MHF-F14-3262

Patient brought in to ED by case manager after her group home discharged her due to ongoing behaviors and aggression. Case manager did not have alternate placement and therefore patient now boarding in ED until new placement can be found. Patient in need of shelter or crisis respite placement while longer term placement is found. Awaiting funding.

PH-F16-2714

Updated 3/7/224: Admission scheduled for 3/12, discharge from hospital will occur same day
Updated 3/1/24: SW was informed the admission date was moved to March 12th. Scheduled admission to Nexus East bethel for March 12th
Updated 2/28/24: East Bethel Accepted- Admission scheduled for March 7th time TBD, pt remains on the inpatient unit.
Updated 2/15/24- East Bethel Accepted- Opening now first week of March, pt remains on the inpatient unit.
Updated 2/1/24: East Bethel Accepted- Opening mid February
Updated 1/25/24: East Bethel tentatively accepted- opening mid February
Updated 1/11/24: East Bethel will review, if accepted- admission in a few weeks.
Update 1/9/24: Patient has been declined to Grafton PRTF due to her behaviors not being appropriate for current milieu and identified as it would not be therapeutic.

Discharge Plans: PRTF is medically recommended by inpatient treatment team
PRTF: Nexus East Bethel (Referral sent & under review, will likely hear about acceptance decision in January 2024)
PRTF: Grafton (declined on 1/9 due to behaviors not appropriate fit for current milieu)
-(DHS eligibility form for PRTF sent and approved)

Referrals to RTC’s made previously by the county:
-LSS, Sioux Falls: Couldn’t meet pt’s needs, low cognitive function, and FAS diagnosis
-Gerard: Couldn’t meet pt’s needs and FAS diagnosis
-North Homes: CMHCM referred for 35 day evaluation, still working on an acceptance
-Avanti: Pt’s legal guardian did not consent due to distance away from home
-Boys Town, Nebraska: Declined due to FAS diagnosis

Continue with established outpatient providers:
-CMHCM: Des Moines Valley Health and Human Services
-Medication Management: Windom Hospital
-Individual Therapist: Greater MN

This is patient’s 5th psychiatric inpatient hospitalization. Patient’s current admission is due to increased suicidal ideation, behavioral dysregulation, and homicidal threats towards staff and peers at school. Patient has utilized outpatient mental health supports such as psychotherapy, medication management, children’s mental health case management, children’s therapeutic support services, vocational rehabilitation skills, as well as group home and respite care. Patient has engaged in partial hospitalization program twice.

ADYC-M14-1768

Update: 1/19/24 Pt. still looking for placement.

15-year-old male looking for a group home and residential program. Children’s Mental Health Case Manager has tried everything, and doors are being shut. Client has a physical aggression, verbal aggression, history of PTSD and sexual abuse. Client has experienced abuse from biological father who is in still in the home, and sexual assault that happened possibility of more than one with an older cousin sister. Client mother is giving up on hope on trying to help her child. Client is struggling at home, school, and community. Children’s Mental Health Case Manager has been trying everything to find a placement for him. He’s been going in and out of the ER like every two months now. Children’s Mental Health Case Manager still trying to offer support the way she can by being there every hospital stay, seeing client like twice a month, and having mom keep her on speed dial to talk to client.

Because of experiences, client is chemical dependent on marijuana, perks, and opioids.

C8SM8M-M10-3146

Patient presents to ED for behavior escalation from foster setting. Guardianship lies within county.

C8SM8M-F16-3153

Patient presents from former group home placement, unable to return. In need of placement, a county is guardian.

AH-F15-2953

Presented to the ED for suicidal ideation. Boarded in the ED and attempts were made to safety plan with family but family refused to take patient home. Pt has an extensive history of running away, threatening others, suicidal ideation and there have been concerns (not proven) about patient taking advantage of vulnerable peers and children. Patient was admitted to ANW in early 2023 for 68 days. RTC was recommended but patient was declined from programs in MN and nationwide. Family was resistant to taking patient home but eventually patient discharged home.

AH-M16-2983

This child has a history of chaotic/unstable social/living situation. There is a long history of CPS involvement including being removed from his home living environment. There has historically been concerns for medical neglect (mother refusing to consent to treatment/medications, poor/lack of outpatient follow-up) and physical abuse. In recent months he has spent time between living with his mother in Minnesota and his father in North Dakota (parents are divorced). Parental rights were recently terminated and as of ~1 week ago is now under the legal guardianship of Hennepin/County/Sarah Conway (he was reportedly recently physically assaulted by mother). There is a history of trauma with maladaptive coping including chronic suicidal ideation with significant history of self-injury and/or suicidal threats. There is also a history of endorsing auditory command hallucinations of a male or female voice telling him to harm/kill himself. It has previously been noted that he copes with stress/frustration/emotion by acting out/harming self and running away.

Patient is not recommended for inpatient mental health and needs support in establishing safe placement in the community.

HCMCH-M15-2928

1/19/24 he’s slated to discharge to Bar None on 1/22/24.
15 y/o male whose ward of the state presented to ED after an episode of emotional dysregulation which led to destroying property.

AH-M15-2038

UPATE: 1/18/24: Still inpatient. May be going to crisis programming in the near future, but no date yet.
UPDATE 11-15-2023: Still inpatient 1:1 staffing, strict behavior plan.
Patient is a 15 yo M with a past psychiatric history of RAD, PTSD, and ADHD as well as unspecified mood disorder (MDD vs DMDD), spells of trembling, and unspecified anxiety disorder, mostly documented as GAD. Multiple previous inpatient admissions, most recently Feb 2023. Has had numerous ED visits since 02/2023 for aggression. He has a psychosocial history of early parental loss, institutional care, neglect, and profound physical and sexual abuse while living in an orphanage in Ghana following the death of his biological mother in child birth. He was adopted when he was seven years old. Since that time, he has struggled with physically aggressive behavior, typically triggered by losing control of situations by not getting what he wants, being challenged, etc., assaulting both parents and endangering siblings. He can also become agitated and engage in aggression and property damage at the school. When he is not aggressive, however, he presents as extremely polite, pleasant, playful, and affectionate, and he does not struggle with chronic irritability or agitation. His family has worked to keep him in the home and community by maintaining two residences, with father caring for him in a rental and his mother caring for his sibling in their family home for safety over the past three years. He has had numerous inpatient stays, crisis placement, shelter, and residential stays as well as outpatient psychiatric and counseling services in clinic and in the home. Still, his behaviors remain persistently dangerous, culminating in the sexual assault of his father on 10/21/23.
Reach out to Heather Hanson, Social Worker at Abbott with questions or possible matches. She can be reached at 612-863-8569 and/or heather.hanson2@allina.com

MHF-M14-2692

1.4.24 – Nexus YCT doing an intake next week.
Presented to ED after altercation with Mom resulted in property destruction and pushing her. Behavior concerns specifically aggression in home towards mother, siblings; patient is in a level 4 special-education program due to ongoing challenging behavior at school often leading to multiple suspensions, needing higher level of intervention. The police have been called to the home multiple times due to patient’s increasingly violent and aggressive behavior, poor impulse control, low frustration tolerance, agitation and oppositional behavior.