MHF-F17-4287

Came to ED on 7/8 after parent-child conflict, verbal altercation and mother reports she was scratched. She had been attending Fairview’s PHP program but has been minimally engaged there, reports that she prefers individual therapy over PHP. She has not had any behaviors since being in the ED. Goal is for patient to return to family with services, but Mom has not been agreeable to pick up yet, continuing to work on services to support the family and see if pt can return home.

AH-F16-4271

Adopted at birth with in utero meth exposure. Several inpatient, residential and outpatient avenues explored both instate and out of state. Patient is declined or asked to leave to due aggression to peers. Juvenile system has discharged back to mental health. Engages in self harm, significant aggression, stealing and fraud, fire setting, etc.

PH-F13-4223

Recommendation is for level 5 QRTP, patient is currently inpatient.
Patient admitted on 5.29 to inpatient hospital. Patient has had 3 prior inpatient hospitalizations at Abbott Northwestern Hospital. January 2022, July 2023 and August 2023 her mother estimated. She also has participated in partial program. Patient had no incidents of aggression towards peers or staff. Referring information described her as needing to be on 1:1 staffing, due to aggression on the unit, however this was prior to the last inpatient hospitalization, in which no incidents of aggression were reported. The initial statement of ‘no incidents of aggression” was reported by the patient herself. Patient does have a history of psychiatric hospitalizations, day treatment, skills groups and individual therapy. Patient does not have a history of eating disorder treatment. Patient does have formal mental health history, including formal psychiatric evaluations, engagement in therapy, psychotropic medication trials and psychiatric hospitalizations.

Residential Treatment (referrals submitted 6/24, pending county funding)
– Avanti
– North Homes
– Nexus Gerard

PH-F14-4234

6/4/24 admission note: Patient is a 14-year-old female admitted to PrairieCare for suicidal ideation and self-injurious behaviors. Patient was recently discharged from a 45-days residential program. 2 days post discharge patient began threatening to kill her mom and reported SI with plan to jump in front of a car. Pt has a history of recurrent major depression SI, and SIB.

Discharge Plan:
SMRT-Hennepin County (7/8)
PRTF/QRTP – Level 6:
-Grafton (declined due to current milieu at facility)
-Nexus East Bethel (unable to refer due to insurance)
-Leo A Hoffman (unable to refer due to males only)
-Bar None Haven (SW to send referral once consent obtained)
-Northwood (SW to send referral once consent obtained)
-The Youth Village in Tennessee (guardian pursuing)
-Acadia Healthcare (SW to send referral once consent obtained)

Current Providers-
Therapy- Paula Ocampo at Lake Country Associates
EMDR therapy-Tiffany Rundquist, Sanford Health Bemidji
Pediatric Neurology- Dr. Ilgarli, Essentia Health
Psychiatry- Daniel Janiczak, MD and Kayla Scheneit, MD- Sandford Bemidji
CMHCM- Erika Kjellberg, Hubbard County
CTSS- Megan Berg, Hubbard County
EMPATH at Bemidji Sanford 2 times/week

PH-F15-4188

Recommendation is for level 6 RTC/PRTF – patient is currently inpatient.
15-year-old Female from RTC level 5. Patient admitted to inpatient after struggling with self-regulation after recent inpatient discharge. Patient has had 5 inpatient hopsitalizations since March 2024 with attempts at individual therapy, PHP, RTC (elopment), and In alignment with CMHCM, seeking RTC level of care. Referrals have been sent to Nexus East Bethel, Bar None Haven
Patient insured by Medicaid.
Pt has the following outpatient supports:
CMHCM

MHF-F13-4168

Pt came into our ED on 6/13 after a verbal altercation at home with mom, where she left the house and walked to the police station who called crisis and brought pt to ED. Mom is refusing to pick up. Its reported pt was in residential treatment until April 2024, and prior to that was in PHP through Fairview. Mom reports that Case Manager is looking into residential treatment again however we have been unable to reach the CM and their offices are closed the rest of this week. Unsure if there is a recommendation for residential or county approval for that LOC.

PH-F16-4145

Recommendation is for dual diagnosis residential programming (ASAM 3.5)

Patient arrived at Inpatient from ED due to increased suicidal ideation. This is his 5th psychiatric inpatient hospitalization in the past few years. He has done RTC through Northwest Passages, PC PHP, and began programming at Options day tx before it closed. He does have a history of aggression towards school peers although aggression has not been a concern while in programming or hospitalized.

Discharge Plan:
Dual Diagnosis RTC:
Dual Diagnosis RTC:
-Newport (patient declined due to impulsivity and aggression concerns)
-MHealth Fairview, Maplewood (declined due to acuity of MH and aggression)
-Hazelden (in network benefits approved – initial phone screen complete, awaiting decision for setting up next assessment)
-Wings (pt declined due to physical aggression in previous six months)
-Rogers BH (Referral sent – guardian to complete phone screening and then pt screening will be scheduled)
-Lakeside Academy (Christian based program – patient declines referral due to this)
-Bar None Omegon (unable to refer – only accepts biological males)
-Anthony Louis Center (unable to refer – will not accept those needing dimension 3 ratings or above)

EHS-M16-4154

Patient was brought to ED after making suicidal and homicidal statements during his psychiatric medication appointment. He was evaluated and inpatient psychiatric stabilization was recommended. While in the ED he has been calm and cooperative. Denying suicidal ideation or Homicidal ideation at this time. He does recognize that he has been dysregulated and struggling to find effective coping skills. Recent increase in conflict at home. Has been engaging in self-harm. Mom does not feel safe having him in the home at this time.

AH-F15-4120

Presented following disclosing suicidal ideation at school. Previous foster home is unwilling to take her back due to mental health needs. County/hospital is pursuing therapeutic foster care and group homes. She has previously been placed at JDC due to running away from home. She has not run away from previous placements

RMC-F16-4041

16 year old female who was brought in by EMS in 4-point restraints after being restrained by PD trying to enter river to “drown herself”. Patient argued with her mother just before she threatened to “drown herself in the river;” destruction of house/property per mother’s report. Patient admits to past similar behaviors and has multiple MH hospitalizations on record.