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-M16-3492

Patient admitted to North Homes Shelter on 4/5 while awaiting North Homes RTC admission!

Update 4/3/24: Pt admitting to North Homes Shelter 4/5 at 1100 until North Homes RTC admission- Thank you, Connie!!!!

Insurance:BCBS MN PMAP

Case Description: Patient presents to PrairieCare Inpatient Hospital from the ED. Prior to the ED, she was at Village Ranch RTC/group home. Patient is no longer able to return to Village Ranch as they are recommending a higher level of care that can provide more supports, she also is not able to return home at this time.
Recommendation is for level 5 QRTP.

Discharge Plan:
RTC:
-Avanti Center for Girls (Referral sent)
-Gerard (Referral sent)
-North Homes (Referral sent, tentative opening beginning of May, interim North Homes Shelter)
-Village Ranch (pt unable to return due to recommending more support/higher LOC)

-CMHCM with Crow Wing County

PH-M15-3418

Update 4/10/25: declined at Leo Hoffman, East Bethel, Bar None Haven, does not meet criteria for Grafton, Northwood wait list 2 years. Discharged from Mille Lacs RTC.
Update 4/3/24- declined Leo Hoffman, East Bethel, Waiting to hear back from Grafton, Bar None Haven. Discharged from Mille Lacs. Northwood waitlist 2 years.
Update 4/1/24: Nexus East Bethel PRTF declined pt due to not having a male unit at this time.

15-year-old female identifying patient with a history of depression, anxiety, RAD, PTSD, ADHD, and ODD. Patient has been in and out of treatment settings for 3+ years and has not been at home since. Patient was at an unknown treatment facility and was discharged due to its closing, Northwood Children’s Services PRTF (discharged due to not needing level 6 care) and most recently has been at Nexus Mille Lacs RTC since October 2022. Patient has a history of four inpatient hospitalizations. Patient has been discharged from Nexus Mille Lacs RTC as of 3/20/24 due to them recommending a higher level of care.

Current provider:
CMHCM: Kanabec County

PRTF: (MN DHS eligibility submitted by county and approved)
-Leo Hoffman (declined due to pt acuity)
-Northwood (added to wait list, about 2 years)
-Grafton (pt does not meet acceptance criteria)
-Nexus East Bethel (declined due to not having a male unit)

RTC:
-Nexus Mille Lacs (pt discharged from program as of 3/20 due to lack of engagement)
-Bar None Haven (declined due to aggression and behaviors)

MN DHS Complex Transitions Team (in process of scheduling care conference)

MHF-F13-3515

Patient presented from North Homes due to suicidal ideation and aggressive behaviors. Patient was initially recommended for IPMH however stabilized in ED and no longer required admission. Patient has been discharged from North Homes and is in need of long-term placement as she cannot return to guardian’s home. Case manager will be working on referrals for RTC and out of home placements.

PH-F16-3524

Update 4/3/24- funding in place, waiting available RTC- accepted at Gerard and North Homes. Waiting to hear back from Avanti and East Bethel.

Case Description: Patient is a 16 y/o individual w/ hx MDD, GAD, ADHD, multiple previous hospitalizations, currently presenting due to SI. Patient went to foster care after discharge in previous hospitalization at PC ( october 2023) and returned to mothers home end of Dec after 1 month. Patient was hospitalized at Prairie St Johns for 1 week ( discharged 3/8) due to intrusive SI . Patient feels she was discharged earlier than she should have been because she was still struggling w/ “feeling safe”. Patient indicated that depression /anxiety and intrusive SI improved significantly in foster care. Patient indicated during the time in foster care, patient worked on her relationship w/ mother and feels it was “helpful. Patient transitioned to mothers home and feels that overall relationship has improved and does not know why depression/SI has escalated again.

Discharge Plan: RTC (county funding approved for RTC)
-Avanti (Referral done, waiting to hear back)
-Gerard (Referral done, Accepted)
-North Homes (Referral done, Accepted, currently on waitlist, openings anticipated in June)

PRTF:
-Nexus East Bethel (Referral in progress)

Existing outpatient providers:
-CMHCM at Sherburne County
-Individual therapy Main Street Family Services-Elk River (Appt scheduled 3/27)
-Family therapy at Main Street Family Services-Elk River
-Primary care at Stellis Health-Monticello
-Psychiatry s at Nystrom & Associates
-In-home skills

PH-M16-3429

Update 3/29- Pt discharge home while waiting potential tx
16-year-old male presenting to PrairieCare Inpatient Hospital. Patient has a known past psychiatric history significant for Depression, Anxiety, Polysubstance abuse. Patient has had multiple psychiatric hospitalizations.

