Presented from partial hospitalization program (Clara’s House) for worsening aggression and self-harm. Has had in-home skills worker and outpatient providers. Was referred to Clara’s House for worsening non suicidal self-injurious behaviors. Recommended residential treatment due to attempting all lower levels of care.
Psychiatric Diagnosis: Autism Spectrum/PDD
Autism Spectrum/PDD encompasses a range of neurodevelopmental disorders characterized by difficulties in social interaction and communication, as well as restricted and repetitive behaviors. Autism is considered a spectrum because it can vary in severity and presentation.
MHF-M13-6110
Pt came to FV ED from North Homes, after aggressive behaviors, and they are unable to take him back at this time, stating he needs a higher level of care. He has a history of aggression and often refuses medications. Grandparents are the current custodians and are unable to have him. A referral has been made to CABHH however their wait list is long. A DA is being completed by an OP provider 9/24 as there is not a current one. MNchoices is also being completed 9/24.
PH-M15-6144
Recommedning PRTF/RTC
15 year old male who presents to PrairieCare Inpatient Hospital due to suicide attempt with increased SI and SIB.
He has a history of several inpatient stays, has engaged in PHP, individual therapy, family therapy, and RTC at Gerard
Funding is in place for RTC with Polk County
Discharge plan as of 9/29:
PRTF/Level 6 (referrals placed by CMHCM, Approved by AFMC for PRTF)
– Northwood (reviewing, waitlist 3-4 months)
– Nexus East Bethel (referral submitted, reviewing possible opening early Oct.)
– Grafton (referral submitted, under review, declined due to inability to support level of care)
– Leo Hoffman Center (CMHCM to resubmit referral, declined due to safety concerns and inability to provided 1:1 staffing, able to re-refer upon further stabilization)
QRTP/ Level 5:
– Return to Nexus Gerard (under review, declined to return. Discharge effective 9/12)
– Bar None Haven (referral submitted)
MCR-F16-5994
She had been residing at Von Wald 180 Degrees since May. Big escalation on 8/19 and brought to ED. Unable to return to Von Wald; parents are guardians but unwilling to have her in their home (possibly homeless?) and want to terminate their parent rights. Mom is difficult to get in touch with and wants all communication through her attorney.
CH8SCH-F16-6006
Was in metro area with adoptive parents. Placed at Youth Shelter in St. Cloud. Came to hospital. Shelter d/c’d her and refused to pick her up. Ramsey probation and SW already involved. Adoptive parents want to relinquish any rights to patient as aggression is focused on mom.
MHF-F17-5914
Came to our ED from her CRS home, who issued a temp suspension and are not allowing her back at this time. On DD waiver with DD CM. No other CM involvement currently. Has IQ of 60. Last DA completed in March recommended PHP. On list for crisis respite.
MHF-M10-5723
Youth came to our ED 5/28 from home after an escalation. Mom unable to take him back currently. Dakota County CPS has a custody hearing today, 6/4/25. If given custody, they will be working on foster/shelter placement and kinship. All have been explored in the past for this kiddo, but previously denied due to behaviors. Kiddo has trauma history and does very well in school, only behavioral at home. Unsure if there is a current DA- team is looking into it. Its reported by CPS that they tried to get CMH CM for kiddo 4 months ago but that was denied. No waiver currently.
MHF-F15-5707
Youth came to our ED on 5/24/25 after physical altercation at Red River Valley placement, and they refuse to let her return. Has history of physical aggression and a rule 20. Has boarded with us multiple times prior- 12/5/23-12/29/23, 2/13/25-2/27/25, and 3/6/25-3/12/25. Looking both in and out of state for placements that might take her.
AH-M15-5556
Impression of Crisis Behavior (precipitants): Patient presented to the ED due to agitation and SI. The identified precipitant for this crisis is a verbal and physical argument with his mother and her boyfriend at the home. Patient was released from the JDC to home on 4/5/25.
Vulnerabilities: adolescent, ASD, h/o trauma, recently released from JDC, parent-child conflict, inadequate outpatient supports
Behaviors / Symptoms to address in the ED: deferred
Methods to increase desirable behaviors in the ED: meet basic needs, set behavioral boundaries/limits,
Barriers to Discharge include: At this time, patient is NOT felt to meet criteria for inpatient hospitalization. There are no new acute safety needs that warrant admission. His mental health concerns are chronic and environmental.
Mom is refusing to take him home, JDC won’t take him back as there are no new charges and he has no place to go. CPS is investigating allegations of abuse by parents and child but are not seeking placement. Mom does not consent to use of a shelter or Nexus YCT.
MCR-M9-5609
He has been in foster care since he was removed from home in 10/2022 due to physical abuse. He was in foster care with a family and was relatively stable until the past few months, when the foster father died and since then there has been an increase in behaviors. He is unable to return to that foster home. He has very low cognitive functioning, reported to be around a 3 year old, and he was attending school only a few hours per day. He was on a lot of medications and psychiatry has optimized them during his time here.