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.
Psychiatric Diagnosis: Depression
Depression is a psychiatric diagnosis characterized by persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in activities.
PH-F17-4728
Patient is needing an out-of-home, secure, placement, due to ongoing, chronic, safety concerns, that are unable to be managed at home. Patient is recommended to attend Residential Treatment or enter into a supportive living environment.
Patient has a significant psychiatric history including:
Psychiatric hospitalizations
-Mayo Clinic Generose 08/2019
-PrairieCare 10/29-11/11/2022
-PrairieCare 08/30-9/7/2023
-Mayo Clinic Generose 09/2023
-PrairieCare 11/8-11/20/2023
-Mayo Clinic Generose 12/2023
-Mayo Clinic Generose 04/2024
-PrairieCare 06/25-7/11/2024
-PrairieCare 07/25-8/14/2024
Residential Treatment:
-North Homes for a 35-day evaluation
-Gerard 08/2020-06/2021
-Gerard 12/2022-06/2023
Day Treatment:
-Fernbrook Family Center
Partial Hospitalization:
-Mayo Clinic November 2021, June 2022; Prairie St. John’s February 2022 and July 2022
-PrairieCare Rochester 11/16-12/21/2022
-PrairieCare Rochester 09/11-9/15/2023
-PrairieCare Rochester 09/19-10/11/2023
History of self-harm by cutting (recently daily), with one prior reported suicide attempt (by overdose, 6/2024), who re-presents to PrairieCare inpatient due to safety concerns related to self-harm by cutting, with increasing suicidal ideation and intention, with an inability to contract for safety, in the context of stressors related to school re-starting.
CH-F14-4759
Patient presented to the ER following an intentional overdose to end her life and had just started PHP the week of admission. She had an additional overdose of the same medications in March 2023 and has had reported several other suicide attempts. Patient is on probation for assaulting her mother and has a history of running away, physical & verbal aggression, sexual misconduct (sending nude photos of herself to adult males for money), alcohol/chemical use, school difficulties, and parent/child conflict.
CH-F13-4756
The patient is a 13 year-old female with a history of ADHD, inattentive type, anxiety, depression, sexual abuse, suicidal ideation, and self-injurious behaviors that presented to the ER following an intentional overdose in an attempt to end her life. She has had 2 previous inpatient hospitalizations. Patient has a complicated home life with several CPS reports and basically does the caretaking for her younger siblings. Patient has several tattoos given to her by her mother and sister and mother is unwell as well and frequently struggles with suicide attempts and self-harm. Sounds like a significant sexual abuse history within the entire family that may still be occurring. The patient is at risk for sexual exploitation given increased sexuality.
HCMCH-M12-4692
12 year old male with ADHD, unspecified mood disorder with recent suicide attempt, T1DM, hypothyroidism, asthma who is in the ED after intentionally setting fire and burning house down. Has an IEP for speech therapy.
PH-M15-4658
Pursuing QRTP – patient is currently in psychiatric inpatient hospitalization.
Patient is a 15-year-old male. He presented to inpatient via ED due to increased SI and SIB. He has three historical inpatient hospitalizations, has done DBT and outpatient psychotherapy services, and most recently was at Newport RTC – although was discharged early due to aggression and property destruction.
From an acute psychiatric standpoint, youth is safe to discharge form inpatient care and receive services in the community prior to admission to QRTP. He has made significant progress on treatment goals during hospitalization.
Discharge Plan:
Referrals sent to the following residentials:
– Omegon Ascend (Reviewing, no current waitlist)
– Nexus Gerard (Reviewing, waitlist about a week)
– Nexus Mille Lacs (Reviewing, Current waitlist 2 months)
– North Homes (Declined d/t hx of aggression towards others)
– Northwood (Received, 6-9 month waitlist)
– PrairieCare Residential (Reviewing, 2-3 week waitlist)
Alternative Placement through Wright County:
-Wright County unable to identify alternative placement as of 9/24/24
Plan to bridge until residential:
PrairieCare PHP at MOB (unable to pursue establishing care at this time due to pt continuing to be hospitalized)
Continue with established outpatient providers:
Individual Therapist- Bridging Hope Buffalo
Medication Management- LifeSpan Mental Health Monticello
PCP- HealthPartners Elk River
CMHCM- Wright County
Neuropsych Testing- Clary Clinic St. Cloud
PH-F16-4545
Recommendation is now for level 6 PRTF. Patient is currently in psychiatric inpatient hospitalization.
Patient is a 16-year-old who identifies as non-binary using they/them. They presented to inpatient from ED due to increased SI. This is patient’s 14th psychiatric inpatient hospitalization. They have participated in outpatient services and PHP historically.
Patient was initially recommended for level 5 QRTP by inpatient providers although Dakota County recommended level 6 PRTF.
Discharge Plans:
PRTF (county determination/recommendation – DHS approved)
-Nexus East Bethel (referral submitted & under review)
-Grafton (not an option as they do not meet admission criteria)
-Northwood (referral submitted; two year waitlist)
RTC: (county declined funding for level 5 QRTP, recommended Level 6)
-Avanti (declined)
-Gerard (referral sent, unable to move forward due to lack of funding)
-North Homes (referral sent, unable to move forward due to lack of funding)
Established outpatient providers:
Individual Therapist: Your Vision
Psychiatrist: Associated Clinic of Psychology
PCP: Allina Healthcare
CMHCM: Dakota County
PO: Dakota County
HCMCH-M17-4606
17 y/o male with MDD with psychotic features, neurodevelopmental disorder, intellectual disability. He recently discharged from CABHS. Waiting for MSCOCS placement hopefully will be admitted on 10/2. There concern of excessive irritability, agitation, disorganized thoughts, delusions, history of auditory or visual hallucinations, history of self injury and impulsive behaviors leaving to being in dangerous situations.
MHF-F12-4571
Pt came to our ED on 9/6 following a verbal altercation with foster parent. Foster parent is refusing to let kiddo return. County has custody, limited parental involvement. Was supposed to begin Fairview’s PHP program 9/10 however is unable to being in the ED, should be able to begin that program once placement is found. County is currently searching for shelter/other foster care options and screening for MH group home placements.
MHF-F17-4510
Came to ED after altercation with mother. Ongoing family conflict between Mother and Daughter. CPS has just began getting involved on case. Currently mother is telling our team we must admit to IP and has not been willing to sign any ROIs to proceed with anything as of yet. Unable to proceed with any placements, waiting for further direction from CPS.