Previously diagnosed with depression, anxiety, PTSD . Numerous admissions to psychiatric hospitals and Emergency Departments because of suicidal ideation, suicide attempts and self-injury. History of CPS, county mental health case managers and crisis services. Plan to jump off a bridge. Self injury has included cutting, scratching, burning and head banging.
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-F16-5020
Kiddo arrived in ED on 12/22 after altercation at Passageways Shelter. Has boarded with us many times previously, including 3 in the past month: 11/29-12/5, 12/14-12/18, and now 12/22. Also previously boarded with us 4/26 to 5/29. Was recently at Aspen and Passageways shelters, neither which she can return to. Long history of elopement. County has interim custody. Team was working toward RTC but has also historically been denied by these programs.
CH-F16-4861
The patient is a 16 year-old female that presented to the ED on 11/11/24 from PHP via EMS after attempting to stab herself in the arm with a pen. This is the same concern which has led patient to having multiple ETC visits and this being her 4th psychiatric hospitalization, all since October 2023 (attempted PHP x2 though was brought to the ER due to stabbing herself with a pen in the arm). Patient was placed on a county emergency protective hold with CHIPS now in place. Patient and parents open to residential treatment.
MHF-F15-4901
Came to our ED on 11/25 after altercation at home with Aunt, who is current custodian. Aunt has refused to take her back home and is refusing any involvement in her care currently. CPS is getting involved. Has CMH worker as well. Nexus YCT has been involved ongoing and is trying to work on referrals for residential, but needs ROIs first. Has interview with residential provider who previously accepted today 12/3.
MHF-M14-4646
Kiddo came into ED on 9/24 from school for aggressive behavior, was in foster care who is not willing to take pt back. Under custody of the County. Has history of both residential txt (Northwoods 2x) and juvenile detention centers, and has a rule 20. Referral has been made to Prairie Lakes, waiting for response.
NMH8R0MGH-M13-4848
Patient was placed in residential treatment for one year in 2022-2023 from the ER. Grandmother/legal guardian does not feel safe with patient in her home as he has been physically aggressive with her, she is declining to pick him up from the ER and wants out of home placement. Per Grandma, he was successful in the home following residential treatment, however, this year his aggression has become worse. Community case manager has been unsuccessful in securing placement.
HCMCED-M11-4844
On 11/14/24 the patient’s foster parents brought him to HCMC APS after he was discharged from Children’s Hospital St Paul because of his aggressive behavior. When in APS the patient began hitting his foster mom and becoming increasingly agitated. Security had to assist in transporting the patient to an emergency department bed, where he was then put into restraints for his and others safety. He was given sedative medications, IM.
The patient has been in foster care since he was 7 years old. He was physically and emotionally abused by his biological mother. He has been hospitalized at Fariview inpatient pediatric psych for a year, where he was then transferred to a residential treatment center. He has been with his current foster parents since August 7th, 2024.
AH-F13-4837
Admitted inpatient after running away twice from home and expressing HI towards her brother. This all occurred shortly after being discharged from M Health Fairview MICD residential treatment. She was discharged from Fairview due to threatening a peer. In the last year she has been engaging in high-risk behaviors including but not limited to substance use, fighting peers at school, theft from peers and stores, and making allegations against others (peers and family) that have not been substantiated.
EHS-F16-4792
Patient is a 16-year-old girl with history of mental illness who was brought to the emergency department from port group home where she has been residing for about 5 days. Patient states that she was in juvenile detention immediately prior to going to the group home. Patient has been prescribed psychotropic medicines in the past, but is not currently using any medications. Recommendation from probation officer and county social worker is juvenile detention center or psychiatric inpatient hospitalization pending long term psych placement. However, LE states they can’t bring her to JDC as she has no charges that would make that appropriate at this time without order from probation. Pt has been aggressive, verbally and physically while in the ED. She has eloped on multiple occasions and has attempted to harm herself.
PH-F8-4701
Recommendation is for QRTP or PRTF – either could potentially meet the needs of this patient and limited treatment centers available due to patient’s age. Patient is currently in psychiatric inpatient hospitalization.
Patient is an 8-year-old female. Patient presented to inpatient from the ED due to increase in unsafe and risk-taking behaviors. This is her fourth inpatient hospitalization; one in 2022 and three in 2024. Patient has attended day treatment twice and participated in outpatient psychotherapy and medication management.
Discharge Plan:
PRTF/QRTP: (county funding approved for QRTP)
– Grafton (declined due to not meeting criteria)
– Northwood (referrals submitted 9/9, on waitlist 9/23 – awaiting update on admission timelines)
– Gerard (unable to accept due to age)
– Avanti (unable to accept due to age)
– Bar None Haven (unable to accept due to age)
– North Homes (unable to accept due to age)
– Heartland Girls Ranch (unable to accept due to age
Continue with following outside providers:
– Therapy/Therapist: Solutions Behavioral Healthcare Professionals
– Primary Care Provider: Sanford Health
– Medication Management: Solutions Behavioral Healthcare Professionals
– Case Management: Solutions Behavioral Healthcare Professionals
– Occupational Therapy: Beyond Boundaries Therapy and Wellness