Patient presents from group home. Patient is known to our ER and previously boarded 12/3/24-1/7/25. Patient presents after engaging in aggressive behavior that reportedly included verbal threats and chasing them with a shovel. She has had episodes of aggression with staff in the ER and has been targeting another patient that is boarding. The group home has provided a suspension of services and plans to submit a termination of services. County case worker has been making referrals and looking for crisis respite placement. She will likely need a home created for her.
Psychiatric Diagnosis: PTSD
PTSD is a psychiatric diagnosis that results from exposure to a traumatic event or series of events. It is characterized by symptoms such as flashbacks, nightmares, and severe anxiety, often resulting in impaired daily functioning.
MHF-M16-5515
Came to our ED on 4/10 only because the County had no where else to bring him. Mille Lacs County has custody. He just left the lino lakes juvenile detention center. Has been to many juvenile detention placements, but is no longer required to be there. Has some history of substance use, but most SUD treatments have denied him due to aggression. Has been sober for 2 months now as he was at JDC and now the hospital. County is exploring out of state MH treatment facilities, as well as in state MH group homes, shelters, evaluation programs. Working on getting a recommendation for PRTF through a psychologist who had seen him for civil commitment. Working on SMRT and MNchoices for waiver placement options.
PH-F12-5504
Patient is a 12-year-old female, currently at PrairieCare Inpatient Hospital.
Recommendation is for level 6 PRTF.
Patient would be able to discharge to a lower level of care while awaiting admission to a PRTF, although she does not have a current placement through the county.
Patient has had a previous inpatient hospitalizations, through UMMC for 38 days waiting for a placement through the county and
PrairieCare Inpatient Hospital 02/02/2025-03/17/2025. Patient was admitted to PrairieCare Residential 03/17/2025-03/20/2025 although was stepped back up to inpatient due to safety concerns.
She has a known history significant for MDD, GAD, and PTSD.
Establish PRTF:
(eligibility form sent to AFMC on 3/26)
-Nexus East Bethel (referral sent & under review)
-Northwood (referral sent, pt’s mother revoked consent on 4/10 due to distance)
-Leo Hoffman (not viable option due to only male patients)
-Grafton (not viable option due to needing ASD, ID, or DD)
MHF-M9-5478
Youth came to our ED 3/30 after an altercation in the car with his foster care provider. Foster Care provider is not willing to accept him back. Has permanent custodianship through the County. Open to waiver and looking at crisis respite, getting updated DA for treatment placement information, and is on the list for foster care/shelters.
MHF-M10-5493
This youth came into our ED 3/31 after a behavioral altercation at his group home. They have issued a suspension notice. Parent is refusing to take home. He has both CMH CM and is open to CADI. CMH is making the CADI referrals currently, for crisis respite and CRS. The current DA does not recommend treatment placement however CMH is working with OP therapist to try and update the DA.
MCHSRW-M12-5457
Patients mother shared that the patient has an extensive treatment history, but has continued to struggle with challenging behaviors and emotion dysregulation. Mom described that “over the last few days he’s just been a terror, despite our best efforts. He freaks out when we try to redirect him. Mom reported that the patient has “aggressive towards people, getting physical and violent, he’s been assaulting his younger brothers.” Mom described that on the day of admission the patient had been going into his brother’s bedroom “trying to annoy them,” and hitting them. Mom called her husband, the patient’s step-father, who is currently out of state for work. The patient’s step-father spoke to the patient over the phone and told him that he needs to change his behavior and reminded him that he has been through so many different programs and should be able to “put on the breaks” with his behavior. The patient began talking back and got confrontational with his step-father, asking “what are you going to do about it?” The patient’s step-father indicated that their would be consequences when he returned and urged the patient not to put his job at-risk by making him return home early to deal with his behaviors. The patient challenged his step-father further making statements such as “fuck you, why don’t you say that to my face?” and “bet, come home then and see what happens.” The patient further stated “I’ll shoot you in the fucking face, right through the eyes.” Mom reported that their is a gun in the home, however it is locked in a gun safe and the patient does not have access to this. Mom then asked the patient where he would get a gun from and the patient indicated that his friends at school have guns. Mom expressed “this has escalated so far beyond me. We are walking on eggshells from the time he gets home from school until he goes back the next day.” Mom reported that she did not feel safe bringing the patient back home. She reported that she had attempted to press charges on the patient today, however police had declined and brought him to the emergency department instead. The patient is uninsured, county is working on his application, but he does not have a county social worker. Has a contracted mental health case manager through Fernbrook.
C8SM8SP-F12-889
Patient was receiving residential services through Aspen House and sent to the ED following an altercation with another resident. Aspen House would not take Pt back. County is guardian and Patient has spent time in and out of foster care settings.
MHF-M14-1900
Patient presents to the ED via EMS after his group home called 911 due to patient’s aggression. Patient reports that he threw a stool at staff when they asked him to go to bed. Group home to determine whether they will take him back.
Patient has a previous mental health diagnosis of Mood Disorder, Intellectual Disability, Nocturnal Enuresis, Anxiety, ADHD and Autism Spectrum Disorder. Medical records indicate patient presented with similar behaviors to the ED, including defiance, a history of emotional and behavioral dysregulation, and acting out towards staff.
This is patient’s 6th visit in the ED in 2023 for behavioral and/or mental health.
MCR-F12-5376
Adopted at age 8 from private agency (so ineligible for MA). Comes in with Homicidal ideation and threats to kill sister and burn down house. Family not willing to bring her home for safety. Have tried many services but terminated them about 2 years ago and now are trying to re-engage. No approval for placement at this time.
MHF-F13-5365
Kiddo was just boarding with us 1/9/25 – 2/19/25, prior to that was in residential in FL for almost 2 years. Discharged to treatment GH 2/19 and had been doing fairly well there. Was supposed to start school yesterday and refused. GH staff gave her the option of going to school or back to the hospital and she chose the hospital so was brought back to our ED. Staff are saying that pt cant return without being willing to go to school. Pt reports that the school scares her because it has locked doors and they do holds.