Mental Health Collaboration Hub
Patient presented to the ER via EMS on 12/4/24 after an intentional overdose of chlorpheniramine maleate 4 mg / dextromethorphan hydrobromide 30 mg pills in an attempt to get high. He required PICU admission for anticholinergic toxicity and treatment with Precedex related to agitation and history of aggression with anticholinergic toxicity. He has had multiple ER visits for substance use. He was previously admitted here for inpatient psychiatric hospitalization from 11/7-11/15 and was discharged with plans to attend outpatient SUD treatment in Wisconsin. as he was not willing to participate in residential treatment. This is at least his 6th intentional overdose in attempts to get high and his 5th hospital admission requiring PICU admission. He is currently under the emergency guardianship of Mille Lacs County related to a CHIPS petition as he has been abandoned by his mom who moved to Wisconsin. He is also currently on probation with Mille Lacs County. He has not previously been successful with past SUD treatment or inpatient psychiatric hospitalizations. Has very poor insight and follow through- though is able to express his desire for sobriety.
Race/Ethnicity: White
GC8S-M10-4890
Patient was at school when he began having hallucinations, pulled his hood over his face, then ran into a concrete wall. He was admitted to Gillette for medical management of his bleed needing surgery to repair. Initially he was calm and not demonstrating behaviors then once he was fully off all sedation, he began showing his behaviors. He verbalized thinking everything is poison so he wouldn’t eat or drink, hearing and seeing things that are not there, extremely anxious and afraid. He needed physical holding for safety this am due to behaviors that put him at risk for his safety and others in the room. Patient has a history of this behavior prior to this incident. Strong family history of schizophrenia, this is currently in question for patient. Have connected with Children’s, Abbott and Prairie Care for possibly inpatient psych placement and med management.
SL8SHOD-F15-4879
Pt has has multiple psychiatric hospitalizations, is aggressive often, and very unpredictable in her behaviors. She was in an ED for about a month, and was placed at Northwoods residential treatment. She was engaging in self harm. and making threats to jump out of a window. Pt assaulted police who came to remove her from the facility for psychiatric care. Northwoods does not feel that they can keep her or the other patients safe there, so they are not willing to accept her back.
MHF-M14-4646
Kiddo came into ED on 9/24 from school for aggressive behavior, was in foster care who is not willing to take pt back. Under custody of the County. Has history of both residential txt (Northwoods 2x) and juvenile detention centers, and has a rule 20. Referral has been made to Prairie Lakes, waiting for response.
HCMCED-M11-4844
On 11/14/24 the patient’s foster parents brought him to HCMC APS after he was discharged from Children’s Hospital St Paul because of his aggressive behavior. When in APS the patient began hitting his foster mom and becoming increasingly agitated. Security had to assist in transporting the patient to an emergency department bed, where he was then put into restraints for his and others safety. He was given sedative medications, IM.
The patient has been in foster care since he was 7 years old. He was physically and emotionally abused by his biological mother. He has been hospitalized at Fariview inpatient pediatric psych for a year, where he was then transferred to a residential treatment center. He has been with his current foster parents since August 7th, 2024.
AH-F13-4837
Admitted inpatient after running away twice from home and expressing HI towards her brother. This all occurred shortly after being discharged from M Health Fairview MICD residential treatment. She was discharged from Fairview due to threatening a peer. In the last year she has been engaging in high-risk behaviors including but not limited to substance use, fighting peers at school, theft from peers and stores, and making allegations against others (peers and family) that have not been substantiated.
MHF-F16-4834
Kiddo came to us on 11/7 from East Bethel PRTF. East Bethel has discharged reporting they are unable to meet his needs based on his ongoing SI and behaviors. They are completing a referral to CABHH. Has a long history of SI. There is currently no County involvement. Aunt is working on setting up CMH services, but County has reported they don’t have any placement options. Our team will be requesting County look at approval for out of state options once they are open due to limited options in MN for this level of care.
PH-F17-4728
Patient is needing an out-of-home, secure, placement, due to ongoing, chronic, safety concerns, that are unable to be managed at home. Patient is recommended to attend Residential Treatment or enter into a supportive living environment.
Patient has a significant psychiatric history including:
Psychiatric hospitalizations
-Mayo Clinic Generose 08/2019
-PrairieCare 10/29-11/11/2022
-PrairieCare 08/30-9/7/2023
-Mayo Clinic Generose 09/2023
-PrairieCare 11/8-11/20/2023
-Mayo Clinic Generose 12/2023
-Mayo Clinic Generose 04/2024
-PrairieCare 06/25-7/11/2024
-PrairieCare 07/25-8/14/2024
Residential Treatment:
-North Homes for a 35-day evaluation
-Gerard 08/2020-06/2021
-Gerard 12/2022-06/2023
Day Treatment:
-Fernbrook Family Center
Partial Hospitalization:
-Mayo Clinic November 2021, June 2022; Prairie St. John’s February 2022 and July 2022
-PrairieCare Rochester 11/16-12/21/2022
-PrairieCare Rochester 09/11-9/15/2023
-PrairieCare Rochester 09/19-10/11/2023
History of self-harm by cutting (recently daily), with one prior reported suicide attempt (by overdose, 6/2024), who re-presents to PrairieCare inpatient due to safety concerns related to self-harm by cutting, with increasing suicidal ideation and intention, with an inability to contract for safety, in the context of stressors related to school re-starting.
PH-F8-4701
Recommendation is for QRTP or PRTF – either could potentially meet the needs of this patient and limited treatment centers available due to patient’s age. Patient is currently in psychiatric inpatient hospitalization.
Patient is an 8-year-old female. Patient presented to inpatient from the ED due to increase in unsafe and risk-taking behaviors. This is her fourth inpatient hospitalization; one in 2022 and three in 2024. Patient has attended day treatment twice and participated in outpatient psychotherapy and medication management.
Discharge Plan:
PRTF/QRTP: (county funding approved for QRTP)
– Grafton (declined due to not meeting criteria)
– Northwood (referrals submitted 9/9, on waitlist 9/23 – awaiting update on admission timelines)
– Gerard (unable to accept due to age)
– Avanti (unable to accept due to age)
– Bar None Haven (unable to accept due to age)
– North Homes (unable to accept due to age)
– Heartland Girls Ranch (unable to accept due to age
Continue with following outside providers:
– Therapy/Therapist: Solutions Behavioral Healthcare Professionals
– Primary Care Provider: Sanford Health
– Medication Management: Solutions Behavioral Healthcare Professionals
– Case Management: Solutions Behavioral Healthcare Professionals
– Occupational Therapy: Beyond Boundaries Therapy and Wellness
EH8D-M14-4364
This patient was brought to the hospital by police for aggression and dysregulation exhibited at the group home. He was charged with 5th degree assault after injuring staff members at his group home. His behavior has persisted despite medication adjustments and behavioral plans. He struggles in settings where there is too much sensory input and lack of structure. He has been destroying property and presenting with escalating aggressive, dangerous behaviors, homicidal threats and sexualized behaviors. Despite his impulsive behaviors and subsequent harm to staff members, he displays no remorse, though some question of whether he is able to adequately engage in reality testing possibly related to intellectual disability.
He is a ward of the state. He was placed in foster care at age 6 after suffering from neglect by his biological family. Their rights have been terminated.