Discharge Plan:
-Dual Diagnosis RTC:
– MHealth Fairview – declined due to behaviors at previous placements
– Rogers Behavioral Health – cannot accept pts insurance
– Hazelden – cannot accept pts insurance
– MN Adult & Teen Challenge Lakeside Academy – declined due to behaviors at previous placements
– Wings – referral sent, pt denied in past
– Anthony Louis Center – CD only – declined due to dimension 3 score
– VOA Omegon Pathways – referral sent, will make determination week of 3/25/24, earliest availability mid-late Apr

Continue with currently established providers:
-Probation Officer: Swift County

HCMCH-M16-3181

Per Emergency Protective Care Order, in need of out of home placement. Legal guardian through county, living with father in ND wasn’t successful.
Foster placement is not being recommended. Kinship placement has not been successful and is not a current option.
Patient has gone through Hennepin County QRTP screening – residential placement is recommended and is in alignment with psychology and psychiatry consult recommendations.

MHF-F15-3389

Patient presented from guardian’s home after a verbal argument. Guardian unwilling to have patient return home and patient does not wish to return home. Guardian in agreement for need for shelter placement at this time, awaiting acceptance to a shelter bed.

RMC-M17-3365

This patient presented to Ridgeview Medical Center via P.D. after running from his home. He was found in the woods nearby his home with a knife (patient has an ankle monitoring device). Patient reportedly desires out-of-home placement and verbalized plans to use the knife to harm kids who bully him at school. Patient has a significant history of running away from home with more than 30 reported incidents. Patient maintains a desire not to return home at this time. Carver Co. holds temporary decision making authority over patient, by court order.

CH-F16-3295

Patient presented to the ER with concerns for SI. The patient has had multiple residential and inpatient hospitalizations and reports they will not be safe if they return home. The patient was discharged from a 13 month stay in residential in January and was discharged from a 2 week inpatient stay in February.

PH-F10-2765

Update 2/22/224- Admission to Grafton tentatively scheduled 2/28/24, can discharge interim pending availability.
Update 2/15/24- waiting admission to Grafton end of Feb- date pending- can discharge home interim, pending availability.
Pt is medically cleared for discharge- parents informed county they need to pursue crisis respite for patient.

Discharge Plan:
Residential treatment referrals-
Grafton PRTF (Accepted, next opening tentative end of February)
Northwood Children’s (Referral not sent d/t insurance)
Nexus-East Bethel (Denied d/t not in 6th grade)
Nexus-Gerard (Denied d/t functioning for programming)
Avanti Center (Referral not sent d/t patient’s age)
VOA-Bar None (Referral not sent d/t patient’s age)
Heartland Girls’ Ranch (Referral not sent d/t patient’s age)
Nexus-Mille Lacs (Referral not sent d/t male only programming)
North Homes (Referral not sent d/t patient’s age)
Newport Academy (Referral not sent d/t patient’s age and insurance)
PrairieCare Residential (Referral not sent d/t insurance)
Village Ranch (Referral not sent d/t patient’s age)
Northwest Passage (Referral not sent d/t patient’s age)
Dakota Boys & Girls Ranch (Referral not sent d/t not ND resident)
Rogers Behavioral Health (Referral not sent d/t insurance)

Plan to bridge until residential availability:
Cradle of Love (Accepted, pending county funding)
Northwood Children’s Shelter (CM placing referral)
Kindred Care (CM placing referral)
MCCP Crisis Respite (CADI CM placing referral)
Trauma focused/attachment therapy (Referrals to be placed by CM)

Continue with established outpatient providers:
Ramsey County CADI- (Shakir Consulting Services)
Ramsey County CMHCM- B
PCP- (Entira Vadnais Heights)
OT- Fairview
CTSS- (Nystrom & Associates)
PCA/companion care 3x/week