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-F17-6710

Inpatient Team is recommending Locked QRTP/PRTF.
17-year-old patient admitted to inpatient as a step up from PrairieCare Residential. They were admitted due to continued episodes of emotional dysregulation, intrusive SI and attempts to elope. This is their 9th psychiatric inpatient hospitalization. They have done PHP, outpatient care and residential treatment.

Discharge Plan as of 04/22/2026:
Hospital and PCR treatment team recommends:
-Bar None Haven locked RTC. They were accepted on 3/18; county did not approve placement.
-Heartland Girls Ranch. They were accepted and on wait list, county did not approve placement.

County team pursuing:
RTC-
-Gerard (reviewing)
PRTF-
-Nexus East Bethel (declined)
-Northwoods (county sent referral, currently a 2 year wait)
-Grafton (county sent referral, does not meet admission criteria)

Interim plan:
-Consider Shelter care at Ain Dah Yung Center, The Bridge for Youth- Supportive Housing-Marlene’s place, Youth Transitional Housing Program – Life Haven/ Lutheran Social Services of Minnesota
-Establish Psychiatry
-Establish Therapy
-Continue with Hennepin County Team, Guardian Ad Litem, and Tribal Representation

This youth has been medically cleared to discharge from inpatient to the appropriate next level of care although due to barriers with accessing the recommended level of care, they are now boarding. The Hennepin County Boarding team is working with inpatient on this case as well.

MHF-F17-6700

Youth came to our ED on 4/9 after being on the run for 3 weeks. Has a long history of elopement and some aggression as well. Is open with CPS, ACT team, and DD waiver, and there is a VPA for placement currently. County team is looking at all placement options- all waiver options, RTC, out of state. Has been denied many places already primarily due to the elopement behaviors.

MFIUP-M14-6668

Pt presented to ED with family after FBI visited family after an anonymous tip that patient was having SI and HI regarding a mass shooting in the context of worsening depression and anxiety. Pt acknowledged recent homicidal ideation as a means to justify ending his own life. Initially pt denied creating a written plan, denies attempts to get a gun or have possession of a gun, or thought of a specific school or time he would do this, though, he now states he identified two elementary schools as potential targets. During past assessments he has acknowledged reasons for not going forth with this shooting – like the attempt would fail and he would be in a worse situation and he does not want to actually hurt people. Similarly, suicidal thoughts are present with thoughts of shooting himself, but does not have intent or obtained means to act on it. Although these are moderate-high risk thoughts, patient is able to keep self and others safe while in the hospital at this time. Aspects of his clinical history that put pt at risk for progressing to future violence include pre-occupation with prior shooters, nihilistic beliefs, and time spent in a potentially radicalizing online community. Additionally, mom reported partner had a gun in the home and patient + step-brother was looking around the house for this gun. The leading drivers of current SI and HI seem to be significant anxiety and co-morbid depression. Has experienced significant neglect and sexual abuse that have impacted his current mood and outlook as well.

MHF-M16-6652

Youth came to our ED on 3/24 from home after an altercation with Mom. He has a history of physical aggression against Mom. He is commercial insurance, so there is currently no County involvement. Mom would like him to get RTC however there isn’t a DA with that recommendation currently. Mom is not currently agreeable to shelters.

CH8SCH-F13-6644

Patient presented to ER from residential treatment after assaulting staff. This was patient’s second day of residential treatment followed by lengthy back-to-back hospitalizations. Patient recently assaultive to staff and oppositional at times. Has required multiple PRN’s for dysregulation. Residential treatment facility therapeutically discharged her to the hospital.

CH8SCH-F14-6487

Patient presented from local residential facility after getting into an argument with staff where she tied rubber bands around her neck in an attempt to end her life resulting in staff needing to remove the bands and discoloration of her face. She was able to hide and sneak in additional items to self harm with into the ER and inpatient unit where she again placed something around her neck. Residential unable to accept her for return as they feel they are not able to keep her safe and that she needs a higher level of care.

MHF-M16-6455

Youth came into our ED on 1/13/26 and was determined to be ready for discharge. Came from Grandparents who are refusing to take him home until he gets SUD treatment. He is unagreeable to SUD treatment at this time, willing to do OP. County is not funding shelter due to not having custody. Parent referred shelter referrals have been made however custodians refused the Bridge who were looking at accepting him. Has been to Lakeside Academy and Wings SUD treatment in the past and eloped from both. No waiver currently. FV Maplewood declined primarily due to pt being unagreeable to treatment, but also due to concerns of elopement and Grandparents being willing to get him from the ED. Has been declined by many other RTCs as well. Referral pending with Anthony Louis.

CH8SCH-F16-6368

Patient was at Heartland Girls Ranch and reports that she tried to run from the facility, scratching her arm and hitting her head on the wall. Patient reported suicidal ideations with a plan. County is guardian of patient due to past abuse. County feels like patient needs PRTF level of care. On the waitlist at CABHH.

SBMC-F15-6411

Patient presented to the ED with her father after ingesting a screw while at school. EGD completed to remove the screw and she returned to the ED. Mental health team met with patient and father making the recommendation for acute inpatient MH placement. Patient denied ingestion to kill self and denied SI. She has a history of swallowing 2 AA batteries in Dec as well as another episode of swallowing a button batter a couple days prior. After those interactions she spent 11 on our medical floor waiting for a discharge plan. She was finally placed at an acute inpatient unit only to return home in a week with no additional supports in place. The original recommendation was for a long term residential placement but that was changed to discharging to home.