, since she’s been there. She does not participate in groups or other activities much. She’s been in an inpatient mental health unit, mostly at M Health FV, at least four times. The last admit was 4/21-4/27/2022 at FV. She’s had the following RTC placements: Eau Claire Academy, 4-8/2022, CRTC 8/2022-1/2023, and Avanti 1-4/2023. She receives Psychiatry and Therapy services through the group home.
She has had two prior suicide attempts by choking herself.
Psychiatric Diagnosis: Anxiety
Anxiety disorders are a group of psychiatric diagnoses that involve excessive and persistent worry or fear. These disorders can significantly impact daily life and well-being.
SMCW-F15-1775
Pt is brought to the ED by law enforcement due suicidal ideations. Pt has a long standing mental health history. She Has been hospitalized innumerable amounts of times for suicidal ideations. In August alone, she was hospitalized for mental health twice. She has a case worker with social services who is supposedly working on long term placement for her. She is living at home again. In the past, it has been shown that this living situation is not ideal and she has innumerable mental health hospitalizations as she reports self harm and suicidal ideation and plans. 2 days ago, she was walking in the road hoping to get hit by a car. The sheriff was called and pt removed herself from the road and went back home with her mother. Crisis team was called again last night. Pt was outside walking and threatening self harm for 12 hours. Her CSS worker was there during this time. She threatened to hang herself with the clothes line. She finally agreed to go home and watched TV until she fell asleep. She slept until 1:30 pm today. Tonight she was at the church and took a cord and wrapped it around her neck threatening self harm. Law enforcement was contacted as she was refusing to leave the church. She was brought to the ED for evaluation.
Pt reports she doesn’t feel safe to return to home. She reports she wants to die and threatens to cut herself or overdose on medication.
Mother reports pt has a PCA that she stays with. This PCA is her cousin. The cousins father died and pt has not been able to go to stay with her for the last week. Pt has been staying at home with her mother, father and siblings.
Mother reports that this is overwhelming to her and her other children. Supposedly social services is working on long term placement for this patient.
HCMCH-F15-1627
15 y.o. female with history of childhood sexual abuse and more recent sexual exploitation in 2023 with concern for victim of sex trafficking. Presents with suicidal ideation, self-harm behaviors including substance abuse. During this admission drug screen positive for fentanyl and methamphetamine. Patient transferred from HCMC to Sacred Hearth Inpatient Behavioral Health Unit 8/23/23; long term recommendation is residential care. Substance use and placing self in high risk social situations occurs in the context of her trauma history.
MHF-M16-1654
UPDATE : Transferred to BAr None shelter 9/13/23
UPDATE 9.7.23 – working with Nexus FACTS for Placement Coordination Services. New Diagnostic Assessment 9/7.
Patient presents to the Emergency Department from a residential treatment facility, following attempted self-harm and suicidal ideation, with a plan to slit his throat with a screw. Staff monitored and stopped the patient from harming himself. The patient experienced intense emotions as he thought about the trauma he experienced at the hands of his father.
Patient was seen in the ED on 8/14/2023 with a similar presentation. Medical records indicate a hx of physical and sexual abuse, conflicts with his father, patient had pulled a knife on this father, and hx of substance abuse. Patient denies current substance use, and has 60 days of sobriety.
8/24- Patient was discharged from residential facility
MHF-F14-1736
Patient presented to the ED via police due to physical and verbal aggression, threats to kill group home staff members, and damaging property. Patient became upset with group home staff after they questioned where she had received money during a shopping trip. After returning back to the group home, patient threatened to kill staff and threw a brick at their car. Group home staff report that patient is demonstrating a pattern of unsafe behavior and are not allowing her to return, citing police involvement on multiple occasions.
PH-F16-1316
UPDATE: Pt discharged home with improvement of some symptoms and wraparound services. CABHH and PRTF referral stand.
16 yo adopted white gender fluid/nonbinary adolescent with Albinism of Otter Tail County. No hx of attachment concerns. Delay with speech. Some historical cognitive and attentional concerns. No substance use. Expressing SI, SIB urges and lability. Hospitalized twice in early 2023 until admission to PrairieCare RTC on 4/11/23, needing a higher level of care, admitting to Inpatient 4/18/23. Patient has severe lip biting when dysregulating causing multiple lip lacerations, requiring suturing.
