17 yo female with hx of dep, anx, PTSD, eating d/o, mood lability, and personality concerns who lives with her dad and siblings in Menahga. She is in the 12th grade and reports having a 504 plan. She has a hx of around 10 inpatient hospitalizations and 3 stays in RTC. Stressors include family conflict, social stressors, and school. Family hx of MICD concerns. Patient has been struggling with worsening symptoms and safety concerns including SI with multiple plans (cut, OD, hanging, crash, etc) and SIB. She has been admitted for acute stabilization.
Psychiatric Diagnosis: Depression
Depression is a psychiatric diagnosis characterized by persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in activities.
MHF-M17-5279
Pt came into our ED 2/13/25 from parent’s home after conflict there. Parents are refusing to let him return home at this time. Parents report a lot of substance use history, primarily marijuana. Has an IQ of 66 and has reportedly been denied by SUD programs due to this. Also is turning 18 in approx 2 months. Just opened to CADI waiver. Team is exploring waiver placements, long and short term, YSN shelters, seeing if IRTS might consider due to almost being 18, and exploring SUD programs that may accept IQ.
MHF-F13-5276
Kiddo came to our ED on 2/13/25 from a foster home. Foster parents are refusing to take back at this time. Has boarded in our ED in the past, 2/13/24-3/27/24. County has since taken over custodianship. Pt also has tribal involvement and has CADI waiver. Was previously in residential for a year and that is not the recommendation at this time, primarily searching for waiver paid placements. Not wanting to pursue hotel crisis. Nexus YCT has intake scheduled for their placement coordination.
PH-F15-5177
Patient is currently inpatient and are unable to move further with discharge planning due to not having a County of Financial Responsibility. Stearns County and Wadena County have both been consulted and neither have accepted responsibility at this time.
Discharge Plan:
Establish PRTF; referral made to Nexus East Bethel, INTAKE SCHEDULED 3/3/25
Establish Level 6 Program; referral made to Bar None Haven
Establish County Support/Funding; assigned for CMHCM at VOA
Continue with established outpatient providers:
-PCP: Lakewood Health System
-MM: Lakewood Health System
-Therapy: Lakewood Health System
HCMCH-F15-1627
15 y.o. female with history of childhood sexual abuse and more recent sexual exploitation in 2023 with concern for victim of sex trafficking. Presents with suicidal ideation, self-harm behaviors including substance abuse. During this admission drug screen positive for fentanyl and methamphetamine. Patient transferred from HCMC to Sacred Hearth Inpatient Behavioral Health Unit 8/23/23; long term recommendation is residential care. Substance use and placing self in high risk social situations occurs in the context of her trauma history.
MCR-M15-5209
He completed day treatment on 1/23/25 but has been dysregulated off and on during that time, residing at foster home and eloping. Prior to presentation, eloped and was away from home for 12+ hours, sleeping outside in someone’s truck (not running) in zero degree temperatures. Nobody feels he can be maintained safely in the community.
MHF-F14-5169
Kiddo boarded in our ED from 11/18/24-12/18/24 after being discharged from JEC Miller GH. JEC Miller took her into a temporary placement in an apartment setting while County worked toward another permanent placement. On 1/19/25 she returned to our ED after ingesting glass and was sent to our medical floor, where she is currently boarding. County team is looking into placement options- primarily crisis respite. On CADI. Working on Nexus YCT referral to assist with placement coordination.
CH-F13-5105
Brought to the ER via mom for assessment of suicidal ideation following an argument with guardians resulting in behavioral dysregulation and hitting their head into the wall and sitting on the driveway in inappropriate weather wear. Patient has a long history of psychiatric services and continues to struggle with emotional dysregulation. Parents requesting residential level of care.
CH-F16-5102
Patient was brought to the ER for assessment of suicidal ideation after locking herself in the bathroom with broken glass following an argument with parents. Patient has ongoing cannabis abuse despite participating in 3 treatment programs and has no desire to stop. Patient struggles with taking accountability for her actions. Patient also with history of suicide attempts and legal charges related to stealing parent’s vehicles and assaulting mom.
CH-F16-5073
Presented from Newport Academy on 1/7/25. Patient engaged in property destruction and made suicidal comments. Patient admitted to Newport in November. Patient was administratively discharged at the end of December. Patient has a history of running/eloping and is believed to have been trafficked to Ohio in October. Patient was tracked down by his cell phone and detained by law enforcement at a juvenile detention center in Cleveland. Patient returned to MN and was admitted to Newport. Not meeting criteria for acute inpatient psychiatric placement. Long-term placement in a secure/locked facility is recommended.