17 yo female with hx of dep, anx, PTSD, eating d/o, mood lability, and personality concerns who lives with her dad and siblings in Menahga. She is in the 12th grade and reports having a 504 plan. She has a hx of around 10 inpatient hospitalizations and 3 stays in RTC. Stressors include family conflict, social stressors, and school. Family hx of MICD concerns. Patient has been struggling with worsening symptoms and safety concerns including SI with multiple plans (cut, OD, hanging, crash, etc) and SIB. She has been admitted for acute stabilization.
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.
PH-F15-5177
Patient is currently inpatient and are unable to move further with discharge planning due to not having a County of Financial Responsibility. Stearns County and Wadena County have both been consulted and neither have accepted responsibility at this time.
Discharge Plan:
Establish PRTF; referral made to Nexus East Bethel, INTAKE SCHEDULED 3/3/25
Establish Level 6 Program; referral made to Bar None Haven
Establish County Support/Funding; assigned for CMHCM at VOA
Continue with established outpatient providers:
-PCP: Lakewood Health System
-MM: Lakewood Health System
-Therapy: Lakewood Health System
MHF-M16-5234
Kiddo came to us on 2/2 following suicidal behaviors. Plan was originally for inpatient however while waiting for bed he stabilized in the ED and became a boarder on 2/10. Was in SUD residential treatment, but they are declining to have him return, explaining that his needs are more mental health based than what their program can provide. He has a tentative acceptance at a residential program, just waiting for them to process more paperwork and identify a discharge date. Currently under temp custodianship with Ramsey County but Mom is involved ongoing.
MHF-M14-5199
Kiddo was previously boarding on our IPMH unit from 10/30/24-12/11/24, then discharged to hotel crisis respite. He came to the ED multiple times end of January for behavior at the hotel crisis placement. Upon driving home from ED on 2/1, pt became aggressive in the car and was brought back to the ED again. The provider now indicated that he is unable to return to their crisis program. He has been accepted at Chelida in WI, however its reportedly a long wait list, and they may not be able to admit him until this summer. He is also on the wait list for CABHHS but it’s reported they would not have a bed for him for several months. Needing an interim crisis placement while awaiting placement at Chelida. Referral is being made for Nexus YCT to assist with placement coordination. He is suspected to have autism however the full assessment has not been completed for diagnosis. Has previously denied at Grafton, Leo Hoffman, Mille Lacs/Gerard.
MCR-M15-5209
He completed day treatment on 1/23/25 but has been dysregulated off and on during that time, residing at foster home and eloping. Prior to presentation, eloped and was away from home for 12+ hours, sleeping outside in someone’s truck (not running) in zero degree temperatures. Nobody feels he can be maintained safely in the community.
CH-F14-4594
Patient presented to the Emergency Trauma Center at St. Cloud Hosptial with aunt. Patient presented after being on run from NW Passages in Wisconsin. During times of elopement, patient is known to spend time at the home of a person known for drugs and trafficking. Patient has a county mental health case manager that is working to make referrals for appropriate levels of care. Patient has a history of aggression towards their aunt. Patient does not have any contact with biological father as he is incarcerated and limited contact with biological mother. Parental rights have not been terminated, but patient’s aunt has physical and legal custody. Patient is very vulnerable and has no insight into the unsafe nature of his behaviors.
AH-M16-5148
The patient has a history of ADHD, disruptive mood dysregulation disorder, anxiety, and PTSD. Last night he became frustrated at residential treatment facility- Bar None, kicked a door with his right foot, and put a shoestring around his neck out of frustration. He states he was not trying to hurt himself and did not intend to hurt himself. Bar None completed an administrative review and will not allow his return.
MHF-F13-5110
Kiddo was brought into our ED on 1/9/25 by her County Case Manager. She was in residential treatment at Deveruex in FL for over a year, she then aggressed, and was charged with assault so was brought to a JDC for 21 days in FL. After that time was up, she was ordered back to MN and the County had no placement so she was brought to the ED. Ramsey County currently has custody. Their goal is a long term group home with 2:1 staffing, but are needing somewhere for pt to go in the interim. Our team tried to refer to Nexus YCT for placement assistance, but the County worker refused that service. She has been declined by Gerard and North Homes RTCs. She currently is eligible for waiver placements but a waiver worker won’t be assigned until placement is found, so the Child Family Svs worker is doing all referrals, for MH and waiver placements. County is currently refusing hotel crisis as an option.
MHF-F17-5090
Kiddo came to our ED from NW Passages in WI on 1/3. She can not return to NW Passages as she has told them she refuses to return there. She had made threats to peers and family while there and was showing increased aggression. She was only going to remain there until turning 18 this spring and then the team did not know where she was going to go next. Currently they are looking at shelters, PRTFs, and anywhere that may accept her. (We have not had a team meeting yet to get full details) There is an intake meeting with Nexus YCT today at 1pm to get their assistance with placement.
CH-F16-5073
Presented from Newport Academy on 1/7/25. Patient engaged in property destruction and made suicidal comments. Patient admitted to Newport in November. Patient was administratively discharged at the end of December. Patient has a history of running/eloping and is believed to have been trafficked to Ohio in October. Patient was tracked down by his cell phone and detained by law enforcement at a juvenile detention center in Cleveland. Patient returned to MN and was admitted to Newport. Not meeting criteria for acute inpatient psychiatric placement. Long-term placement in a secure/locked facility is recommended.