DISCHARGE PLANNING EFFORTS:
Primary Recommendation is CABHH; Referral made, on waitlist.
Residential Treatment or PRTF consideration:
-Avanti; referral made, declined due to aggression and seclusion history
-Northwoods; referral made, on call back list, 9 month waitlist
-North Homes; referral made, accepted, waitlist out to mid-summer/fall 2023> still would need QRTP funding*
-Gerard; referral made, reviewing, declined due to staffing needs in educational settings
-CRTC; referral made, declined
-Heartland Girls Ranch, county SW to refer
-Village Ranch, county SW to refer
PRTF:
-Grafton, referral made, denied, can reach out in a couple months for re-review due to their staffing
-NorthWoods, waitlist 12 months
-Leo A Hoffman; referral not made, only accepting Male patients
Out-of-state RTC:
Guardian declines referrals for out-of-state placement at this time
*QRTP funding is not in place- Parent does not consent to Relative Search which Otter Tail County uses in the QRTP pre placement screening process.
PH-F10-1534
UPDATE 8/31/23: Discharge to family with wraparound services planned for 8/31/23 at 1300 while waiting next Gerard admission (tentative late September) as QRTP pre placement screening has now approved.
UPDATE 8/24/23: Pt remains accepted to Gerard, next admission now late September. QRTP pre placement screening team approved 60 days RTC as of 8/24/23. We will discharge home with wraparound services while waiting RTC admission.
UPDATE 8/8/23: Pt is accepted to Gerard and can admit tentative 8/21- pending preplacement screening/QRTP approval from Hennepin County.
10- year-old female with a history of anxiety, depression, social difficulties, anger and trauma. Aggressive behaviors and increase in suicidal ideations. Has participated in PHP, individual therapy, and psychiatry. Insured by BCBS PMAP.
DISCHARGE PLANNING EFFORTS:
Primary Recommendation: Residential Treatment.
Patient recommended to return to home/community with wraparound services while waiting for Residential. Discharges have been attempted, patient threatened grandmother. (Patient cannot return to mother or to grandmothers- CPS involved)
Wraparound:
Establish CMHCM (Referral to be made internally from CPS case worker)
Establish CTSS (Referral completed to Summer Counseling, reviewing; Referral completed to MN CarePartner, on waitlist, 2-3 months)
Establish FT (Referral completed to Family Attachment Center and Empower)
Continue Individual Therapy with Rachel at ELEOS Psychology Center
Continue Psychiatry with Catherine McCormick-Deaton, DO at Allina Health-St. Paul
Continue PCP at Allina Health-Maple Grove
Residential, when available due to waitlists*:
Consider Nexus-Gerard RTC (Declined due to aggression, being re-reviewed currently)
Consider Northwood Children’s RTC (Referral sent, waitlist 6-9 months)
*Juvenile Treatment Screening with Hennepin County needed to request funding for QRTP/RTC level of care. CPS worker aware of request.
Estimated length of stay:
Patient is medically ready for discharge as of 6/30/23
MCR-F15-1269
UPDATE: Mom wouldn’t sign ROI for CRTC to she still awaits placement.
Patient is a 15 year-old with a history of PTSD, MDD, and GAD. She has a history of five previous psychiatric hospitalizations and one premature discharge from residential treatment this past spring after restricting her food and water intake (start of present hospitalization). Nutritional intake has continued to decline to the point of needing tube feeds to meet daily nutritional requirements, with symptoms more closely resembling anorexia nervosa at this time.
Patient is already connected with medication management, county case management, CPS, and psychotherapy.
MCR-M16-382
Update 7/27 Genesis Group Homes is pursuing an intake to potentially utilize crisis services.
16 year old adopted from Ecuador at age 8 (with twin brother with similar difficulties, as well as 2 other siblings without similar struggles), with ASD and intellectual disability, associated with a microduplication at chromosome 8p23.1, likely in-utero substance exposure, as well as early life neglect (living in an orphanage for much of his young life). Significant aggression difficulties that are becoming more unmanageable by family as he grows larger; unsuccessfully discharged from Chileda in November 2022. Family have financial resources and have purchased a second home for the boys and hired private caregivers in the evenings, but their income limits eligibility for MA and state-funded services. New behavior analyst started working with the family in March. May be on the MSOCS wait list. Currently on the wait list for inpatient care at Kennedy Krieger near Baltimore (brother previously had a good experience there).