Update: has been aggressive, destructive. Feeling helpless. With Rule 20 assessment, not fit to have charges brought. Due to have another Rule 20 assessment in December. Has some past felonies.
Patient presented to the ER from out of state due to being kicked out of residential treatment for elopements and aggression towards staff and peers. She was boarded in the ER for a significant amount of time before being admitted to the mental health unit for boarding. Patient has CHIPS case though parents are actively involved in her care. Patient has an extremely high risk of elopement and has a history of being sexually trafficked while on elopement. Patient struggles with conduct, low academic performance, and history of aggression. She has had 2 rule 20 assessments and was found incompetent. Patient has been declined from PRTF’s from over 25 states.
Patient was in Prairie Lake JDC and his ‘time was served’. County did not have a place for him and reported a judge ordered for a sheriff to drive him from there to ANW for acute MH care. He does not need IP MH care, Crow Wing County does not have a place for him. They are connected with Solutions, working on group home placement.
The patient presented to the ER for the second time on 8/22 via law enforcement for aggressive behavior after she assaulted a staff member at the group home and attempted to bite, throw things, and hit staff upon arrival to the ER resulting in restraints and IM Zyprexa. She had been in the ER earlier in the day after intentionally swallowing a rock in an attempt to get out of her group home and was subsequently discharged back to her group home following psychiatric assessment. Of note, she presented to the ER 3 additional times over the week prior to admission for similar presentations and is well known to the ER due to multiple presentations of pseudoseizures, aggression, and suicide ideation.
She was admitted to the unit after her group home provided a suspension of services notice with the requirement of medication adjustment to be completed in order to return to the group home. Medication adjustments were made, and she has been psychiatrically and physically stable since at least October though she is not able to return to her group home until additional staff are hired and trained. The patient is beginning to decompensate with the prolonged length of hospitalization.
Primary Recommendation – RTC
-Avanti, referral made, declined
-North Homes, referral made, reviewing, would need county support
-Gerard, referral made, declined
*County Pre Placement Screening scheduled 12/5/23, funding approved, county started QI process
INSURED BY PRIME WEST MA
Presenting Problems: Experiencing school stressors, family dynamic changes, depression, mood lability, SI via ingestion.
Recommendation is RTC-
Avanti -referral made, accepted, can admit next week -just waiting county funding
North Homes- referral made
Gerard- referral made
Presenting Problems: Major Depressive Disorder, PTSD, SI/SIB, Inpatient for the third time this year, has done PHP twice this year
Patient is presenting to the ED for the following concerns: verbal agitation, suicidal ideation, threats to harm others, property destruction. Patient became upset at school, threw items, and ripped things off of the wall. Patient left school grounds, and police/ambulance were called. Patient has been living with her aunt for the past few months. Patient’s biological mother died when she was an infant, and was abused by a family member who obtained guardianship. Patient makes suicidal and homicidal threats often.
Patient was in the Fairview PHP program earlier this year. She was in the ED in May ’23. Patient no longer has a medication management provider. She has a county CPS worker and a newer case manager. Patient is currently in Equine Therapy 1x/week at Hold Your Horses.
attempted strangulation with the dog leash. HX of MDD, PTSD, ADHD & anxiety.
Came from Bar None. Sig family trauma, sex trafficked by parents who are incarcerated. Some drug use, but sober now (benzos and opiates). been behaving ok so far. Responding well to limit setting in ED. At Omegon was doing ok aside from relationship issues. Grandmother had custody but has been terminated.
Several referrals – denied due to chemical use/abuse. Shelters denied d/t aggression. High risk for placement. Check into returning to Bar None Omegon? Youth Villages in TN – they can take more aggressive behaviors. ***Discharged to Hotel Care with crisis staffing. The Hennepin County CM/guardian arranged for the placement after 30 days in the ED.
History of trauma, sexually exploited youth, aggression, ODD, multiple placements, adjustment disorder. Had an Intake with FV PHP program, was accepted, but nowhere to place her to do the program. Meeting today with county to discuss the case. Looking at intensive therapy services, shelters.
Patient been accepted to Fairview’s PHP, pt has a foster mom who is only willing to take pt home after completing PHP, county seeking residential. 3/23 update: transferring 3/24 @ 10:15 am to DIVINE.
PTSD, Disinhibited Social Engagement Disorder, Conduct Disorder, ADHD, ODD. Just got approval from HC for funding. Case mgr will start making calls. Doest present well on paper. Challenging behaviors – gets escalated and disreg. with peers. Is able to walk away. Threatens to hurt people but hasn’t yet. Remorseful about behavior. Learning about her dx. Fun kid, gets along with certain peers. Doesn’t work well with peers who have made statements about race. Ready to benefit from res. tx. and work with people 1 on 1. A lot of early childhood disruptions. Not sure why removed from bio mom – per aunt and gramma, she didn’t know how to be a parent. Aunt and gramma say that she has tried to kill them, threatens people, hard to know what’s what and what is recent behavior.