Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, and significant behavioral change. Per patient’s mom, patient has been struggling for several years with anger and aggression, but this past month things have been escalating. Patient got upset at home, threw things, and punched his mom in the face. Patient’s mother called the police. Patient was in Riverside’s inpatient unit 3x in 2020. Patient was referred to PHP, and attended a 3-week PHP at Children’s Hospital. At the completion of the 3-week PHP, patient was recommended for additional treatment in a residential/inpatient setting. Patient has previous mental health diagnosis of PTSD, ADHD, DMDD, anxiety, and depression. Patient has a mental health CM and a psychiatrist.
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-F11-2021
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression. Patient was discharged from residential treatment last week. Patient was supposed to discharge to a group home, but her CADI waiver had expired, and she was discharged home without services. Patient became upset after a stressful day, and began arguing with her brother and mother. Patient “destroyed her room”, attempted to kick out her window, and ran a piece of glass under her nails. Patient’s mother called the police.
Patient has a history of ADHD, depression, anxiety, and aggressive behaviors. She had 5 admissions to inpatient psychiatry, with the most recent one on 9/28/22.
HCMCH-F16-1812
A 16-year-old female with a history of mood disorder, borderline personality disorder, PTSD who presented to ED with suicidal ideation, threatening behaviors towards her family, and altered mental status. She also struggles with low frustration tolerance, severe emotional dysregulation, and a lack of coping skills. She is currently awaiting inpatient placement.
AH-F16-1908
Brought to ED after altercation with mom (family adopted patient after years of fostering). Patient went after mom with a knife, patient reports conflicting stories about incident and what she remembers happened. Had been in residential over a year ago. Was recently suspended from school for 10 days after getting into a fight with another student. Unclear if there have been any other incidents of this nature with mom or family, however, mom is not feeling safe if patient were to return home. CPS is involved, Nexus is now involved, but no placement options on horizon at this time.
MHF-F11-1660
9/28: Youth still awaits placement to RTC.
9/19: Accepted to Nexus FACTS to assist with Placement Coordination.
9/14/23 UPDATE: Nexus YCT program looking into helping with this child.
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, significant behavioral change, abuse or neglect, anxiety, worsening psychosocial stress, suicidal ideation, depression. Patient was staying at a crisis residence after discharging from the ED on 9/1/23. Police were called due to patient becoming aggressive/violent, dysregulated and exhibiting SI/HI plans and threats. Staff at the crisis residence do not feel safe keeping patient at the home due to her violent outbursts, and fear for other residents’ safety.
Patient is a Hennepin County state ward. She has an extensive history of childhood trauma, including neglect, physical abuse, and suspected sexual abuse. She was also prenatally exposed to cocaine. Patient’s grandmother adopted her, who fled with the patient to a different state. Her grandmother’s rights were terminated, and patient has been living in foster care with her aunt since the end of June 2023. Prior to that, patient was living in a group home for approx. six months in Duluth, after completing residential treatment at Northwoods. She arrived to the ED on 08/09/23 following an episode of significant behavioral dysregulation involving throwing furniture down the stairs. She was subsequently admitted to 7ITC and discharged on 08/28/23, returning to the ED on 8/28, and discharging to crisis residence on 9/1. Has a CPS worker, who is her guardian, but no other services/case managers.
PH-F15-1621
Updated 10/23/23: DC home to in home therapy through CIBS. Still no county funding for QRTP
Updated 10/19/23: Still no county funding for QRTP. Discharge home 10/23 or 10/24 with in home therapy through CIBS.
Update 10/12/23: Still no county funding. Likely moving forward with CIBS at Gerard, will likely discharge next week home.
Update 10/5/23: Gerard admission pending 10/11 now. County funding remains pending. Pt declined from CD RTC noting Mental Health long term RTC.
Update: 9/7/2/3 Gerard admission tentative 9/20, pending county funding.
Update: 8/31/23 Approved for Gerard admission week of 9/18, pending county funding. Also accepted at NorthHomes, 3-6 month waitlist.
SI since the 4th grade, history of trauma, living in cars/shelters, history of CD use.
Discharge Plan:
Primary DC recommendation is RTC*:
Gerard (accepted; pt is next on list for placement; openings week of September 18th)
North Homes (accepted; 3-6m waitlist)
CRTC (referral placed; admissions paused due to staffing)
Avanti (referral not placed; facility not accepting referrals)
*QRTP/RTC County Funding needed as pt has a UCARE PMAP Plan:
Dakota County CMHCM: Referral Placed
-Mother lives in Dakota County and father lives in Rice County (pt will reside with mother following hospitalization, mother provided consents)
-Le Suer County and Scott County CMHCM previously referred to: Cancelled Referral due to Family Moving
MCR-14-1888
a history of diagnoses of PTSD, reactive attachment disorder, Oppositional Defiant Disorder, ADHD and substance use disorder. Her social and developmental history is notable for significant early life trauma related to parental substance use, including at least one episode of Lily herself ingesting methamphetamine as an infant. She was removed from mother’s care at age 10 months and father’s care at age 5 years, and was adopted by maternal grandparents at age 7. She has had essentially lifelong difficulties with dysregulated behavior. She has been at Mayo Clinic since 9/6/2023 following an altercation at the home where she was staying. She was previously residing with a family friend, but is unable to return due to safety concerns by all adults involved, including Olmsted County who assessed this not to be a safe discharge location. Her legal decision maker is her maternal grandmother who has previously adopted her.
MCR-F15-1882
a history of diagnoses of PTSD, Conduct Disorder, Alcohol and Cannabis Use disorders, and unspecified mood disorder. Her social and developmental history is notable for recurrent physical abuse by mother and mother’s romatic partners leading to termination of parental rights 6/21/22, alleged sexual assault, first JDC placement at age 12, and recurrent residential placements through juvenile justice over the last few years. Comes after a violent episode at a foster home; she is unable to return.
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.
MHF-M12-1891
Patient presents to the ED via EMS, via police. Patient had altercation with brother, and pulled out a knife, threatening to kill his brother and grandpa. Patient has been diagnosed with depression, anxiety, bipolar and receives level 4 services in an intensive special education school. Grandpa has custody, as well as his parents, but state they cannot keep patient safe, as they live in a dangerous neighborhood.
Patient spent several months at RTC at BarNone and Gerard Academy, and returned to live with grandpa this summer. Patient has also done Peoples Inc. day treatment program, and PHP at Prairie Care three times.
Patient has placement at Northwoods in Duluth, and is waiting for an open bed.