Patient presented from North Homes due to suicidal ideation and aggressive behaviors. Patient was initially recommended for IPMH however stabilized in ED and no longer required admission. Patient has been discharged from North Homes and is in need of long-term placement as she cannot return to guardian’s home. Case manager will be working on referrals for RTC and out of home placements.
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.
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
MHF-M16-3505
Pt was in residential at Prairie Care and was discharged due to behaviors/property destruction/aggression, not allowed to return. Just switched custody from one CPS worker to another so details of history are not complete, but information is being gathered. Know she was previously in out of state placement in Oklahoma where she was discharged due to physical aggression. County is looking at VOA- Bar None Haven and Nexus East Bethel, and hospital is referring to Nexus YCT.
PH-M16-3429
Update 3/29- Pt discharge home while waiting potential tx
16-year-old male presenting to PrairieCare Inpatient Hospital. Patient has a known past psychiatric history significant for Depression, Anxiety, Polysubstance abuse. Patient has had multiple psychiatric hospitalizations.
Discharge Plan:
-Dual Diagnosis RTC:
– MHealth Fairview – declined due to behaviors at previous placements
– Rogers Behavioral Health – cannot accept pts insurance
– Hazelden – cannot accept pts insurance
– MN Adult & Teen Challenge Lakeside Academy – declined due to behaviors at previous placements
– Wings – referral sent, pt denied in past
– Anthony Louis Center – CD only – declined due to dimension 3 score
– VOA Omegon Pathways – referral sent, will make determination week of 3/25/24, earliest availability mid-late Apr
Continue with currently established providers:
-Probation Officer: Swift County
CH-M17-3298
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.
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.
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.
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
ADYC-M14-1768
Update: 1/19/24 Pt. still looking for placement.
15-year-old male looking for a group home and residential program. Children’s Mental Health Case Manager has tried everything, and doors are being shut. Client has a physical aggression, verbal aggression, history of PTSD and sexual abuse. Client has experienced abuse from biological father who is in still in the home, and sexual assault that happened possibility of more than one with an older cousin sister. Client mother is giving up on hope on trying to help her child. Client is struggling at home, school, and community. Children’s Mental Health Case Manager has been trying everything to find a placement for him. He’s been going in and out of the ER like every two months now. Children’s Mental Health Case Manager still trying to offer support the way she can by being there every hospital stay, seeing client like twice a month, and having mom keep her on speed dial to talk to client.
Because of experiences, client is chemical dependent on marijuana, perks, and opioids.