Update: 1/15/24- Patient has been accepted by Nexus with an admission date of 1/16/24!!
Patient presented to the ER from out of state due to being kicked out of residential treatment for elopements and aggression towards staff and peers. She was boarded in the ER for a significant amount of time before being admitted to the mental health unit for boarding. Patient has CHIPS case though parents are actively involved in her care. Patient has an extremely high risk of elopement and has a history of being sexually trafficked while on elopement. Patient struggles with conduct, low academic performance, and history of aggression. She has had 2 rule 20 assessments and was found incompetent. Patient has been declined from PRTF’s from over 25 states.
Update- 1/11/24- The patient has been accepted to MNCCS respite home with a planned admission date of 1/17/24!!!!! Thank you to this facility!!
The patient presented to the ER for the second time on 8/22 via law enforcement for aggressive behavior after she assaulted a staff member at the group home and attempted to bite, throw things, and hit staff upon arrival to the ER resulting in restraints and IM Zyprexa. She had been in the ER earlier in the day after intentionally swallowing a rock in an attempt to get out of her group home and was subsequently discharged back to her group home following psychiatric assessment. Of note, she presented to the ER 3 additional times over the week prior to admission for similar presentations and is well known to the ER due to multiple presentations of pseudoseizures, aggression, and suicide ideation.
She was admitted to the unit after her group home provided a suspension of services notice with the requirement of medication adjustment to be completed in order to return to the group home. Medication adjustments were made, and she has been psychiatrically and physically stable since at least October though she is not able to return to her group home until additional staff are hired and trained.
Discharging to Gerard on 1/10
Patient presented from Bar None shelter after A verbal altercation. Had been in Bar None RTC however got into a physical altercation several days prior and moved to the shelter on a behavior contract. When patient became verbally agitated, patient was sent to ED and is now discharged from the facility. Patient denies MH symptoms, has no placement. Guardian reports referring patient to North Homes and Gerard who report several month wait lists.
Update 1/24- County funding for RTC denied on 12/26, now following alternate recommendations as determined by the county. DC was scheduled for 1/4, due to parent request, rescheduled for 1/5.
DISCHARGE PLANS:
Hospital Recommendation is RTC-
Avanti -referral made, accepted, intake 12/28/23
North Homes- referral made, reviewing, no immediate openings
Gerard- referral made, accepted, intake 1/9/24
Alternate Plan:
Mobile Crisis Team (Referral sent by CMHCM)
Day Treatment- Christian Family Solutions (Referral sent by CMHCM, waitlist to about 1/19/24)
Intensive family therapy (Referral to be sent by CMHCM)
PCP- Marlene Jilek, APRN (Mankato Clinic)
Therapy- Claire Alexander, MS, LPCC at PrairieCare Mankato (Availability as soon as next week, requests patient guardian call to schedule appointments)
CMHCM- Nicole Wigern (Blue Earth County)
Presenting Problems: Major Depressive Disorder, PTSD, SI/SIB, Inpatient for the third time this year, has done PHP twice this year
Patient brought from foster placement as foster family was going out of town and no other placement could be located for patient in the interim, therefore county brought to ED for shelter. History of sexual assault charges and schizophrenia. Patient denies MH concerns currently. Unclear if foster family will take patient back when they return. Patient is accepted to an RTC in PA however ICPC needs to be completed by county and timeline for completion is unclear.
Patient was in Prairie Lake JDC and his ‘time was served’. County did not have a place for him and reported a judge ordered for a sheriff to drive him from there to ANW for acute MH care. He does not need IP MH care, Crow Wing County does not have a place for him. They are connected with Solutions, working on group home placement.
Patient placed at Crisis respite hotel.
Patient presented to the ED after threatening father and becoming agitated. Father refusing to pick up or allow to discharge to another family member. Patient with SUD concerns and after completing CD assessment, recommended for residential SUD treatment. Referrals being made for this, parents will not pick up until treatment is secured.
Patient is presenting to the ED for the following concerns: verbal agitation, suicidal ideation, threats to harm others, property destruction. Patient became upset at school, threw items, and ripped things off of the wall. Patient left school grounds, and police/ambulance were called. Patient has been living with her aunt for the past few months. Patient’s biological mother died when she was an infant, and was abused by a family member who obtained guardianship. Patient makes suicidal and homicidal threats often.
Patient was in the Fairview PHP program earlier this year. She was in the ED in May ’23. Patient no longer has a medication management provider. She has a county CPS worker and a newer case manager. Patient is currently in Equine Therapy 1x/week at Hold Your Horses.
Patient had a court hearing today and was ordered to present to the ED for psych evaluation. This past year, patient disclosed that he had sexually assaulted the 6-year-old daughter of his mother’s girlfriend. The state picked up the case and charged the patient. He was on probation for many months and then physically assaulted a family friend, unprovoked. Patient was then sent to Arrowhead Regional Center for their inpatient sexual offender program. Patient was unable to complete this program and sent to JDC, where he has been since July.
Patient’s mom states that he had suicidal ideation last year and was then sent to the hospital where he was admitted to inpatient. Patient has a significant history of trauma, physical and suspected sexual abuse.
Patient’s mom reports that psych. reports from JDC reported psychosis and signs of OCD and Autism. Report also states that patient has history of auditory hallucinations and paranoia.
Patient court ordered to remain in the ED until 10/17/23 court hearing.
attempted strangulation with the dog leash. HX of MDD, PTSD, ADHD & anxiety.
