Mental Health Collaboration Hub
Was in metro area with adoptive parents. Placed at Youth Shelter in St. Cloud. Came to hospital. Shelter d/c’d her and refused to pick her up. Ramsey probation and SW already involved. Adoptive parents want to relinquish any rights to patient as aggression is focused on mom.
Psychiatric Diagnosis: Oppositional Defiant Disorder
Oppositional Defiant Disorder is a psychiatric diagnosis typically diagnosed in children or adolescents who display a pattern of defiant, hostile, and disobedient behavior toward authority figures.
PH-F10-5904
Pt is a 10 year-old female with historic diagnoses of anxiety, depression, ODD, specified neurodevelopmental disorder who presents today to address running away from home. Upon interview pt was observed to be easily distracted and appears to be guarded. Pt was resistant to the interview stating, “I don’t want to answer any questions.” After roughly 5 minutes pt refused the interview process leaving the room and forcefully pushing the door close with writer still in the room. Writer could hear pt yelling and laughing from the hallway “she’s locked in there” and “I locked her in there”.
Mother reports pt has been running away from home and putting herself in dangerous situation. Mother reports pt was sexually assaulted during one of her runaways. Mother reports pt’s motive for running away this time was to get on an airplane. Mother stated due to pt’s behaviors, pt has been hospitalized 3 times within one and a half weeks. Mother reports pt’s mental health is worsening. Mother reports pt struggles with authority figures and being held accountable. Mother states they use to have structure and routine in the home and is trying to incorporate it into the home again but when pt is held accountable, pt will threaten mother and think mother is “being mean.”
AH-M15-5556
Impression of Crisis Behavior (precipitants): Patient presented to the ED due to agitation and SI. The identified precipitant for this crisis is a verbal and physical argument with his mother and her boyfriend at the home. Patient was released from the JDC to home on 4/5/25.
Vulnerabilities: adolescent, ASD, h/o trauma, recently released from JDC, parent-child conflict, inadequate outpatient supports
Behaviors / Symptoms to address in the ED: deferred
Methods to increase desirable behaviors in the ED: meet basic needs, set behavioral boundaries/limits,
Barriers to Discharge include: At this time, patient is NOT felt to meet criteria for inpatient hospitalization. There are no new acute safety needs that warrant admission. His mental health concerns are chronic and environmental.
Mom is refusing to take him home, JDC won’t take him back as there are no new charges and he has no place to go. CPS is investigating allegations of abuse by parents and child but are not seeking placement. Mom does not consent to use of a shelter or Nexus YCT.
MHF-F13-5313
This pt has boarded with us multiple times in the past. 2/13/24-3/27/24 and 2/14/25-2/21/25. Came to us again 2/27/25 after self harm in the shelter setting where she had discharged to on 2/21. Shelter is unable to take her back. County has custodianship currently and is searching for additional shelter and foster placements, as well as waiver placements. (Was in foster prior to 2/14/25) Previously had residential treatment, in 2024. Is open to CADI waiver.
MCR-F8-5371
This 8 year old has been in two foster homes (skilled) that have been unable to keep her safe; no other foster homes available. Getting updated DA today. Has a YBH worker since 2022, in-home family therapy with family, in-home CTSS skills, individual therapy, medication management, partial hospitalization at PrairieCare Feb 2023 and March 2024, hospitalization Jan 2023; Level 3 at school.
Complex trauma (sex abuse, poor attachment, placement / moves); ongoing CPS case with pending charges. Parenting assessment indicates to cease parenting time
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.
MHF-M16-5234
Kiddo came to us on 2/2 following suicidal behaviors. Plan was originally for inpatient however while waiting for bed he stabilized in the ED and became a boarder on 2/10. Was in SUD residential treatment, but they are declining to have him return, explaining that his needs are more mental health based than what their program can provide. He has a tentative acceptance at a residential program, just waiting for them to process more paperwork and identify a discharge date. Currently under temp custodianship with Ramsey County but Mom is involved ongoing.
CH-F17-5216
Presents from home. Patient is known to our facility having previously boarded. Patient lives with aunt and uncle. There are issues with their relationship, and it has been increasingly difficult for aunt and uncle to manage, and they do not want patient to return home.
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.
CH-F11-5026
Pt presented from home, adopted parents, for aggressive behaviors. Third ER visit this month, unable to take pt back home due to frequency and intensity of behaviors as well as 4 other children in the home. Pt initially recommended IP hospitalization, however unable to find placement due to acuity, no beds, or declined due to IQ (56) and inability to participate in programming. Medications adjusted in ER. No violence since medication increase. Family/CADI worker have been looking for more support for several years and pt seems to fall through the cracks due to IQ and aggression.