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MHF-F14-1493

UPDATE: as of 8/24/23 she has been accepted to a residential facility in Georgia, and the family is waiting for some pieces from their insurance company. Transportation is ready to go once insurance is approved – hopefully end of this week or early next.

Pt is presented to the ED via EMS for the following concerns: verbal agitation, physical aggression, significant behavioral change, and anxiety. Pt has been in a residential treatment center for approximately 5 weeks, and had been in a “crisis state” all day, on day of admission. Pt was requiring frequent restraints, supervision and redirection for up to 8 hours. She was non-compliant with treatment activities, frequently trying to run away from program activities, and into the street. Pt kept searching for sharp objects to self-harm, and assaulted staff when they tried to take objects from her.
These are chronic behaviors for pt. Pt is currently in a 3rd residential treatment program (secure), with a hx of one prior group home placement. Pt has a hx of several mental health hospitalizations, with most recent in October 2022. Patient has a hx of refusing medications.
Residential facility stating that pt has been discharged, however there is no discharge paperwork available. From North Dakota. No case mgr or services in place. Her parents were able to get her into the residential treatment center she was at. Able to DC but nowhere to go at this point.

MCR-F15-1269

UPDATE: Mom wouldn’t sign ROI for CRTC to she still awaits placement.

Patient is a 15 year-old with a history of PTSD, MDD, and GAD. She has a history of five previous psychiatric hospitalizations and one premature discharge from residential treatment this past spring after restricting her food and water intake (start of present hospitalization). Nutritional intake has continued to decline to the point of needing tube feeds to meet daily nutritional requirements, with symptoms more closely resembling anorexia nervosa at this time.

Patient is already connected with medication management, county case management, CPS, and psychotherapy.

MHF-M12-1583

Pt is presented to the ED via EMS after increased verbal and physical threats towards his family. Patient attempted to burn a locked door down with his mom and sister behind it. Patient’s mother called the police, and patient threatened to jump off of the balcony. Patient has a diagnosis of ASD and ADHD.
Patient was hospitalized and in outpatient program about 4 years ago. Per patient’s mother, the patient had been receiving wrap around treatment until he was discharged 4 months ago, when the patient brought a knife to therapy and threatened his therapist with said knife. The patient has been declined for all services by Prairie Care. Patient was assessed by Fairview recently and planned to start day treatment, but he refused to get in the car to go to therapy.
Patient has shown increasing aggression since about October 2022 when he decided he no longer wanted to have a relationship with his father.

PH-F16-1369

*UPDATE: Admission to Gerard 7/28/23- just pending county funding at this time, 2nd screening today, 7/20

16 YO Female in 10th grade. Two previous psychiatric hospitalizations (2/23/22-3/4/22 and 9/17/23-9/27/23) in addition to the current admission. Has attended Day treatment. No alcohol or Drug use. Increasing SI and history of self harm. Hx of sexual abuse at age 9.

DISCHARGE EFFORTS:
-RTC: Avanti Center for Girls (Referral sent, pt accepted, 6 month wait list)
-RTC: Gerard Academy (Referral sent, pt accepted, admission, 7/28/23, pending county funding)
-RTC: North Homes (Referral Sent, pt approved, opening estimated for August-September)
-RTC: Northwood Children’s Services (Referral Sent)

Interim Plan:
-Day Treatment: TSA (pt able to return if/when it is safe to DC)
-CMHCM: Janet, Isanti County
-DBT: (SW to provide resources upon DC for guardian to use after RTC)

MCR-M17-283

State of MN is trying to find a way to build his own home, timing TBD.

Aggressive, DD, low IQ – 40-50, FAS, ward of state, targeted case mgr. Was provisionally discharged from CABHH, not allowed to return. Perhaps a plan is a state run group home, in development?

MHF-M9-808

Patient is presented to the ED by EMS for aggressive behavior towards staff and another resident in his group home. At the group home staff brought the patient out to his school transportation but the patient became dysregulated when he saw the driver was different from prior trips. Patient then eloped to a neighbor’s house where he entered. Staff followed and called the police. Patient was brought back to the group home, but later got into a physical fight with another resident and staff member. Police were called a second time, and patient was transported to the hospital using restraints. The patient has a history of ED visits and has had approximately 6 previous hospital admissions (5/21; 7/21; 10/21; 11/21; 12/21; 9/22). The patient has a diagnosis history of DMDD, ODD, ADHD, GAD, depression, and RAD

MHF-F13-1411

Pt presents to the ED via EMS for the following concerns: aggression. Pt was refusing to take her medication, and became aggressive with her parents when they tried to make her. Parents called 911 due to pt becoming aggressive with them, and punching holes in the walls. Medical records indicate mental health diagnosis of Unspecified disruptive impulse control and conduct disorder, major depressive d/o, unspecified anxiety and binge eating d/o. Pt has a rule out diagnosis of autism spectrum d/ and other neurodevelopmental disorder. Pt has a hx of mental health admissions as follow: 3/12 – 3/17/2023. Pt had frequent visits to the ED due to behavioral and emotional dysregulation at home as follow 3/20 – 3/21/2023, 3/22-3/31/2023, 04/02 – 04/03, 04/07-04/11/2023, 04/18/23, and 4/19- 04/20/2023.

MHF-F16-1057

Patient is under the guardianship of Swift County, and presented to the ED from his group home in Hennepin County. Patient got upset after being denied an outing, and went out to the road (not a busy road) and threatened suicide by getting hit by a car. Police were called, and patient was taken back to his group home where he made homicidal threats towards a neighbor. Group home staff then requested patient be seen by the emergency department. Patient has had multiple psychiatric hospitalizations. Patient reports frequent suicide attempts with methods unlikely to harm him, such as tying shoestrings around neck. Patient has a history of self-harm.

EH8D-M15-414

15 year old male with a history of ASD, ADHD, trauma, and multiple prior psychiatric hospitalizations and residential placements. He was admitted to the hospital after becoming aggressive and self-injurious while at crisis stabilization home. Patient has a history of making significant threats of violence and has been repeatedly sexually inappropriate. He was removed from his home after having molested a younger cousin. Patient will, at times, express remorse for his behaviors while at other times appearing grandiose and narcissistic, with violence perpetrated in response to narcissistic injury.