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-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

MHF-F13-7240

This youth presented to the hospital after eloping from her foster residence. She had been on the run for over a month and was brought in by EMS after attempting to enter a youth shelter. She was admitted to the hospital for medical needs and determined to be appropriate for discharge. The foster residence is unable to take her back at this time due to needed home repairs and working on increasing staffing from 1:1 to 2:1.

MFIUP-M9-7237

Admitted to hospital due to suicidal ideation, auditory & visual hallucinations. Pt presented after a suicide attempt via intentional overdose on her prescription methylphenidate.
Predisposing factors: chronic mental illness, extensive family history mental illness; early exposure to domestic violence, childhood trauma, seizure disorder. Precipitating factors/Stressors: family dynamic. Perpetuating factors: history of CPS involvement, chronic mental illness, family dynamic/stressors.

MFIUP-F15-7229

Admitted due to suicidal and homicidal ideation. Patient struggles with explosive outbursts when she does not get her way. Patient has a hx of calling CPS frequently alleging abuse against mom. Diabetes was managed with an insulin pump until recently, when the pump was removed for inpatient admission and she was transitioned to insulin injections. She reports that the pump was helpful in regulating her diabetes. She reports daily suicidal ideation, describing it as a persistent struggle, with plans to smother or strangle herself. She also experiences homicidal ideations, particularly directed toward her mother and sister.

MFIUP-F14-7201

Pt has hx of several suicide attempts, chronic SI, impulsivity, substance use, and PTSD with dissociative symptoms. Pt has a long history of IPMH and two residential stays at Heartland Girls Ranch. She recently was at a dual treatment center but was discharged following a suicide attempt. We were initially looking for dual RTC, but we have expanded our search to find placement as pt continues to struggle with prolonged hospitalization.

C8SM8SP-F15-7087

Child presented to Children’s ED due to increased suicidal ideation. Dakota County has had guardianship prior to him presenting to ED. Child was residing at a group home and reported to staff about increase thought of self-harm. Staff at group home called EMS and child was brought to Children’s ED for mental health evaluation. They did not meet inpatient criteria and have been recommended to discharge. The group home denied their return due to unsafe behaviors, such as tying clothing around their neck when dysregulated. Extensive trauma history from bio parents.

OCC0FS-F17-7034

Was hospitalized in at Prairie Care Psychiatric Hospital discharged May 30th- June 15th for significant self-harm by cutting, recommendations were residential, was accepted to Newport, Prairie Care RTC, and Rogers; however, due to bed availability was discharged home and started Prairie Care PHP on June 16/17th. Wound became infected on leg, he was hospitalized and treated for Sepsis, wound vac was placed. He was discharged home with recommendations of residential treatment once wounds healed. He was unable to go back to PHP or Residential (there was a bed opening at one of the placements) he was unable to return to PHP or be admitted to Residential due to wound vac/wound care needs. Within 24 hours of discharge, he was back in the hospital due to self-inflicted wounds on his leg caused by a blade of a box cutter requiring medical intervention and hospitalization. He has been in the hospital since his wounds are healing, there is no longer a wound vac, 9 or the 10 wounds have been sutured and one on his leg requires wound packing 2x per day.

MHF-F17-6987

Youth came into the ED 6/26 after being discharged from the shelter program they were in. Reportedly were boarding in a different hospital last week. Currently accepted at RTC but admit isn’t until 7/10. Needing an interim plan. County has permanent guardianship. Has been denied by most shelter programs. Does have waiver funding but no waiver CM yet.

MHF-F13-7007

Youth came into the ED 7/2, from home, after being discharged from Fairview’s IPMH program on 7/1. Mom is refusing to allow her to return home. IP unit set pt up with attachment-based therapy to start 7/2, day treatment to start 7/9, psychiatry appt 7/9, and a referral for CTSS when available. Parents are declining to take back with those services. County offered CIBS services again as well, parents refused. Parents state they will only take home with 24/7 in home care which isn’t an option. Parents also state they will only accept RTC or a permanent group home (CRS) There is no current LOC recommendation for RTC, and pt just got onto the wait list for MNchoices assessment yesterday for the 1st time, so neither are options currently. Parents are not allowing referrals to parent referred shelters as those are not permanent solutions. No placements being explored currently because parents aren’t agreeable to current options., and no CPS involvement for County paid shelters.

MHF-F16-6930

Youth came to our ED 6/5 from Mom’s home. Previously resided with Dad, moved to Mom’s 3 weeks ago, neither are willing to allow pt to return to their home. Youth has CADI waiver. Not currently open with CMH as they need youth to agree to those services. County is willing to look for short term crisis respite with a plan to return to parents after, but not willing to explore CRS. No LOC recommendation for treatment placement at this time.