A 16-year-old female with a history of mood disorder, borderline personality disorder, PTSD who presented to ED with suicidal ideation, threatening behaviors towards her family, and altered mental status. She also struggles with low frustration tolerance, severe emotional dysregulation, and a lack of coping skills. She is currently awaiting inpatient placement.
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-F15-1621
Updated 10/23/23: DC home to in home therapy through CIBS. Still no county funding for QRTP
Updated 10/19/23: Still no county funding for QRTP. Discharge home 10/23 or 10/24 with in home therapy through CIBS.
Update 10/12/23: Still no county funding. Likely moving forward with CIBS at Gerard, will likely discharge next week home.
Update 10/5/23: Gerard admission pending 10/11 now. County funding remains pending. Pt declined from CD RTC noting Mental Health long term RTC.
Update: 9/7/2/3 Gerard admission tentative 9/20, pending county funding.
Update: 8/31/23 Approved for Gerard admission week of 9/18, pending county funding. Also accepted at NorthHomes, 3-6 month waitlist.
SI since the 4th grade, history of trauma, living in cars/shelters, history of CD use.
Discharge Plan:
Primary DC recommendation is RTC*:
Gerard (accepted; pt is next on list for placement; openings week of September 18th)
North Homes (accepted; 3-6m waitlist)
CRTC (referral placed; admissions paused due to staffing)
Avanti (referral not placed; facility not accepting referrals)
*QRTP/RTC County Funding needed as pt has a UCARE PMAP Plan:
Dakota County CMHCM: Referral Placed
-Mother lives in Dakota County and father lives in Rice County (pt will reside with mother following hospitalization, mother provided consents)
-Le Suer County and Scott County CMHCM previously referred to: Cancelled Referral due to Family Moving
PH-F15-1865
**Update 10/18/23: Patient discharged home with outpatient supports, while awaiting Group Home placement**
Patient came to inpatient hospital from residential treatment, patient cannot return to RTC and is not being recommended to attend RTC at this time. Patient in need of group home placement. Adoptive parents are legal guardians and have verbalized that the patient cannot return to their home.
County currently pursuing:
-Group Home (CMHCM pursuing this)
Current/In Progress Wraparound services:
Continue CADI Waiver Services through Hennepin County
Continue Medication Management with Associated Clinic of Psychology
Continue PCP with Sara Brandt at Southdale Pediatrics
Continue with Jessica at Southdale Pediatrics
Continue CMHCM with Doug Inwards at Hennepin County (612-490-9342)
Continue BCBS Insurance Case Management with Allison (888-815-7461)
MHF-M14-1900
Patient presents to the ED via EMS after his group home called 911 due to patient’s aggression. Patient reports that he threw a stool at staff when they asked him to go to bed. Group home to determine whether they will take him back.
Patient has a previous mental health diagnosis of Mood Disorder, Intellectual Disability, Nocturnal Enuresis, Anxiety, ADHD and Autism Spectrum Disorder. Medical records indicate patient presented with similar behaviors to the ED, including defiance, a history of emotional and behavioral dysregulation, and acting out towards staff.
This is patient’s 6th visit in the ED in 2023 for behavioral and/or mental health.
RMC-M12-1802
2nd visit to RMC in one week for running away (from school and from home). Verbally abusive towards authority (Sheriff’s Dept. and his grandparents). Recent theft (stole a sweatshirt from the mall) and violation of school policy (vape found in locker). Patient is refusing to return home with grandparents (legal guardians since 10 months old), now claiming they physically and emotionally abuse him. Hennepin Co. CPS has no concerns with safety at home. Patient is now making threats to grandparents, expressing that he wants them to “be murdered.” Grandparents are concerned for their safety after threats made by patient.
MHF-F13-1289
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.
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.