PH-M13-6717

Recommending PRTF.
13-year-old male who presented to Inpatient from ED after aggression towards adoptive parents and suicidal ideation with intention to act. This is his 2nd psychiatric inpatient hospitalization, and he has been engaged in outpatient care.

Discharge Plan as of 04/22/2026:
Grafton (Declined due to inclusion criteria)
Leo Hoffman Center (Accepted with approx waitlist 2 months)
Nexus East Bethel (Reviewing)
Northwood Children’s (Does not accept pt’s insurance, 2-year waitlist)

In the interim:
Establish PHP: PrairieCare PHP at Mankato (Guardian prefers continuing with ABA Day Program instead)

Continue with established outpatient providers:
CMHCM: Blue Earth County
Psychiatry: Mankato Clinic
IT: Surdey Family Services
Day Program/ABA Therapy: Northway Academy, Children’s Autism Services-Mankato
OT: Mankato Clinic Pediatric Therapy Services

PH-F17-6710

Inpatient Team is recommending Locked QRTP/PRTF.
17-year-old patient admitted to inpatient as a step up from PrairieCare Residential. They were admitted due to continued episodes of emotional dysregulation, intrusive SI and attempts to elope. This is their 9th psychiatric inpatient hospitalization. They have done PHP, outpatient care and residential treatment.

Discharge Plan as of 04/22/2026:
Hospital and PCR treatment team recommends:
-Bar None Haven locked RTC. They were accepted on 3/18; county did not approve placement.
-Heartland Girls Ranch. They were accepted and on wait list, county did not approve placement.

County team pursuing:
RTC-
-Gerard (reviewing)
PRTF-
-Nexus East Bethel (declined)
-Northwoods (county sent referral, currently a 2 year wait)
-Grafton (county sent referral, does not meet admission criteria)

Interim plan:
-Consider Shelter care at Ain Dah Yung Center, The Bridge for Youth- Supportive Housing-Marlene’s place, Youth Transitional Housing Program – Life Haven/ Lutheran Social Services of Minnesota
-Establish Psychiatry
-Establish Therapy
-Continue with Hennepin County Team, Guardian Ad Litem, and Tribal Representation

This youth has been medically cleared to discharge from inpatient to the appropriate next level of care although due to barriers with accessing the recommended level of care, they are now boarding. The Hennepin County Boarding team is working with inpatient on this case as well.

MHF-F17-6700

Youth came to our ED on 4/9 after being on the run for 3 weeks. Has a long history of elopement and some aggression as well. Is open with CPS, ACT team, and DD waiver, and there is a VPA for placement currently. County team is looking at all placement options- all waiver options, RTC, out of state. Has been denied many places already primarily due to the elopement behaviors.

MFIUP-M14-6668

Pt presented to ED with family after FBI visited family after an anonymous tip that patient was having SI and HI regarding a mass shooting in the context of worsening depression and anxiety. Pt acknowledged recent homicidal ideation as a means to justify ending his own life. Initially pt denied creating a written plan, denies attempts to get a gun or have possession of a gun, or thought of a specific school or time he would do this, though, he now states he identified two elementary schools as potential targets. During past assessments he has acknowledged reasons for not going forth with this shooting – like the attempt would fail and he would be in a worse situation and he does not want to actually hurt people. Similarly, suicidal thoughts are present with thoughts of shooting himself, but does not have intent or obtained means to act on it. Although these are moderate-high risk thoughts, patient is able to keep self and others safe while in the hospital at this time. Aspects of his clinical history that put pt at risk for progressing to future violence include pre-occupation with prior shooters, nihilistic beliefs, and time spent in a potentially radicalizing online community. Additionally, mom reported partner had a gun in the home and patient + step-brother was looking around the house for this gun. The leading drivers of current SI and HI seem to be significant anxiety and co-morbid depression. Has experienced significant neglect and sexual abuse that have impacted his current mood and outlook as well.

CH8SCH-F13-6644

Patient presented to ER from residential treatment after assaulting staff. This was patient’s second day of residential treatment followed by lengthy back-to-back hospitalizations. Patient recently assaultive to staff and oppositional at times. Has required multiple PRN’s for dysregulation. Residential treatment facility therapeutically discharged her to the hospital.

MHF-F12-6621

Youth came to our ED 3/9/26 after an altercation at home. Mom is not willing to have her return at this time. Mom ultimately wants RTC however County JST has not approved that currently. County team has put intensive in home services in place (CIBS) and report they would like family to try that program completely as the less restrictive option before going to RTC. Youth only seems to have behaviors at home, do not see them at school, at respite, or in the hospital. County reports plan to treat behaviors where they are occurring for best success, but Mom continues to refuse to bring pt home.

MHF-M16-6455

Youth came into our ED on 1/13/26 and was determined to be ready for discharge. Came from Grandparents who are refusing to take him home until he gets SUD treatment. He is unagreeable to SUD treatment at this time, willing to do OP. County is not funding shelter due to not having custody. Parent referred shelter referrals have been made however custodians refused the Bridge who were looking at accepting him. Has been to Lakeside Academy and Wings SUD treatment in the past and eloped from both. No waiver currently. FV Maplewood declined primarily due to pt being unagreeable to treatment, but also due to concerns of elopement and Grandparents being willing to get him from the ED. Has been declined by many other RTCs as well. Referral pending with Anthony Louis.

PH-F12-6449

Recommending PRTF
12 year old trans male who presents to PrairieCare Inpatient Hospital due to suicide attempt with increased SI, SIB, elopement, and aggression.
He has a history of several inpatient stays, has engaged in PHP, individual therapy, family therapy, and RTC at PrairieCare
Funding is in place for RTC with Hennepin County

Discharge Plan:
PRTF/RTC:
– PrairieCare Residential (administratively discharged due to acuity)
– Bar None Haven (under review)
– Nexus East Bethel ( under review)
– Grafton (referral submitted by PCR, Accepted )

Continue with established outpatient providers:
– Primary Care with Mhealth Fairview
– Psychiatry with Roman Becicka, MD at U of M
– CMHCM with Nakami Tongrit-Green at Hennepin County

CH8SCH-F16-6368

Patient was at Heartland Girls Ranch and reports that she tried to run from the facility, scratching her arm and hitting her head on the wall. Patient reported suicidal ideations with a plan. County is guardian of patient due to past abuse. County feels like patient needs PRTF level of care. On the waitlist at CABHH.

MHF-F14-6421

Youth came into our ED on 12/28 after altercation at hotel crisis respite. Was in this setting for approx 5 months, and prior to that was boarding in our ED from 5/28-7/3. Hotel crisis will not take her back. She has 4 different felony charges pending, awaiting a rule 20 assessment. Most placements including non secure corrections settings will not accept due to aggression. Team is working toward a single site CRS home, but that is a few weeks from being completed, waiting on provider’s waiver enrollment with DHS and finalized staffing. Last DA done a few weeks ago recommended GH with supports, and scored a level 5, however not pursuing treatment placement as all MN options have denied and pt was in RTC in Florida for 2 years previously.