Depression is a psychiatric diagnosis characterized by persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in activities.
1/11/24 – YCT has a lead on somewhere to go today or tomorrow.
Patient presented to the ED following a sexual assault, no significant MH concerns at this time but adoptive parents are unwilling to bring home due to ongoing behaviors. Recently boarded in another emergency room and was placed at Hope House shelter, unclear if she can return there. Needs shelter placement.
Update- 1/11/24- The patient has been accepted to MNCCS respite home with a planned admission date of 1/17/24!!!!! Thank you to this facility!!
The patient presented to the ER for the second time on 8/22 via law enforcement for aggressive behavior after she assaulted a staff member at the group home and attempted to bite, throw things, and hit staff upon arrival to the ER resulting in restraints and IM Zyprexa. She had been in the ER earlier in the day after intentionally swallowing a rock in an attempt to get out of her group home and was subsequently discharged back to her group home following psychiatric assessment. Of note, she presented to the ER 3 additional times over the week prior to admission for similar presentations and is well known to the ER due to multiple presentations of pseudoseizures, aggression, and suicide ideation.
She was admitted to the unit after her group home provided a suspension of services notice with the requirement of medication adjustment to be completed in order to return to the group home. Medication adjustments were made, and she has been psychiatrically and physically stable since at least October though she is not able to return to her group home until additional staff are hired and trained.
Discharging to Gerard on 1/10
Patient presented from Bar None shelter after A verbal altercation. Had been in Bar None RTC however got into a physical altercation several days prior and moved to the shelter on a behavior contract. When patient became verbally agitated, patient was sent to ED and is now discharged from the facility. Patient denies MH symptoms, has no placement. Guardian reports referring patient to North Homes and Gerard who report several month wait lists.
1.4.24 – Nexus YCT doing an intake next week.
Presented to ED after altercation with Mom resulted in property destruction and pushing her. Behavior concerns specifically aggression in home towards mother, siblings; patient is in a level 4 special-education program due to ongoing challenging behavior at school often leading to multiple suspensions, needing higher level of intervention. The police have been called to the home multiple times due to patient’s increasingly violent and aggressive behavior, poor impulse control, low frustration tolerance, agitation and oppositional behavior.
UDPATES TO Discharge Plan 12/12/23:
-Grafton PRTF (Pt accepted, could admit 12/20, due to staffing moved back to mid-end of January)
-Nexus-East Bethel PRTF (Pt accepted, could admit mid -January)
-CABHH (Pt denied admission)
Recommending PRTF. Referrals completed.
Cannot return to previous Group Home. Per County, no interim plan available as parents and foster parents are reportedly not an option. Still seeking county to arrange interim living arrangement between Inpatient and PRTF – for crisis stabilization or group home.
Patient was previously at a group home, due to running away and SI/SIB, pt was readmitted to Inpatient. Inpatient hospitalizations 7/8/23-7/28-23, 9/29/23-10/13/23, 10/16/23-Present.
Patient has the following outpatient providers:
CPS Worker/Legal Guardian
CMHCM
GAL
Medication Management
PCP
School Counselor
Insurance: BCBS MN and MN MA
Update 1/24- County funding for RTC denied on 12/26, now following alternate recommendations as determined by the county. DC was scheduled for 1/4, due to parent request, rescheduled for 1/5.
DISCHARGE PLANS:
Hospital Recommendation is RTC-
Avanti -referral made, accepted, intake 12/28/23
North Homes- referral made, reviewing, no immediate openings
Gerard- referral made, accepted, intake 1/9/24
Alternate Plan:
Mobile Crisis Team (Referral sent by CMHCM)
Day Treatment- Christian Family Solutions (Referral sent by CMHCM, waitlist to about 1/19/24)
Intensive family therapy (Referral to be sent by CMHCM)
PCP- Marlene Jilek, APRN (Mankato Clinic)
Therapy- Claire Alexander, MS, LPCC at PrairieCare Mankato (Availability as soon as next week, requests patient guardian call to schedule appointments)
CMHCM- Nicole Wigern (Blue Earth County)
Presenting Problems: Major Depressive Disorder, PTSD, SI/SIB, Inpatient for the third time this year, has done PHP twice this year
Patient presented to ED due to concerns of sexual abuse. Patient has extensive history of eloping from home to meet up with adult men she met online and have sex with them. Mom does not feel she can keep her safe at home due to her risky behaviors.
Patients a 16yr female with a history of albinism, anxiety and depression, ADHD, unspecified intellectual disability and borderline personality disorder presenting to the ED with complaints of suicidal ideation with plan. Was discharged from PSJ on 11/08/23. Started PHP at PSJ on 10/9/23, became aggressive and had a episode with SI statements and brought to the ED. Extensive inpatient psychiatric hospitalizations over the past year with >4 at Prairie St Johns, and 4 months at Prairie Care Medical Center from 4/18/23 -8/25/23.
Patient is presenting to the ED for the following concerns: verbal agitation, suicidal ideation, threats to harm others, property destruction. Patient became upset at school, threw items, and ripped things off of the wall. Patient left school grounds, and police/ambulance were called. Patient has been living with her aunt for the past few months. Patient’s biological mother died when she was an infant, and was abused by a family member who obtained guardianship. Patient makes suicidal and homicidal threats often.
Patient was in the Fairview PHP program earlier this year. She was in the ED in May ’23. Patient no longer has a medication management provider. She has a county CPS worker and a newer case manager. Patient is currently in Equine Therapy 1x/week at Hold Your Horses.
Patient is presenting to the ED for the following concerns: suicidal ideation, depression. Patient reports he tried to kill himself last night by stabbing himself with a dull pencil. Patient reports suicidal and homicidal thoughts that have increased in last two weeks. He has been at North Homes for three months. He was discharged to North Homes after a hospital stay at UMMC in September for SI. At North Homes, the patient escalated and told staff he was suicidal. He took the batteries out of a remote and tried to swallow them. He also tried to stab self with dull pencil. He became combative and needed to be restrained and then kicked staff in chest and tried to kick another staff. Patient then stated he would find each clients personal info and then take pictures of other clients after he killed them and send to parents. Patient told staff he would kill other clients and himself.
Patient reports long history of MH including PTSD, MDD and GAD. Patient has been hospitalized 2 x in past 6 months. Patient reports history of trauma. Patient states he has history of SIB.
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