Update: has been aggressive, destructive. Feeling helpless. With Rule 20 assessment, not fit to have charges brought. Due to have another Rule 20 assessment in December. Has some past felonies.
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.
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. The patient is beginning to decompensate with the prolonged length of hospitalization.
Recommendation is RTC-
Avanti -referral made, accepted, can admit next week -just waiting county funding
North Homes- referral made
Gerard- referral made
Presenting Problems: Major Depressive Disorder, PTSD, SI/SIB, Inpatient for the third time this year, has done PHP twice this year
Ward of the state-currently under Wright County Guardianship. Parental rights have been terminated. History of aggressive behavior with homicidal and suicidal comments towards multiple people/on multiple occasions. On 11/15/23, patient was sent to a “calming room” at his school due to throwing a ball at another students face. This caused him to miss out on an outdoor activity that he wanted to attend. Patient was upset and punched one of his teachers (mental health support services personnel) in the nose, causing a broken nose. Had been living with bio-grandparents prior to this incident. He has been removed from foster homes in the past due to homicidal threats to the foster parents/others in the home.
Patient is presenting to the ED for the following concerns: suicidal ideation, depression. Patient reports he tried to kill himself last night by stabbing himself with a dull pencil. Patient reports suicidal and homicidal thoughts that have increased in last two weeks. He has been at North Homes for three months. He was discharged to North Homes after a hospital stay at UMMC in September for SI. At North Homes, the patient escalated and told staff he was suicidal. He took the batteries out of a remote and tried to swallow them. He also tried to stab self with dull pencil. He became combative and needed to be restrained and then kicked staff in chest and tried to kick another staff. Patient then stated he would find each clients personal info and then take pictures of other clients after he killed them and send to parents. Patient told staff he would kill other clients and himself.
Patient reports long history of MH including PTSD, MDD and GAD. Patient has been hospitalized 2 x in past 6 months. Patient reports history of trauma. Patient states he has history of SIB.
This child was previously on the HUB as MCR-M17-2128. Originally admitted 10/12/23, and discharged 11/17/22 to CD group home and eloped within 24hours. Brought back to ED after being found ODing on 12/4/22. Eloped on 12/30 and returned 1/6; attempted to elope again on 2/4 but successfully stopped.
Chemical dependency (fentanyl and meth), suicidal statements when intoxicated. On MI/CD Civil Commitment. Needs locked CD or dual diagnosis residential treatment. County Attorney pressing charges, which may help with JDC placement options.
Autism spectrum disorder and ODD, mother struggling with her own mental health issues and just started a day program. Multiple ED and SERCC presentations for physical aggression at home, typically triggered by conflict with mom. Completed PrairieCare PHP in September/October. SERCC declining due to lack of benefit and property destruction, Von Wald shelter has him on a wait list but no anticipated discharges. Only recently opened YBH case so in process of having worker assigned, no options for out of home placement. On wait list to start day treatment, perhaps week of 2/13, but he and mom can’t tolerate being in the same room together without escalating to yelling and throwing things. When not with mom, he is calm and engaged in crafts all day long. Care conference with mom and YBH intake 1/24 and 1/27 with a planned discharge 1/30 but mom refusing to take him home because of her concerns about his escalation in her care even in the hospital. Olmsted County CPS has screened out and does not have resources to offer.
This child has been on the HUB previously as MCR-10-283.
Patient was admitted to Prairie Care Residential on 11/8/22 but was transferred to Prairie Care’s inpatient psychiatric hospital on 11/10/22 due to aggression. Patient remains on the Northwoods Residential wait list. There will be additional residential treatment waitlist’s the patient can be added to, once they turned 11 on 1/16/23. Patient remained psychiatrically hospitalized at Prairie Care until she was discharged on 1/5/23 with the recommendation of returning to community-based treatment. Adopted but adoptive parents surrendered her to Goodhue County.
Patient ran away from Aspen House shelter with three other people. The car that patient and others had taken was stolen, and they crashed into a sign. Patient drove the vehicle to another girl’s house, where the police came. Patient had written a note that implied she was suicidal, and was brought to the ED.
Patient has a history of anxiety, depression, ADHD, PTSD. She has had numerous ED visits and hospitalizations. Patient has had 4 ED admissions in the past 6 months. Pt was most recently at Prairie Care from 4/9/23-4/27/23. She is currently seeing an individual therapist, a SIBS in home family therapist, and has a Dakota County case manager.
Came from Bar None. Sig family trauma, sex trafficked by parents who are incarcerated. Some drug use, but sober now (benzos and opiates). been behaving ok so far. Responding well to limit setting in ED. At Omegon was doing ok aside from relationship issues. Grandmother had custody but has been terminated.
Several referrals – denied due to chemical use/abuse. Shelters denied d/t aggression. High risk for placement. Check into returning to Bar None Omegon? Youth Villages in TN – they can take more aggressive behaviors. ***Discharged to Hotel Care with crisis staffing. The Hennepin County CM/guardian arranged for the placement after 30 days in the ED.