Race/Ethnicity: White

AH-F16-7617

Previous psychiatric diagnoses: PTSD, depression, anxiety, eating disorder, ADHD, complex trauma, suicide attempts, self-harm

Patient presented to the ED after reporting SI to their guardian. Patient reports a near daily experience of SI and AH/VH of his brother who abused him. Therefore, this is not a new symptom. Patient reports that yesterday there was no particular trigger for his SI and AH/VH, that he took a PRN medication, which usually works for him, and then called his guardian who told him to go to the ED.

While in the ED (and as is common in the community), patient will attempt to use clothing to strangle themselves when dysregulated, often revolving around trauma.

Guardian is Dakota County (Tori Thompson). No contact order for anyone in the biological family.

Hospitalized in ND for a full year and a recent over month stay at Children’s for placement from which they were placed in Mn Care Counseling Crisis home.

Crisis home has given an immediate termination notice and state as they are a crisis home they do not require a 30 day notice, due to inability to keep pt safe. They report running into traffic as a particular concern.

Recommendation is discharge with ongoing outpatient support coping skills, distress tolerance, emotional regulation and behavioral support. Pt presentation appears to be baseline and unlikely to mitigated by an admission which may conversely increase risk of maladaptive coping skills and hospital seeking behavior.

Referrals:

· Wingspan is future development of home for patient; not ready until January

referrals made to all PRTFs
Grafton
Leo Hoffman
North Woods
Nexus East Bethel
No update on possible openings

CABHHS – pt has been declined multiple times due to various reasons including high acuity, Diabetic, Eating disorder – A new referral is in process
Bridgeview—-Dakota county crisis placement; on list but currently full (2 bed facility for Dakota County youth)
Kid Link – referral to all 50 of the facilities they work with, no update on potential openings.
Out of state (Rogers and Acadia)—active referrals, no timeline

PH-F16-7411

Recommendation is now for group home. Patient presented to the hospital from the ED for acute safety concerns related to self-injurious behaviors and suicidality following an assault on patient by other residents in a shelter. Patient has a history of multiple inpatient hospitalizations and residential treatment.

NMH8R0MGH-F14-7544

Patient presents for psychiatric evaluation in the setting of suicidal ideation and recurrent self-harm behaviors. Per nursing report, the patient has generally been calm but has repeatedly attempted to harm herself by scratching her arms. At times, her behaviors have escalated to lashing out at staff, requiring restraints to prevent further self-injury and maintain safety. Nursing reports that her parents have not been visiting because their presence appears to trigger increased emotional distress.

C8SM8SP-F12-7511

Child presented to Children’s ED to receive a mental health evaluation after becoming dysregulated in foster home. Child was recently separated from grandmother’s house and sister. Pt made suicidal comments because she “misses her family”.

CH8SCH-M16-7447

Patient presented to the ER from group home after engaging in extreme aggression/property destruction. Group home moved to immediately terminate services. Patient has a recent history of boarding in ERs (5/29/26-6/29/26) and brief placements in group homes. Notably, patient was admitted to group home on 9/29 and presented to the ER within 12 hours due to extreme aggression and dysregulated behavior.

C8SM8SP-F17-7421

Child was brought to Children’s ED due to medical care concerns from group home. Group home reported they did not feel like they were well-equipped to attend to child’s medical needs; most recently she was choking or coughing when eating foods. Patient’s mother is currently undergoing her own medical care and is undergoing an amputation next week; mother will not be able to care for child while she is recovering. County worker is looking for respite placements and housing.

C8SM8SP-M14-7394

Child presented to Children’s ED after becoming dysregulated at group home; he wanted to leave, became upset and began throwing staff’s badges across the room. GH called EMS and child was transported to ED-Saint Paul. He is no longer able to return to GH after this incident. Child has a long history of foster care since he was three years old.

C8SM8SP-F12-7384

Child came to the emergency department after getting into an altercation with grandmother at home. Child had gotten physical with grandmother due to phone usage. Child’s legal guardian is grandmother and does not have contact with bio parents. Child has a long history of trauma. Child’s aggression is only toward grandmother; they have also presented to the ED on 5/7, 6/29, 7/8, and 7/28 for similar situation (physically aggressive towards grandmother). Grandmother is refusing to discharge child back into her care.

CH8SCH-F15-6993

Patient is well known to our ER/Hospital. She previously boarded in the ER 3/12/25-5/9/25 when she was transitioned to the Adolescent inpatient unit and boarded until 10/2/25. Patient moved into a group home built for her.

Patient returned to our ER on 6/28/26 and the group home suspended services effective 6/29/26 due to the level of aggression patient has displayed and injuries to staff. Sherburne County and patient’s guardian (adoptive mom) are not appealing.

MHF-M15-7373

This youth came into our ER 9/13 from Grandparents home, who are custodians. He was just in our inpatient unit until 9/11. He came in for suicidal ideation and was cleared for discharge. It’s reported by his team that ongoing he uses suicidal threats to get out of unpreferred activities, and if that doesn’t result in what he wants, he escalates further. He had safety planned with our team for discharge, but when Grandma called him on 9/14 to discuss, he was making suicidal statements to avoid returning home and Grandma then refused to get him. Grandma tried to get him again 9/16 but when she showed up to the ED he escalated and threw an object at her and she left the ED. It’s reported he’s been struggling since the death of his great grandma early last month. Currently there is no recommendation for residential or higher level of care. He’s done PHP in the past and is currently set up with CTSS, DBT, Individual therapy, family therapy and psychiatry at home, but has been in the hospital a lot so hasn’t gotten a lot of these services, and uses suicidal statements to get out of participating in some of them. The County is not exploring any out of home placements at this time. Bereavement counseling and respite were discussed, but those can’t begin until he is discharged. He has endorsed that he enjoys the hospital setting and ambulance rides.