Disruptive Mood Dysregulation Disorder (DMDD) – Mental Health Collaboration Hub

PH-M10-6705

Recommending PRTF/RTC
10-year-old male who presents to PrairieCare Inpatient Hospital after an episode of behavioral escalation at home.
This is his 2nd psychiatric inpatient hospitalization and had been engaging in outpatient therapy services.
Funding is in place for QRTP with Mower County

Discharge Plan as of 04/20/2026:
RTC/QRTP: (Funding approved 2/17)
– Gerard (Declined due to safety concerns, recommending Bar None Haven or PRTF level of care)
– PrairieCare Residential (Declined due to acuity)
– Northwoods (one year WL, not viable immediate option)
– Bar None Haven (Declined due to safety concerns)
– Nexus Mille Lacs (Declined due to safety concerns)
-Avanti (unable to refer d/t gender criteria)
-North Homes (unable to refer d/t age)
-Newport (unable to refer d/t insurance)

PRTF:
– Grafton (Declined due to request for further diagnostic clarity)
– Nexus East Bethel (reviewing)
-Leo Hoffman (unable to refer d/t age)
-Northwoods (one year WL, not viable immediate option)

Interim Plan:
Establish Psychological Testing
-Sagent Behavioral Health in Rochester
-Southern MN Psychological Services
Establish Occupational Therapy with School
Establish CTSS
-Fernbrook
-Independent Management Services
-Cedar House

Continue with following outpatient providers:
– Medication Management at Olmstead County Medical Center
– CMHCM with Mower County

CH8SCH-M12-6473

Patient presented to the ER 1/21. Patient is familiar to us. Patient has a complex psychosocial history with prior CPS involvement and a chaotic home environment. Patient typically does well in the ER & hospital setting but struggles at home with severe aggression and behavioral dysregulation in relation to conflict with parents. Patient does not appear to comprehend the severity of his actions and feels like his actions are justified (which appears to be related to his level of functioning). Patient likely needs a crisis respite placement/group home placement, but his CADI waiver and insurance are on hold while transferring to Benton County.

CH8SCH-M10-6691

Patient presented from foster care due to concerns of aggression and dysregulation in the context of trauma history and out of home placement. Unable to return to previous foster care. Being referred for residential treatment though needs a safe location while awaiting residential.

PH-M15-6144

Recommedning PRTF/RTC
15 year old male who presents to PrairieCare Inpatient Hospital due to suicide attempt with increased SI and SIB.
He has a history of several inpatient stays, has engaged in PHP, individual therapy, family therapy, and RTC at Gerard
Funding is in place for RTC with Polk County

Discharge plan as of 9/29:
PRTF/Level 6 (referrals placed by CMHCM, Approved by AFMC for PRTF)
– Northwood (reviewing, waitlist 3-4 months)
– Nexus East Bethel (referral submitted, reviewing possible opening early Oct.)
– Grafton (referral submitted, under review, declined due to inability to support level of care)
– Leo Hoffman Center (CMHCM to resubmit referral, declined due to safety concerns and inability to provided 1:1 staffing, able to re-refer upon further stabilization)

QRTP/ Level 5:
– Return to Nexus Gerard (under review, declined to return. Discharge effective 9/12)
– Bar None Haven (referral submitted)

MHF-M14-6607

Youth came to our ED this time on 2/21 after physical aggression at his GH where he injured staff. This is the 3rd time he has boarded with Fairview in the past month. The GH has taken him back previously however are reluctant this time and are considering an immediate suspension but may be willing to take him back one more time with additional supports. Trying to get started with Youth ACT for additional support, they are reviewing but have concerns related to DD and if they are a proper fit. County is also trying to pursue CABHH and PRTF simultaneously as they feel he needs a higher LOC but have not gotten acceptance. Was previously at Northwoods PRTF for 1.5 year. Looking for any additional supports that could be offered to this youth in the GH to make it successful. Currently has 3:1 staffing at the GH, psychiatry, therapy multiple times per week, has had MCCP behavioral analyst in the past and another referral is being made there, seeing if he may qualify for Youth ACT, and if not ACT looking to connect him to MIDB for psychiatry.

PH-M12-6583

Recommending PRTF/RTC
12 year old male who presents to PrairieCare Inpatient Hospital due to suicide attempt with increased SI and SIB.
He has a history of several inpatient stays, has engaged in PHP, individual therapy, and family therapy
Funding to be established with Anoka County

Discharge Plan as of 2/13:
Interim Plan:
– Establish PHP with PrairieCare MOB (IRF Submitted, intake scheduled for 2/19 at 0930)

Establish RTC/QRTP: ( county funding to be established, referrals submitted)
– Bar None Haven (under review, ACCEPTED 2/11 with estimated admission for mid march)
– Gerard (under review)
– Mille Lacs (under review, immediate openings, ACCEPTED 2/11)
– Northwoods (six to nine month waitlist)
– PrairieCare
– North Homes (under review)

Continue with established outpatient providers:
– Psychiatry with Andrea Somers, MSN, PNP, PMHNP-BC at Associated Clinic of Psychology
– CMHCM with Anoka County (guardian working to establish)
– Therapy With Katie Carras at Conscious Healing Counseling
– Primary Care with Dr. Surekha Pagidipala At Park Nicollet in Brookdale

CH8SCH-M12-6493

Patient presents to ER with mom for concern for suicidal ideation, fights at school, along with problematic sexual behaviors towards females. Mom is fearful of the safety of other children including 3-year-old daughter within the home. Patient does not have any active services.

MHF-M14-6458

Youth came in to our ED 1/8 after altercation at his Group Home where he has 3:1 staff. Initial recommendation was IP but he was denied by several units. He stabilized while waiting in the ED and the recommendation changed to discharge. Struggling due to sensory needs and the environment of an ED. GH is likely going to take him back once they can figure out staffing and some modifications. Looking for potential ideas to further support this youth in the community. Referral being made for youth ACT team but unsure if he will be accepted due to DD diagnoses. Has DD waiver and CM.

PCMC-M9-6439

A 9-year-old male brought to the ER by his father. He has history of anger management which turns into aggression. The patient states that when he gets angry he just wants to hit things. Today he was hitting his mother in the face and back and also threatening to hit his little sister. He hit the wall creating holes. Threatened to burn himself with the radiator heater. He has been seen multiple times for the same issues. He was seen and Mayo Clinic behavioral health facility in October 2025. Family is working with the case worker named __________ The father states that the psychiatrist has referred him to behavioral health facility in Duluth and they are waiting for him to be excepted in placed in that facility through commitment. Parents are voluntarily allowing him to go to a facility tonight. They do not feel that their family and other siblings are safe at home with him.

CH8SCH-M10-6397

Patient presented to ER the same day he was discharged from 2 month inpatient hospitalization for aggression/safety concerns. Was threatening harm to self and others in the home. Was accepted for admission to Mille Lacs Academy with admission date unknown. Currently stable and no indication to remain in the hospital though family does not feel safe with him in the home. Looking for interim placement while awaiting admission to Mille Lacs.