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.
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-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.
RMC-M12-1802
2nd visit to RMC in one week for running away (from school and from home). Verbally abusive towards authority (Sheriff’s Dept. and his grandparents). Recent theft (stole a sweatshirt from the mall) and violation of school policy (vape found in locker). Patient is refusing to return home with grandparents (legal guardians since 10 months old), now claiming they physically and emotionally abuse him. Hennepin Co. CPS has no concerns with safety at home. Patient is now making threats to grandparents, expressing that he wants them to “be murdered.” Grandparents are concerned for their safety after threats made by patient.
MCR-F12-1396
Update on 8/17/23 – still waiting placement, relocated to peds area, not admitted, still an ED patient.
Patient is ward of state with guardianship by Otter Tail County. On a stay of commitment. Terrible trauma history and aggression – toward inanimate objects, but occ if staff gets close, she will be aggressive toward a person. Multiple hospitalizations/boarding situations, multiple (5-6) PRTF placements and failures, including an out of state facility that was suddenly shut down. Was in Rochester for hotel with respite, but they brought her in after less than a week due to behaviors. Struggles to regulate when frustrated.
MHF-M18-1739
UPDATE 9/21/23 – placement difficult due to the arson incident.
Patient presents to ED for aggressive behaviors. Today, patient lit a fire in the bathroom of his group home because he was “tired of living” and “tired of his group home staff”, after they turned off the wifi in the house. After lighting the fire, police and fire department arrived. Patient was still escalated and refusing to leave the group home while the fire was burning in the bathroom. Patient was brought outside by a police officer, and patient attempted to grab the officer’s handgun. Patient states he did this with intent of using on himself or his group home manager. Patient was quickly handcuffed and restrained into an ambulance.
Patient was reportedly hospitalized in Floriday last month while on vacation for aggression, agitation, med non-compliance. Patient has been living in his current group home since 2019. Patient attends an alternative school which he enjoys. Patient has PCP and psychiatry per his report. States he has been in “placements” his entire life since being adopted from Ethiopia at a young age by his current adoptive parents. Previous admissions in 2018 for DMDD, and aggression.
Hx of learning disability, aggressive behavior, agitation, outbursts.
MHF-F11-1552
UPDATE: Accepted to Gerard Pending date next week.
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, anxiety, worsening psychosocial stress. Patient was threatening to attack kids in her neighborhood with a knife, and threatened to stab her grandfather when he attempted to intervene. Patient’s grandfather locked her out of the house, so she wasn’t able to get anything else to hurt someone with, and patient kicked the lock off of the door.
Patient recently lived in a youth shelter/transitional home called Dignity House for 1.5 weeks until 8/3/2023. She was then sent to the ED for aggression. She had a warrant for arrest due to an assault and threatening homicide to family members. She was taken to JDC on 8/3/2023, had court, and then she was sent to the Bridge for Youth Shelter. Patient got into a physical altercation at The Bridge and was sent back to the ED on 8/8/2023. While in the ED, patient physically assaulted a nurse and was picked up by her grandfather.
Within this year, the patient has had approximately 13 ED visits due to concerns including runaway, aggression, abuse/neglect, and altercations with family members.
PH-F13-1646
UPDATE 9/7/23: Pending potential foster/emergency beds.
UPDATE 8/31/23: Possible emergency foster bed open 9/5, emergent SMRT application in process. Still waiting living placement.
13 y/o female with a history of PTSD, depression, ADHD, mild CD concerns. Patient has a history of previous psychiatric hospitalizations related to increase in SI, SIB, and/or suicide attempts. Patient currently has an outpatient therapist and children’s mental health case manager; treatment history includes outpatient therapy and psychiatric hospitalizations as well as one prior placement at Northwoods crisis stabilization program. Patient is in foster care under guardianship of St. Louis County. Patient was in a foster home prior to inpatient hospitalization but is unable to return to that placement after discharge. Patient has Ucare PMAP insurance.
Discharge Recommendations:
Continue individual therapy established provider
Continue CMHCM with established provider
Continue primary care/medication management with established provider
Establish psychiatry (SW to refer/follow up with outpatient team RE: pending referral)
Estimated length of stay:
Until placement is established by the County (Patient is medically ready for discharge as of 08/16/23)
MCR-M14-1389
UPDATE: 9/7/23 – discharged to AMAS Inc (CADI group home)
UPDATE: 8/31/23 – Care conf tomorrow. Accepted by Sunset House, having zoom meeting with patient today to get to know him better before transition- waiting on them to get licensing.
UPDATE: 8/17/23 – Still in ED. Not able to go to Mille Lacs due to non-participation. There is a CADI group home willing to take him, working on licensing.
UPDATE 7/27 – had a video interview with Nexus Mille Lacs on 7/26, awaiting updates.
Previously MCR 1086: Discharged 6/15/23 to VonWald, returned ED 6/30. 14 year old with significant trauma history, ward of Hennepin County, recent placement at his request with young adult brother that was disrupted due to conflict. Briefly placed at Von Wald shelter but repeatedly eloped in an effort to reunite with his brother, and was brought to the ED. Calm overall except when relocated to a unit that required observation while in the restroom, then repeatedly escalated with verbal threats, closing himself in the bathroom, and hitting the walls. Had an interview with Nexus Mille Lacs on 7/26/23. He is familiar with Nexus Gerard and would feel comfortable there.
PH-F14-1603
UPDATE: PT DISCHARGED HOME TO MOM.
Patient is a 14-year-old female with history of depression, anxiety, SI, SIB, trauma and aggressive behaviors. Has participated in PHP, RTC, and inpatient levels of care. Insured by Medicaid.
DISCHARGE PLANNING EFFORTS:
Primary Recommendation-
Establish Day Treatment (Patient currently refuses)
Continue CMHCM- Family Wise Services, contracted by Hennepin County
Establish outpatient individual therapy (CM is scheduling)
Establish med management (CM is scheduling)
Discharge has been attempted. Mother/LG will not accept patient back into the home. Patient was living at Passageways Shelter prior to admission and mother/LG consents for shelter placement at discharge. Patient’s aunt/uncle had agreed to take patient in with consent from LG, but aunt declined to pick patient up on day of scheduled discharge and rescinded the offer to accept patient.
Patient needs shelter placement due to family dynamics, thus the following are pursued-
Consider The Bridge for Youth (Denied d/t reported severity of aggression towards mother)
Consider Passageways (Denied again as of 8/16/23)
Consider Brittany’s Place (Denied d/t parent is still LG and would need to complete VPA)
Consider Hope House (No current availability, call back once per week to check)
Consider Itaskin Center Shelter (Referral sent by SW, additional referral needed by CMHCM)
Consider VOA Bar None Shelter (Referral sent by SW, additional referral needed by CMHCM)
Consider Ain Dah Yung Center (Referral sent by CMHCM, no current availability)
Consider RTC, as previously recommended by CMHCM prior to admission*-
Nexus-Gerard (Referral started by CMHCM, clinical sent by SW, awaiting records from CRTC for determination)
CRTC (Referral started by CMHCM, clinical sent by SW, declined for admission due to IQ)
*QRTP Pre Placement Screening with Hennepin County needed to approve funding for QRTP.
Estimated length of stay:
Patient is medically ready for discharge as of 7/18/23