Recommendation is for CD residential treatment. Patient is currently inpatient.
17 year old female admitted from the ED. Pt was having increased panic attacks and engaging in self-injurious behaviors by hitting themselves. Patient has been having suicidal ideations. Patient has been using marijuana as a coping strategy. Patient has a history of numerous psychiatric hospitalizations. At this time mother feels the patient can not return home as the family has been staying at a motel.
Pt insured by BCBS PMAP and Medicaid.
Pt has the following outpatient supports:
Individual therapy
Psychiatry/medication management
Primary care
Came to Grand Itasca ED 7/8 after altercation at home where he damaged his room. Has also made threats to family members and gotten in altercations with siblings. Was also in ED 7/5 and 7/3 for altercations taking place at home/in the community. Has history of being abused. Just had a CMH CM assigned a few weeks ago. Hospital has made referral for MNchoices. CMH is looking at placements, options are limited due to age.
Recommendation is level 5 QRTP, patient is currently inpatient.
Patient is a 14 y/o male w/ hx of depression, anxiety, ADHD, conduct disorder, ptsd , FSIQ 77, currently presenting due to ongoing mood/behavioral dysregulation resulting in hospitalization after aggression w/ mother and boyfriend. Biologically, there is a genetic predisposition for depression, anxiety, substance use. Patient w/ a long hx of impulsive/aggressive behaviors (runs away frequently, physically/verbally aggressive w/ authority figures, ect). Patient is a poor historian per outpatient psychiatrist and parents which impacts ability to know how he is actually doing. At this time, outpatient psychiatrist recommended RTC, and patient is on the wait list.
Patient has previously engaged in PHP, IT, CMHCM, and Intensive outpatient services
RTC
– Northwoods (referral submitted by CMHCM, year long waitlist 6/27)
– Gerard (referral submitted by CMHCM, under review 6/27)
PRTF
– Grafton (referral submitted 6.26)
6/4/24 admission note: Patient is a 14-year-old female admitted to PrairieCare for suicidal ideation and self-injurious behaviors. Patient was recently discharged from a 45-days residential program. 2 days post discharge patient began threatening to kill her mom and reported SI with plan to jump in front of a car. Pt has a history of recurrent major depression SI, and SIB.
Discharge Plan:
SMRT-Hennepin County (7/8)
PRTF/QRTP – Level 6:
-Grafton (declined due to current milieu at facility)
-Nexus East Bethel (unable to refer due to insurance)
-Leo A Hoffman (unable to refer due to males only)
-Bar None Haven (SW to send referral once consent obtained)
-Northwood (SW to send referral once consent obtained)
-The Youth Village in Tennessee (guardian pursuing)
-Acadia Healthcare (SW to send referral once consent obtained)
Current Providers-
Therapy- Paula Ocampo at Lake Country Associates
EMDR therapy-Tiffany Rundquist, Sanford Health Bemidji
Pediatric Neurology- Dr. Ilgarli, Essentia Health
Psychiatry- Daniel Janiczak, MD and Kayla Scheneit, MD- Sandford Bemidji
CMHCM- Erika Kjellberg, Hubbard County
CTSS- Megan Berg, Hubbard County
EMPATH at Bemidji Sanford 2 times/week
Update 6/26/24: Patient doing well and has made improvement with emotional dysregulation. No longer recommending PRTF level of care. Interview with Divine House occurred last week.
Update-5/30/24- Patient has had severe decompensation in part due to child protection concerns along with prolonged hospitalization and has been in the BICU for aggression, self harm, and seeking/securing items to self harm with. It is now recommended that she be placed in a PRTF.
11 year old presented to the ER after discharging from residential for concerns of running away, recent sexual perpetration to 6 year old brother, and homicidal ideation towards current guardian. Active CPS investigation over the last 1.5 years and is unable to return to her mother’s care or a home with younger children. This patient struggles with low insight, poor boundaries, antagonizing behavior, and justifies her behaviors. We attempted to obtain psychological testing though patient was not cooperative and refused. Medications are stable. She continues to display oppositional behaviors at times.
Pt came into our ED on 6/13 after a verbal altercation at home with mom, where she left the house and walked to the police station who called crisis and brought pt to ED. Mom is refusing to pick up. Its reported pt was in residential treatment until April 2024, and prior to that was in PHP through Fairview. Mom reports that Case Manager is looking into residential treatment again however we have been unable to reach the CM and their offices are closed the rest of this week. Unsure if there is a recommendation for residential or county approval for that LOC.
Presented following disclosing suicidal ideation at school. Previous foster home is unwilling to take her back due to mental health needs. County/hospital is pursuing therapeutic foster care and group homes. She has previously been placed at JDC due to running away from home. She has not run away from previous placements
16 year old female who was brought in by EMS in 4-point restraints after being restrained by PD trying to enter river to “drown herself”. Patient argued with her mother just before she threatened to “drown herself in the river;” destruction of house/property per mother’s report. Patient admits to past similar behaviors and has multiple MH hospitalizations on record.
Recommendation is for level 5 Residential Treatment; patient is currently inpatient.
Patient is a 17-year-old individual who identifies as non-binary and uses they/them pronouns. They admitted to PrairieCare Inpatient Hosptial via ED due to an increase in suicidal ideation. This is their 3rd psychiatric inpatient hospitalization, they have done PHP, and engaged in outpatient mental health therapy and psychiatry. County funding has been approved for RTC on 4/25/24.
Discharge Plan:
RTC: (county funding approved on 4/25)
-Avanti (ACCEPTED, scheduled admission Tuesday 6/4/24)
-Gerard (Referral sent & received, awaiting secondary review)
-North Homes (accepted with immediate opening – county and guardian declined placement)
Continue with established outpatient providers:
-Individual therapy: South Central Human Relations-Owatonna
-CMHCM: MN Prairie County Alliance
Patient is under guardianship of Scott County; most recently residing at JAF who is not allowing her back. Foster family cannot take back.
