PH-F15-6783

Recommendation is for level 5 QRTP
15-year-old female presenting to inpatient as a step up from PrairieCare Residential after experiencing increased mood dysregulation and suicidal ideation. This is her 4th hospitalization with PrairieCare and has been hospitalized at two other facilities. Guardians are currently hoping for a QRTP closer to home and not out of state.

Continue with established outpatient providers following RTC:
– Individual Therapy
– Medication Management
– CTSS
– Primary Care Provider

MHF-M11-6830

Youth came into our ED on 5/10 after elopement from group home. Provider issued immediate suspension and termination. County has custody after TPR. Has CMH and Waiver CMs. Looking for waiver paid placement, shelters, group homes. No current RTC recommendation but OP therapist is working to update the DA to get that.

MHF-F17-6780

Youth came into our ED 5/5. This is her 3rd time boarding with us in 3 weeks. She discharged to Dignity House and Aspen House the last times and is needing placement again as she can’t return to either. (Eloped from Dignity and got into an altercation at Aspen. ) Looking for waiver or treatment placement, but has been denied from many options.

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.