LAHC-M14-6887

Has been with us since January. Arrived from Prairie care from Mayo Clinic before that for verbalized increase in SI and engaging in SIB. History of abandonment from bio mother and apparent abuse and substance use in the household per history. History of temporary foster care. Difficulty with boundaries and impulsive behaviors. Often losing his temper, being easily annoyed and irritable, arguing with adults of authority, and not complying with rules/structure. Current and historical property destruction and elopement. Behavioral instances at school, threatening gestures and actions. History of vaping nicotine “if I have it I will use it” mentality. Witnessed DV, history of homelessness, and physical abuse.

PH-F16-7411

Recommendation is for residential treatment. Patient presented to the hospital from the ED for acute safety concerns related to self-injurious behaviors and suicidality following an assault on patient by other residents in a shelter. Patient has a history of multiple inpatient hospitalizations and residential treatment.

C8SM8SP-F12-7384

Child came to the emergency department after getting into an altercation with grandmother at home. Child had gotten physical with grandmother due to phone usage. Child’s legal guardian is grandmother and does not have contact with bio parents. Child has a long history of trauma. Child’s aggression is only toward grandmother; they have also presented to the ED on 5/7, 6/29, 7/8, and 7/28 for similar situation (physically aggressive towards grandmother). Grandmother is refusing to discharge child back into her care.

CH8SCH-F14-7113

Patient presented to ER following discharge from residential due to aggression to staff and eloping. No other placement locations as she is not able to return to previous foster placement. Patient with poor boundaries, impulsivity, and instigates other peers to engage in negative behavior. Behaviors worsen in an attempt for connection seeking and to obtain friendships with peers. Patient has been on a 1:1 or close observation through the entirety of her stay as she will engage in negative behaviors to seek connection including self harm, opposition, and defiance.

MHF-M15-7373

This youth came into our ER 9/13 from Grandparents home, who are custodians. He was just in our inpatient unit until 9/11. He came in for suicidal ideation and was cleared for discharge. It’s reported by his team that ongoing he uses suicidal threats to get out of unpreferred activities, and if that doesn’t result in what he wants, he escalates further. He had safety planned with our team for discharge, but when Grandma called him on 9/14 to discuss, he was making suicidal statements to avoid returning home and Grandma then refused to get him. Grandma tried to get him again 9/16 but when she showed up to the ED he escalated and threw an object at her and she left the ED. It’s reported he’s been struggling since the death of his great grandma early last month. Currently there is no recommendation for residential or higher level of care. He’s done PHP in the past and is currently set up with CTSS, DBT, Individual therapy, family therapy and psychiatry at home, but has been in the hospital a lot so hasn’t gotten a lot of these services, and uses suicidal statements to get out of participating in some of them. The County is not exploring any out of home placements at this time. Bereavement counseling and respite were discussed, but those can’t begin until he is discharged. He has endorsed that he enjoys the hospital setting and ambulance rides.

PH-F15-7244

Recommendation is QRTP or PRTF.
Patient presented to PrairieCare Inpatient Hospital after suicide attempt by hanging on two consecutive days while at Avanti Center for Girls Residential. She has been at 3 different residential treatments (North Homes, Bar None Haven, and Avanti). This is her 4th psychiatric inpatient hospitalization.

Discharge Plan:
Establish QRTP/PRTF:
-Avanti (discharged d/t suicide attempts and elopement concerns)
-PrairieCare Residential (declined d/t suicide attempts and elopement concerns at Avanti)
-Grafton (referral sent)

Outpatient Providers:
Red Lake Ombimindwaa Gidinawemaaganinaadog (OMBI) Program: Outpatient therapy
Sagent Behavioral Health: Medication Management/ Psychiatry Services

PH-F15-7329

Recommendation is for QRTP.
Patient presented to Inpatient from the ED after disclosing suicidal thoughts to her outpatient therapist with a plan to overdose on her prescription medication she had been saving. This is her 2nd psychiatric hospitalization in 2026.

Discharge Plan as of 9/9/26:
-North Homes: Referral sent, guardian declined to pursue further
-Gerard: Referral sent, guardian declined to pursue further
-Newport: Patient declined for admission due to continued endorsement of SI/SIB and recent self-harm
-PrairieCare: Admission was available on 8/31, guardian declined in favor of pursuing Avanti
-Avanti: Accepted, awaiting admission timeline

MHF-F15-4948

Came to us 12/9 after altercation at home with sister. Was recently inpatient for 9 days until 12/5. Parents are refusing to pick pt up. County has offered to set up CTSS services for family immediately and family refuses to work with the current Case Manager. No one is currently recommending out of home placement. Parents are wanting RTC. Has CADI waiver and contracted CM. We are continuing to work with the family and team to get her home.

MHF-F16-4834

Kiddo came to us on 11/7 from East Bethel PRTF. East Bethel has discharged reporting they are unable to meet his needs based on his ongoing SI and behaviors. They are completing a referral to CABHH. Has a long history of SI. There is currently no County involvement. Aunt is working on setting up CMH services, but County has reported they don’t have any placement options. Our team will be requesting County look at approval for out of state options once they are open due to limited options in MN for this level of care.

PH-F16-7247

Recommending outpatient wraparound services.
16-year-old female who presented to PrairieCare after being brought to the emergency department from their group home after an increase in suicidal ideation after intervening twice with a peer’s suicide attempt in the group home.
Patient has a history of 5+ inpatient hospitalizations, group home and PRTF placement.
Children’s mental health case manager is pursuing RTC and group homes as an alternative to home. Referrals were sent to:
– Northwoods (PT has been on waitlist, anticipated timeline at least 1 year as of 07/29)
– Community Living Options
– Little Sands
– Nexus Gerard RTC
– Avanti
– PORT
– Acadia Healthcare
– South East Regional Crisis Center (SERCC)
– Boys Town RTC in Nebraska
– North Homes RTC
– Village Ranch