Came to the ED on 8/27 after behaviors at home of head banging and screaming. Mom has refused to pick pt up thus far, wanting medications prescribed before she is willing to do so. Our psychiatrist has been trying to work with Mom on potential medication changes, but there has not been an agreement thus far. CPS has opened a case and is investigating, and Nexus YCT intake was yesterday. Patient is primarily non-verbal. Mom is reporting he needs residential treatment, but there is no professional recommendation for that at this time and due to age and autism diagnosis, options would be very limited. Mom has connected with Chelida in WI. Pt has DD waiver with in-home services, as well as Washburn ready to come out at discharge.
Race/Ethnicity: White
PCMC-F15-4528
Pt presented with mother to ER after taking 30 tablets of 650mg Tylenol arthritis to end her life. She has multiple superficial cuts to her right thigh. Last inpatient treatment in May 2024. Pt states she had argument with couple friends and one friend told another things and now that friend was mad at her or does not like her. This upset her enough to want to end her life.
RMC-M12-4515
12 yo male brought to Ridgeview Medical Center (RMC) via EMS after a verbal and physical outburst at home. Youth felt that his mother was “lying” about him to a visiting social worker and youth became aggressive, throwing dishes on the floor in the kitchen. Youth “pushed” his brother, who then pushed youth. No h/o violence or aggression at school or with individuals outside of his home. Most aggression is shown verbally towards his mother. Mother is not allowing youth back into her home right now. Carver Co. Crisis and COPE have assessed youth and are recommending psychotherapy and/or psychiatry/medication management.
EH8D-M14-4364
This patient was brought to the hospital by police for aggression and dysregulation exhibited at the group home. He was charged with 5th degree assault after injuring staff members at his group home. His behavior has persisted despite medication adjustments and behavioral plans. He struggles in settings where there is too much sensory input and lack of structure. He has been destroying property and presenting with escalating aggressive, dangerous behaviors, homicidal threats and sexualized behaviors. Despite his impulsive behaviors and subsequent harm to staff members, he displays no remorse, though some question of whether he is able to adequately engage in reality testing possibly related to intellectual disability.
He is a ward of the state. He was placed in foster care at age 6 after suffering from neglect by his biological family. Their rights have been terminated.
MHF-M14-4476
Pt came to our ED via EMT on 8/5/24 after an altercation at home. He has a history of multiple inpatient stays, done PHP and day treatment, been to Gerard, Newport, and JDC. There have been 2 rule 20 evals that have deemed him incompetent, one just finalized on 8/7. Dad currently has custody and is refusing to pick up, reporting that he wants more help. Pt has history of abuse from both parents. CPS is petitioning for temp custody and placement is at a stand still while we wait for that to go through.
PH-M17-4298
Patient admitted to inpatient hospital following attempted overdose. Prior to hospitalization pt had resided at home with parents since February 2024. Prior to this pt had 18 month stay at Gerard RTC. Pt also had previous stay at North Homes RTC.
Discharge Plan:
RTC
-PCR (referral sent)
-Gerard (referral sent)
-North Homes (referral sent)
-Village Ranch (declined in February due to behaviors, flight risk, animal cruelty)
-Mille Lacs (referral sent)
-Bar None Shelter Plus (need county referral/funding, CMHCM not supporting)
-Leo Hoffman (referral in progress)
Group Home
-CMCHCM assisting with referrals although pt would need to pursue CADI funding prior to county funding
-MnChoices Assessment through Hennepin County for CADI Waiver (request made, scheduling 6 months out, can expedite if placement is found)
Continue with established outpatient providers:
Individual Therapist: Scott Nielson with Melissa Anderson and Associates
Primary Care Provider: Riverwood in MacGregor
Prescriber/Medication Management: Janet Larson with Riverwood Clinic
CMHCM: Alissa Boser with Aitken County (218-838-2405)
Probation Officer: Jacob Leondhardt with Aitkin County (218-927-7231)
CH-M16-4217
Brought to ER after assaultive behavior towards group home staff. Since being in the ER, patient has denied SI/HI and been behaviorally regulated with the exception of one incident after being here for 6 days, and was asked to go to his room to avoid potential problems with other patient’s in the ER and he was upset and got restrained. He’s been up for discharge back to his group home since the day he presented to the ER. The county worker has been main contact with group home and are trying to problem solve ways to support patient at the group home. Ombudsmen involved.
Update 7/10 – patient remains boarded, now on EmPATH unit (observation unit/extension of ER) without aggression or behaviors. County guardian making referrals for placement options including respite, crisis, group home, shelter
MHF-M15-4172
Pt came to ED from North Homes, after increase in physical/verbal aggression and 30 day notice was given and lapsed without another placement found. Was boarding in our ED in Nov 2023 prior to admit to North Homes. Planning to connect with parent/County about re-involving Nexus YCT. Some sexual inappropriate behavior making him difficult to place.
PH-M13-3281
Recommendation is for level 6 PRTF – seeking interim plan for Respite, Shelter Plus, etc.; patient is currently inpatient.
13 year old female from ED. Pt was at school and was angry and ran from the school. Patient has history numerous psychiatric hospitalizations as well as ten months of treatment at Gerard residential treatment. In alignment with CMHCM, seeking PRTF level of care. At this time parents do not feel they can have the child return home. County looking at respite care, so far unsuccessful. On waitlist (2+ years) at Northwoods, Grafton referral sent, Nexus East Bethel pending acceptance/wiatlist)
Pt insured by Medicaid (had a commercial plan UBH that ended on 3/1/24).
Pt has the following outpatient supports:
Psychiatry
PCP
CMHCM
CTSS
Day tx (not yet started)
PH-F17-4082
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