Mental Health Collaboration Hub
Pt presented to ED with family after FBI visited family after an anonymous tip that patient was having SI and HI regarding a mass shooting in the context of worsening depression and anxiety. Pt acknowledged recent homicidal ideation as a means to justify ending his own life. Initially pt denied creating a written plan, denies attempts to get a gun or have possession of a gun, or thought of a specific school or time he would do this, though, he now states he identified two elementary schools as potential targets. During past assessments he has acknowledged reasons for not going forth with this shooting – like the attempt would fail and he would be in a worse situation and he does not want to actually hurt people. Similarly, suicidal thoughts are present with thoughts of shooting himself, but does not have intent or obtained means to act on it. Although these are moderate-high risk thoughts, patient is able to keep self and others safe while in the hospital at this time. Aspects of his clinical history that put pt at risk for progressing to future violence include pre-occupation with prior shooters, nihilistic beliefs, and time spent in a potentially radicalizing online community. Additionally, mom reported partner had a gun in the home and patient + step-brother was looking around the house for this gun. The leading drivers of current SI and HI seem to be significant anxiety and co-morbid depression. Has experienced significant neglect and sexual abuse that have impacted his current mood and outlook as well.
Race/Ethnicity: White
MHF-M16-6652
Youth came to our ED on 3/24 from home after an altercation with Mom. He has a history of physical aggression against Mom. He is commercial insurance, so there is currently no County involvement. Mom would like him to get RTC however there isn’t a DA with that recommendation currently. Mom is not currently agreeable to shelters.
PCMC-M12-6603
Recurrent episodes of what appears to be anxiety attacks. Patient is supposed to be on Vyvanse but ran out of medication. Has had 2 previous non verbal episodes in the last 2.5 months.
SMCF-M12-6505
Patient has had an increase in ED visits due to an increase in behavioral outbursts including aggression. Patient was transferred to an inpatient psychiatric facility, however, report they cannot meet his medical needs including his incontinence. He was transferred back to the ED. Parents continue to express safety concerns for patient and family members (mom, dad, and 9yr sister). Family report they cannot bring him home at this time. Patient has been denied for hospitalization. He continues to be physically and verbally aggressive towards hospital staff.
MHF-M16-6455
Youth came into our ED on 1/13/26 and was determined to be ready for discharge. Came from Grandparents who are refusing to take him home until he gets SUD treatment. He is unagreeable to SUD treatment at this time, willing to do OP. County is not funding shelter due to not having custody. Parent referred shelter referrals have been made however custodians refused the Bridge who were looking at accepting him. Has been to Lakeside Academy and Wings SUD treatment in the past and eloped from both. No waiver currently. FV Maplewood declined primarily due to pt being unagreeable to treatment, but also due to concerns of elopement and Grandparents being willing to get him from the ED. Has been declined by many other RTCs as well. Referral pending with Anthony Louis.
PCMC-M9-6439
A 9-year-old male brought to the ER by his father. He has history of anger management which turns into aggression. The patient states that when he gets angry he just wants to hit things. Today he was hitting his mother in the face and back and also threatening to hit his little sister. He hit the wall creating holes. Threatened to burn himself with the radiator heater. He has been seen multiple times for the same issues. He was seen and Mayo Clinic behavioral health facility in October 2025. Family is working with the case worker named __________ The father states that the psychiatrist has referred him to behavioral health facility in Duluth and they are waiting for him to be excepted in placed in that facility through commitment. Parents are voluntarily allowing him to go to a facility tonight. They do not feel that their family and other siblings are safe at home with him.
CH8SCH-M10-6397
Patient presented to ER the same day he was discharged from 2 month inpatient hospitalization for aggression/safety concerns. Was threatening harm to self and others in the home. Was accepted for admission to Mille Lacs Academy with admission date unknown. Currently stable and no indication to remain in the hospital though family does not feel safe with him in the home. Looking for interim placement while awaiting admission to Mille Lacs.
CH8SCH-F16-6368
Patient was at Heartland Girls Ranch and reports that she tried to run from the facility, scratching her arm and hitting her head on the wall. Patient reported suicidal ideations with a plan. County is guardian of patient due to past abuse. County feels like patient needs PRTF level of care. On the waitlist at CABHH.
SBMC-F15-6411
Patient presented to the ED with her father after ingesting a screw while at school. EGD completed to remove the screw and she returned to the ED. Mental health team met with patient and father making the recommendation for acute inpatient MH placement. Patient denied ingestion to kill self and denied SI. She has a history of swallowing 2 AA batteries in Dec as well as another episode of swallowing a button batter a couple days prior. After those interactions she spent 11 on our medical floor waiting for a discharge plan. She was finally placed at an acute inpatient unit only to return home in a week with no additional supports in place. The original recommendation was for a long term residential placement but that was changed to discharging to home.
SBMC-F15-6326
Patient presented to the ED after ingesting a button battery. Surgical intervention was needed to remove the battery. Safety plan competed to allow patient to return home with father. While at school the next day, she hid in the bathroom and broke open a calculator to swallow 2 AA batteries. Hospital admission needed until batteries passed the next day. Acute inpatient MH options explored with no accepting facilities. Remains admitted awaiting residential placement at this time. Father does not feel he can keep her safe at home due to the increased risk of swallowing objects.