PH-F15-7244

Recommendation is now for group home
Patient presented to PrairieCare Inpatient Hospital after suicide attempt by hanging on two consecutive days while at Avanti Center for Girls Residential. She has been at 3 different residential treatments (North Homes, Bar None Haven, and Avanti). This is her 4th psychiatric inpatient hospitalization.

Discharge Plan:
Establish QRTP/PRTF:
-Avanti (discharged d/t suicide attempts and elopement concerns)
-PrairieCare Residential (declined d/t suicide attempts and elopement concerns at Avanti)
-Grafton (referral sent)

Outpatient Providers:
Red Lake Ombimindwaa Gidinawemaaganinaadog (OMBI) Program: Outpatient therapy
Sagent Behavioral Health: Medication Management/ Psychiatry Services

C8SM8SP-M12-7649

Patient presented to Children’s ED after being discharged from Prairie Care IPMH. After returning home, patient became upset with mother because he did not want to go to Hyvee to pick up medication. Pt became distressed, attempting to hurt mother with a butter knife and kicked mother. Mother called 911 and does not want patient to return home at this time.

AH-F16-7617

Previous psychiatric diagnoses: PTSD, depression, anxiety, eating disorder, ADHD, complex trauma, suicide attempts, self-harm

Patient presented to the ED after reporting SI to their guardian. Patient reports a near daily experience of SI and AH/VH of his brother who abused him. Therefore, this is not a new symptom. Patient reports that yesterday there was no particular trigger for his SI and AH/VH, that he took a PRN medication, which usually works for him, and then called his guardian who told him to go to the ED.

While in the ED (and as is common in the community), patient will attempt to use clothing to strangle themselves when dysregulated, often revolving around trauma.

Guardian is Dakota County (Tori Thompson). No contact order for anyone in the biological family.

Hospitalized in ND for a full year and a recent over month stay at Children’s for placement from which they were placed in Mn Care Counseling Crisis home.

Crisis home has given an immediate termination notice and state as they are a crisis home they do not require a 30 day notice, due to inability to keep pt safe. They report running into traffic as a particular concern.

Recommendation is discharge with ongoing outpatient support coping skills, distress tolerance, emotional regulation and behavioral support. Pt presentation appears to be baseline and unlikely to mitigated by an admission which may conversely increase risk of maladaptive coping skills and hospital seeking behavior.

Referrals:

· Wingspan is future development of home for patient; not ready until January

referrals made to all PRTFs
Grafton
Leo Hoffman
North Woods
Nexus East Bethel
No update on possible openings

CABHHS – pt has been declined multiple times due to various reasons including high acuity, Diabetic, Eating disorder – A new referral is in process
Bridgeview—-Dakota county crisis placement; on list but currently full (2 bed facility for Dakota County youth)
Kid Link – referral to all 50 of the facilities they work with, no update on potential openings.
Out of state (Rogers and Acadia)—active referrals, no timeline

PH-F16-7411

Recommendation is now for group home. Patient presented to the hospital from the ED for acute safety concerns related to self-injurious behaviors and suicidality following an assault on patient by other residents in a shelter. Patient has a history of multiple inpatient hospitalizations and residential treatment.

C8SM8SP-F9-7516

Child presented to Children’s to receive mental health evaluation due to homicidal ideation. Patient has a history of aggressive behavior and dysregulation that leads her to the ED for mental health evaluations. Patient had run away from her home and went into a neighbor’s home where she stole a firearm that was loaded. She pointed the gun at her mother, family, county social worker and police. Child cannot return home at this time.

C8SM8SP-F12-7502

Child presented to Children’s after becoming dysregulated and aggressive towards other while at a funeral. Family was in town from up north. 911 was called when child began becoming physically aggressive towards foster mother. She has a history of aggressive behavior; history of foster placements.

RCCP-M12-7481

Per DA, youth presents with oppositional behaviors: “verbal and physical aggression, making threats toward others, making sexual statements toward others, eloping, undressing himself in front of others.” CP became involved due to him hitting his sister with a baseball bat. He has had episodes of aggression toward family members and toward staff. Additionally, he was most recently homeschooled and did online school for a few years prior to that.

RCCP-F6-7478

6yo girl presents with extensive trauma history of sexual abuse has led to obsessive-compulsive behaviors related to sexualized behaviors including constant thinking about how to touch herself and others and trying to follow through with those thoughts. She has a long documented history of inserting items into her vagina and anus, resulting in pain, leakage, incontinence, and sores on her genitals/fingers/mouth.

LAHC-M14-6887

Has been with us since January. Arrived from Prairie care from Mayo Clinic before that for verbalized increase in SI and engaging in SIB. History of abandonment from bio mother and apparent abuse and substance use in the household per history. History of temporary foster care. Difficulty with boundaries and impulsive behaviors. Often losing his temper, being easily annoyed and irritable, arguing with adults of authority, and not complying with rules/structure. Current and historical property destruction and elopement. Behavioral instances at school, threatening gestures and actions. History of vaping nicotine “if I have it I will use it” mentality. Witnessed DV, history of homelessness, and physical abuse.

MCR-F16-7399

16 year old female who has multiple in state and out of state residential placements, and currently on the waitlist for CABS. Family is unable to meet her needs, and she is boarding in the ED. She is in need of residential placement until she is accepted to CABS.