Patient is presenting to the ED via EMS for suicidal statements and self-harm. Patient returned to her group home from school, and entered the bathroom to self-harm with a paperclip. Patient was told the group home would have to remove some of her possessions, so patient left the home. Patient threatened staff, and threatened to jump off of a bridge. Patient has been inpatient for mental health, at least six times, and has had many ED encounters (6 times in the past month) for similar symptom presentation in the past.
Race/Ethnicity: White
M8SAS-M10-1126
10 male Autistic aggressive at home and due to aggressive mom cannot care for him at home. Incontinent. Excused from MAC due to property destruction. Blue Earth County involved.
M8SAS-M16-1130
Recently at inpatient psych X 10 days. D/c to respite care. Recently transitioned home from respite and aggression within 48 hours of d/c from respite. Needs residential. Interview with North Homes on Monday.
SMCW-F15-1034
DIAGNOSIS
1. Suicidal ideation
2. At risk for intentional self-harm
ASSESSMENT/PLAN/DECISION MAKING:
Patient referred observation for suicidal ideation, patient has had prior ER visit earlier this week, unable to place and patient, mother, decided to trial home with safety plan and close follow-up, unfortunately, patient presents back to ER tonight. Referred observation. Will continue to assess for placement options, consider crisis team evaluation in AM as they had recommended her present to the ER tonight. Patient had labs done on 5/22/23, did not repeat at this time as only home for 24hr otherwise has been under hospital care, will obtain if requested by facilities
15-year-old female who was recently discharged from this ER on 5/24/2023 at 1730, presents back after being home with her mom for 24 hours with actions of intentional harm, statements of hurting herself by throwing herself down a flight of stairs, stating that she will find a way to hurt herself if she is discharged back home. Crisis team had instructed her to come to the ER, not called at this time. Patient will be referred observation while assessing placement options. Patient is difficult to place due to her acuity level and also her need for long-term placement, will be in contact with her case manager tomorrow morning. She is on wait list for multiple behavioral health long-term placement options, however, these wait lists are 3 to 6 months long before her case would be reviewed. Patient is greatly triggered by her home atmosphere. Patient was released from juvenile detention on 5/19/2023, spent the night at her mom’s house but then went to a cousin’s house for 2 days before returning to her mom’s house on 5/22/2023 where she presented to the ER within 8 hours of being back home. Patient had discharge from this facility last evening to her mother’s houses there was not another option for her at that time, a safety plan had been discussed with patient and she did follow that safety plan by calling the crisis team, unfortunately returns to the ER tonight.
Placement options are limited, however, will reach out to behavioral health options for patient this evening and tomorrow, again will discuss with case manager for assistance. Consider contacting crisis team tomorrow once patient has calm down for reevaluation is finding an acute placement for this patient has proven difficult in the past several months and may need to develop a safe plan with the crisis team assistance.
Patient states that her siblings are mean to her and tell her to kill herself, due to the disruption she causes at home.
MHF-F12-635
Patient presented to the ED from CRTC due to increased aggressive behaviors in the facility towards staff and was unable to return to the facility. Patient not safe to return home due to behaviors and case manager is pursuing residential treatment.
C8SM8SP-F14-885
Patient has previous mental health history and does not want to return home to live with her parents. Patient makes efforts to elope from their care and will escalate her behaviors to ensure she does not return home. Patient has grabbed the steering wheel from mom in an effort elope from the car.
MHF-F12-680
Patient presented to the hospital by police for suicidal ideation, homicidal ideation, and physical and verbal aggression towards her family after lowering a dose of patient’s medication. Patient’s mother doesn’t feel safe with her returning home.
5/3/23 discharged to home
MHF-F16-357
PH-M8-352
Admission: 2/24/23
Presenting concern: PTSD, Depression, Anxiety
Ongoing case conferences weekly with Itasca have occurred. Itasca County holds guardianship.
Discharge Plan:> UPDATE 4/20/23:ADMISSION IS 4/24/23> ADMITTED SUCCESSFULLY TO NORTHWOOD on 4/24/23
Patient is medically ready for discharge; will discharge as soon as RTC/living arrangement is identified.
Interim plan:
-PHP while awaiting RTC (foster parents share they are not able to have patient back into their home at this time)
-Itasca County has submitted referral for SMRT; once approved, this will provide access to disability status/waivers and additional placement options
-MNCHOICE assessment (Referral made to Hennepin County on 04/04/2023)
-Continue CMHCM at CMHS/REACH
RTC:
-Northwest Passage (2-3 month waitlist for patient’s age group; guardian declined referral due to waitlist and out of state)
-Gerard Academy (Referral made, Declined for admission on 3/24)
-Northwoods 35-day assessment (Screening meeting completed on 4/12/23, pending acceptance/admission)
-Clinical submitted on 4/5 to treatment placement specialist at Acadia Healthcare for consideration of out-of-state referral options
C8SM8SP-M15-525
Present at Children’s St.Paul due to behavioral dysregulation. Previously admitted for over 1 month and readmitted due to failed discharge to group home. Pt previously at Abbott NW for extended period of time prior to Children’s Hospitalization. Anoka County working to seek discharge placement. Present due to history of aggression. Has period of non-aggression, most recently has not had behavioral codes in past 3 weeks (as of 4/21/23.) Struggles with overstimulation, sensory needs and emotional regulation.