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.

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agreed to take patient in with consent from LG, but aunt declined to pick patient up on day of scheduled discharge and rescinded the offer to accept patient.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

MCR-F15-1269

UPDATE: Mom wouldn’t sign ROI for CRTC to she still awaits placement.

Patient is a 15 year-old with a history of PTSD, MDD, and GAD. She has a history of five previous psychiatric hospitalizations and one premature discharge from residential treatment this past spring after restricting her food and water intake (start of present hospitalization). Nutritional intake has continued to decline to the point of needing tube feeds to meet daily nutritional requirements, with symptoms more closely resembling anorexia nervosa at this time.

Patient is already connected with medication management, county case management, CPS, and psychotherapy.

C8SM8M-M11-881

Patient is an 11-year-old male presenting to Children’s Emergency Department due to increasing behavioral escalations at home. Patient has a history of trauma. Patient has not had stable housing and has been in several different placements within this last year.
Patient does not meet inpatient mental health criteria due to no ongoing or current suicidal ideation, thoughts of self-harm, or thoughts to harm others and was recommended to discharge home to his foster home with his grandmother.

C8SM8SP-M10-1459

Pt is a 10 yo male presenting due to increased aggressive and impulsive behaviors at home. Pt was attempting to light fires in the home prompting mom to call EMS. Mom has other small children in the home and feels as though she is not equipped to care for him. Pt has trauma history and has had inpatient mental health stays in the past. County recently approved funding for PRTF. Looking for a shelter in the meantime. Has sexual concerns so that needs to be considered with shelter placement. Extensive sexual and physical abuse history. Mom unable to take him back at this time, other children in the home. Has not has any sexualized behaviors while at the hospital. Nexus Mille Lacs is able to take someone with potential sexualized behaviors – and is interested in this child. Connecting offline.

PH-F16-1369

*UPDATE: Admission to Gerard 7/28/23- just pending county funding at this time, 2nd screening today, 7/20

16 YO Female in 10th grade. Two previous psychiatric hospitalizations (2/23/22-3/4/22 and 9/17/23-9/27/23) in addition to the current admission. Has attended Day treatment. No alcohol or Drug use. Increasing SI and history of self harm. Hx of sexual abuse at age 9.

DISCHARGE EFFORTS:
-RTC: Avanti Center for Girls (Referral sent, pt accepted, 6 month wait list)
-RTC: Gerard Academy (Referral sent, pt accepted, admission, 7/28/23, pending county funding)
-RTC: North Homes (Referral Sent, pt approved, opening estimated for August-September)
-RTC: Northwood Children’s Services (Referral Sent)

Interim Plan:
-Day Treatment: TSA (pt able to return if/when it is safe to DC)
-CMHCM: Janet, Isanti County
-DBT: (SW to provide resources upon DC for guardian to use after RTC)

AH-F15-1322

came to ED with suicidal and homicidal threats after an upsetting conversation with former foster provider – currently denies HI/SI to staff, unable to be placed with former foster provider, difficulty at group home – arguments with staff and other residents and they have said she is unable to return, CPS worker is guardian and looking for placement,

Nexus -FACTS
– youth has been accepted at Nexus FACTS for assistance with Placement Coordination Services.

MCR-M17-283

State of MN is trying to find a way to build his own home, timing TBD.

Aggressive, DD, low IQ – 40-50, FAS, ward of state, targeted case mgr. Was provisionally discharged from CABHH, not allowed to return. Perhaps a plan is a state run group home, in development?

MCR-M14-1086

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.

MHF-F16-1057

Patient is under the guardianship of Swift County, and presented to the ED from his group home in Hennepin County. Patient got upset after being denied an outing, and went out to the road (not a busy road) and threatened suicide by getting hit by a car. Police were called, and patient was taken back to his group home where he made homicidal threats towards a neighbor. Group home staff then requested patient be seen by the emergency department. Patient has had multiple psychiatric hospitalizations. Patient reports frequent suicide attempts with methods unlikely to harm him, such as tying shoestrings around neck. Patient has a history of self-harm.