Patient presented from home due to aggression and dysregulated behaviors, which are baseline for patient. Guardian will not allow her to return home, citing safety concerns for himself as patient often becomes aggressive with him. Patient has been to Gerard RTC in fall, 2023 but discharged without completing.
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.
AH-M15-2038
UPATE: 1/18/24: Still inpatient. May be going to crisis programming in the near future, but no date yet.
UPDATE 11-15-2023: Still inpatient 1:1 staffing, strict behavior plan.
Patient is a 15 yo M with a past psychiatric history of RAD, PTSD, and ADHD as well as unspecified mood disorder (MDD vs DMDD), spells of trembling, and unspecified anxiety disorder, mostly documented as GAD. Multiple previous inpatient admissions, most recently Feb 2023. Has had numerous ED visits since 02/2023 for aggression. He has a psychosocial history of early parental loss, institutional care, neglect, and profound physical and sexual abuse while living in an orphanage in Ghana following the death of his biological mother in child birth. He was adopted when he was seven years old. Since that time, he has struggled with physically aggressive behavior, typically triggered by losing control of situations by not getting what he wants, being challenged, etc., assaulting both parents and endangering siblings. He can also become agitated and engage in aggression and property damage at the school. When he is not aggressive, however, he presents as extremely polite, pleasant, playful, and affectionate, and he does not struggle with chronic irritability or agitation. His family has worked to keep him in the home and community by maintaining two residences, with father caring for him in a rental and his mother caring for his sibling in their family home for safety over the past three years. He has had numerous inpatient stays, crisis placement, shelter, and residential stays as well as outpatient psychiatric and counseling services in clinic and in the home. Still, his behaviors remain persistently dangerous, culminating in the sexual assault of his father on 10/21/23.
Reach out to Heather Hanson, Social Worker at Abbott with questions or possible matches. She can be reached at 612-863-8569 and/or heather.hanson2@allina.com
MHF-M14-2604
1/18/24. No placement at this time. Waiting for a waiver to open up more funding sources. Denied at respite/shelter due to behaviors
Patient presented from Aspen House shelter due to aggressive behavior and property destruction. Patient is unable to return to shelter. Mother refusing to discharge home. County looking into shelter options and foster care placement
CH-F15-2882
Patient presented to the ER after 3 other ER visits from outside ER for physical concerns that were determined to be panic symptoms verses a physical abnormality. Patient has a chronic history of mood and behavioral dysregulation, self-harm, multiple suicide attempts, truancy, and parent child relationship difficulties. She has a history of trauma in the form of witnessing domestic abuse, physical abuse, possible sexual abuse, and the death of her dad due to an OD 4-5 years ago. She has had 2 inpatient hospitalizations along with 2 PHP admissions with little benefit and participation. Mom struggles with following through on recommendations and struggles with alcohol/substance use. A child protection report was filed last year and she moved in to her neighbors though this is no longer an option. She denies any passive or active suicide ideation, plan, or intent. Inpatient hospitalization is not recommended. Mom is not willing to bring her back home at this time due to disruption in the home.
MHF-F14-2737
Discharging today to A New Direction for Youth
Patient presented from GH after threatening staff with pepper spray and becoming verbally agitated, which is often baseline for patient. GH will not accept back until a meeting can occur to determine if they will be accept back, meeting scheduled for Friday 1/12.
PH-F15-2859
Discharge Plan: *Insurance is BCBS MN PMAP
Residential Treatment – Referrals have been sent to the following facilities:
-Avanti (Referral submitted 10/26, DECLINED)
-Gerard Academy (Referral submitted 10/26; Update received 12/14: Unable to admit due to elopement risk but otherwise approved, will leave on list to review level of risk moving forward; currently under re-review)
-North Homes (ACCEPTED; County funding needed; openings in March/April)
PRTF – Referrals to be sent to the following facilities:
-Grafton (Referral submitted 10/23; pt does not meet exclusionary criteria)
-Nexus East Bethel (Referral sent; only accepting pt’s with MA insurance at this time; will refer once County confirms MA insurance)
Outpatient Services:
Establish CMHCM through Ramsey County (Referral submitted 10/23; intake worker confirmed on 1/10 that a long term worker would be assigned next day)
Continue existing outpatient services:
-Therapy/Therapist: Minnesota Mental Health Clinic in Woodbury
-Prescriber/Medication Management: Nystrom & Associates
-MCRC Runaway Intervention Program at Children’s
-PO Ari Tresselt Ramsey County
-Disability Services intake worker: Ramsey County
Case Description
15-year-old female with a history of depression, anxiety, ADHD, PTSD, as well as some behavioral concerns. Pt has had three hospitalizations in the past year, has done PHP, JDC, outpatient.
PH-F15-2853
Discharge Plan: *INSURED BY BCBS MN PMAP*
Residential Treatment – Referrals have been sent to the following facilities:
-Avanti (Referral submitted 10/26, DECLINED)
-Gerard Academy (Referral submitted 10/26; Update received 12/14: Unable to admit due to elopement risk but otherwise approved, will leave on list to review level of risk moving forward; currently under re-review)
-North Homes (ACCEPTED; County funding needed; openings in March/April)
PRTF – Referrals have been sent to the following facilities:
-Grafton (Referral submitted 10/23; pt does not meet exclusionary criteria)
-Nexus East Bethel (Referral sent; only accepting pt’s with MA insurance at this time; will refer once County confirms MA insurance)
Outpatient Services:
Establish CMHCM through Ramsey County (Referral submitted 10/23; 1/10 intake worker states the long term worker will be assigned tomorrow)
Continue existing outpatient services:
-Therapy/Therapist:Minnesota Mental Health Clinic in Woodbury
-Prescriber/Medication Management: Nystrom & Associates
-MCRC Runaway Intervention Program at Children’s
-PO Ramsey County
-Disability Services intake worker Ramsey County
Case Descreption:
15-year-old female with a history of depression, anxiety, ADHD, PTSD, as well as some behavioral concern. Patient has exhausted several outpatient supports including school in a smaller setting, Childrens hospital, as well as Maplewood PHP, DBT, and engagement with MCRC, JDC and two other shelter placements. Third hospitalization this year.
CH-F16-2246
Update: 1/15/24- Patient has been accepted by Nexus with an admission date of 1/16/24!!
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.
CH-F16-2451
Update- 1/11/24- The patient has been accepted to MNCCS respite home with a planned admission date of 1/17/24!!!!! Thank you to this facility!!
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.
MHF-M16-2642
Discharging to Gerard on 1/10
Patient presented from Bar None shelter after A verbal altercation. Had been in Bar None RTC however got into a physical altercation several days prior and moved to the shelter on a behavior contract. When patient became verbally agitated, patient was sent to ED and is now discharged from the facility. Patient denies MH symptoms, has no placement. Guardian reports referring patient to North Homes and Gerard who report several month wait lists.