Patient presented via law enforcement after jumping in front of a vehicle in an attempt to end his life with additional thoughts to jump off of the bridge he was standing on until law enforcement intervened. Patient reports a 3 year history of auditory hallucinations that tell him to harm himself or others which occurs when he is alone or stressed. (hallucinations appear consistent with audible thoughts). This is his 4th inpatient hospitalization for suicide attempts and he has had multiple ER visits. While here, he attempted to assault a younger peer and was assaulted by a different patient. He was placed in the BICU where he has attempted to “snap” his neck on multiple occasions, head bangs, ingested hygiene supplies x1, and tied towel around his neck x1. Suicidal thoughts are perseverative when they occur and can be difficult to redirect.
Psychiatric Diagnosis: Trauma and Stressor Related Disorders
Trauma and Stressor Related Disorders are a group of psychiatric diagnoses that result from exposure to traumatic or stressful events, such as acute stress disorder and adjustment disorders.
MFIUP-F14-5242
Presented to ED for verbal agitation, physical aggression, significant behavior chance, suicidal ideation. Patient has also been engaging in SIB. Aggression has been ongoing for over a year and has intensified. Aggression comes on suddenly/does not seem to be predictable. Mom feels she has no control. Has an IEP for low IQ and learning difficulties. Refuses medications. Strained relationships with mother, father, and older siblings. Patient reports not having many close friends. Has engaged in lots of community and outpatient treatment options including individual therapy, family therapy, case management, school counseling, child protection, primary care, psychiatric medication management, day treatment. Has been hospitalized before at PrairieCare.
CH-F11-5026
Pt presented from home, adopted parents, for aggressive behaviors. Third ER visit this month, unable to take pt back home due to frequency and intensity of behaviors as well as 4 other children in the home. Pt initially recommended IP hospitalization, however unable to find placement due to acuity, no beds, or declined due to IQ (56) and inability to participate in programming. Medications adjusted in ER. No violence since medication increase. Family/CADI worker have been looking for more support for several years and pt seems to fall through the cracks due to IQ and aggression.
MFIUP-M13-4967
History of present problem: pt endorsed SI and having thoughts/plan to slit his wrists with a knife, which he has access to at his dad’s house, and endorsed self harm via cutting in recent past. Pt reports feeling isolated due to lack of consistent phone connection.
**Aggression is verbal and throwing objects (no contact)
**MnCHOICES Assessment referral made
**Psychiatry scheduled at BHSI – Brooklyn Center
MHF-M13-4922
Pt is adopted, Pts parents signed a voluntary out of home agreement with Rice County, Pt has not been home in approximately 3yrs. Numerous failed placements due to aggression. There has been zero movement in regard to placement options. Patient is very aggressive and has been so on the psychiatric unit. Pt presents with all the symptoms of RAD
CH-F13-4756
The patient is a 13 year-old female with a history of ADHD, inattentive type, anxiety, depression, sexual abuse, suicidal ideation, and self-injurious behaviors that presented to the ER following an intentional overdose in an attempt to end her life. She has had 2 previous inpatient hospitalizations. Patient has a complicated home life with several CPS reports and basically does the caretaking for her younger siblings. Patient has several tattoos given to her by her mother and sister and mother is unwell as well and frequently struggles with suicide attempts and self-harm. Sounds like a significant sexual abuse history within the entire family that may still be occurring. The patient is at risk for sexual exploitation given increased sexuality.
PH-M15-4658
Pursuing QRTP – patient is currently in psychiatric inpatient hospitalization.
Patient is a 15-year-old male. He presented to inpatient via ED due to increased SI and SIB. He has three historical inpatient hospitalizations, has done DBT and outpatient psychotherapy services, and most recently was at Newport RTC – although was discharged early due to aggression and property destruction.
From an acute psychiatric standpoint, youth is safe to discharge form inpatient care and receive services in the community prior to admission to QRTP. He has made significant progress on treatment goals during hospitalization.
Discharge Plan:
Referrals sent to the following residentials:
– Omegon Ascend (Reviewing, no current waitlist)
– Nexus Gerard (Reviewing, waitlist about a week)
– Nexus Mille Lacs (Reviewing, Current waitlist 2 months)
– North Homes (Declined d/t hx of aggression towards others)
– Northwood (Received, 6-9 month waitlist)
– PrairieCare Residential (Reviewing, 2-3 week waitlist)
Alternative Placement through Wright County:
-Wright County unable to identify alternative placement as of 9/24/24
Plan to bridge until residential:
PrairieCare PHP at MOB (unable to pursue establishing care at this time due to pt continuing to be hospitalized)
Continue with established outpatient providers:
Individual Therapist- Bridging Hope Buffalo
Medication Management- LifeSpan Mental Health Monticello
PCP- HealthPartners Elk River
CMHCM- Wright County
Neuropsych Testing- Clary Clinic St. Cloud
HCMCH-M17-4606
17 y/o male with MDD with psychotic features, neurodevelopmental disorder, intellectual disability. He recently discharged from CABHS. Waiting for MSCOCS placement hopefully will be admitted on 10/2. There concern of excessive irritability, agitation, disorganized thoughts, delusions, history of auditory or visual hallucinations, history of self injury and impulsive behaviors leaving to being in dangerous situations.
MHF-F12-4571
Pt came to our ED on 9/6 following a verbal altercation with foster parent. Foster parent is refusing to let kiddo return. County has custody, limited parental involvement. Was supposed to begin Fairview’s PHP program 9/10 however is unable to being in the ED, should be able to begin that program once placement is found. County is currently searching for shelter/other foster care options and screening for MH group home placements.
CH-M11-4380
Patient endorses homicidal ideation towards his sibling. Increasing behaviors at home. PHP (Clara’s House) attempted and will be discharged with recommendation of high level of care (residential). Patient has significant trauma after extensive physical abuse from biological mother and likely operates at a much younger age. Patient was removed from his mother’s custody by Ramsey County CPS in May 2024. Aunt is foster care provider.