Pt is a 10 yo male presenting due to increased aggressive and impulsive behaviors at home. Pt was attempting to light fires in the home prompting mom to call EMS. Mom has other small children in the home and feels as though she is not equipped to care for him. Pt has trauma history and has had inpatient mental health stays in the past. County recently approved funding for PRTF. Looking for a shelter in the meantime. Has sexual concerns so that needs to be considered with shelter placement. Extensive sexual and physical abuse history. Mom unable to take him back at this time, other children in the home. Has not has any sexualized behaviors while at the hospital. Nexus Mille Lacs is able to take someone with potential sexualized behaviors – and is interested in this child. Connecting offline.
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-F16-1369
*UPDATE: Admission to Gerard 7/28/23- just pending county funding at this time, 2nd screening today, 7/20
16 YO Female in 10th grade. Two previous psychiatric hospitalizations (2/23/22-3/4/22 and 9/17/23-9/27/23) in addition to the current admission. Has attended Day treatment. No alcohol or Drug use. Increasing SI and history of self harm. Hx of sexual abuse at age 9.
DISCHARGE EFFORTS:
-RTC: Avanti Center for Girls (Referral sent, pt accepted, 6 month wait list)
-RTC: Gerard Academy (Referral sent, pt accepted, admission, 7/28/23, pending county funding)
-RTC: North Homes (Referral Sent, pt approved, opening estimated for August-September)
-RTC: Northwood Children’s Services (Referral Sent)
Interim Plan:
-Day Treatment: TSA (pt able to return if/when it is safe to DC)
-CMHCM: Janet, Isanti County
-DBT: (SW to provide resources upon DC for guardian to use after RTC)
AH-F15-1322
came to ED with suicidal and homicidal threats after an upsetting conversation with former foster provider – currently denies HI/SI to staff, unable to be placed with former foster provider, difficulty at group home – arguments with staff and other residents and they have said she is unable to return, CPS worker is guardian and looking for placement,
Nexus -FACTS
– youth has been accepted at Nexus FACTS for assistance with Placement Coordination Services.
MHF-M9-808
Patient is presented to the ED by EMS for aggressive behavior towards staff and another resident in his group home. At the group home staff brought the patient out to his school transportation but the patient became dysregulated when he saw the driver was different from prior trips. Patient then eloped to a neighbor’s house where he entered. Staff followed and called the police. Patient was brought back to the group home, but later got into a physical fight with another resident and staff member. Police were called a second time, and patient was transported to the hospital using restraints. The patient has a history of ED visits and has had approximately 6 previous hospital admissions (5/21; 7/21; 10/21; 11/21; 12/21; 9/22). The patient has a diagnosis history of DMDD, ODD, ADHD, GAD, depression, and RAD
MHF-F13-1411
Pt presents to the ED via EMS for the following concerns: aggression. Pt was refusing to take her medication, and became aggressive with her parents when they tried to make her. Parents called 911 due to pt becoming aggressive with them, and punching holes in the walls. Medical records indicate mental health diagnosis of Unspecified disruptive impulse control and conduct disorder, major depressive d/o, unspecified anxiety and binge eating d/o. Pt has a rule out diagnosis of autism spectrum d/ and other neurodevelopmental disorder. Pt has a hx of mental health admissions as follow: 3/12 – 3/17/2023. Pt had frequent visits to the ED due to behavioral and emotional dysregulation at home as follow 3/20 – 3/21/2023, 3/22-3/31/2023, 04/02 – 04/03, 04/07-04/11/2023, 04/18/23, and 4/19- 04/20/2023.
PH-F13-458
Pt has had 4 psychiatric hospitalizations, PHP twice, and outpatient services. Needing RTC and bridging plan. >Discharge from PC Inpatient is 5/11 at 1400, will discharge home until RTC.
Discharge Plan:
RTC-
Avanti (Referral made, declined for admission due to history of aggression)
North Homes (Referral made, 6-8 week waitlist)
Village Ranch (Referral made, pending acceptance)
Gerard (referral made; pending acceptance)
Northwood (referral not made; waitlist over 6 months)
Newport Academy (referral not made; insurance not accepted)
Grafton (CMHCM making referral; though likely doesn’t meet criteria due to no ASD/ID/DD diagnosis)
CRTC (referral placed)
Interim Plan:
Consider PCR (referral not made; insurance not accepted though possibility for a county contract- connecting county worker and PCR)
Continue Psychiatry at Nystrom and Associates
Continue Probation services at Goodhue County
Continue CMHCM at Fernbrook
Establish Family therapy at Nystrom and Associates.
Establish CADI worker at Goodhue County
update as of 6.22.23 – Denied acceptance at CRTC due to aggression and lack of buy in
MHF-M16-1239
Pt is presented to the ED via EMS due to possible ingestion of cold medications. Pt’s father had called 911, reporting patient’s presentation as being confused and “high” on drugs. Pt admitted to taking pills (unclear about the number of pills) in order to get high. He denies that this was a suicide attempt, and currently denies any suicidal ideation. Pt denies recent self-harm, but has a hx of self-harm over one year ago. Pt lives with his father during the week, and mother on the weekends. Medical records indicate the following history: He has a history of major depressive disorder, generalized anxiety disorder, and substance use disorder. He had been evaluated in the ED for close monitoring in the setting of altered mental status secondary to presumed toxic ingestion of unknown substances, and has a history of multiple inpatient psychiatric admissions. Most recently admitted in March 2023 due to “ingestion/inhalation of multiple substances, including dextromethorphan and benadryl”. Pt has a history of residential treatment, and has a hx of substance abuse for several years and participating in both inpatient and outpatient treatment.
MHF-F6-1228
Pt presented to the ED via EMS after jumping out of her mother’s car into traffic, stating that she wanted to die. Pt lives with her mother and brother, who moved to MN from TX in December of 2022, to escape domestic violence and pervasive sexual trauma. Pt has a history of significant sexual abuse from their father, including sex trafficking. Pt has been screaming, kicking, and running outside, placing the family’s housing at risk.
HCMCH-16-1073
Patient is a ward of the State of MN, she has been unsuccessful in foster care placements the past 3 years. She attends a Level 4 school, Reach Academy. Patient in need of higher level of care, group home.
Patient discharged to kinship foster care 6/15/23 while Legal Guardian/Social Worker is still pursuing group home placement. Namia House, Willow Trails.
MHF-F18-995
Patient is presented to the ED by EMS from an RTC facility. Patient assaulted another resident and staff members, and attempted to elope from the facility. Patient is under guardianship of Martin County, and is considered a vulnerable adult. Patient has a significant history of abuse, and suicidal ideation. Patient is supposed to follow a low sugar and fat diet due to pancreatitis.