Recommended Service: Crisis Stabilization

Crisis stabilization services are mental health services, provided after crisis intervention, to help the member return his or her functioning to the level it was before the crisis.

AH-F16-1908

Brought to ED after altercation with mom (family adopted patient after years of fostering). Patient went after mom with a knife, patient reports conflicting stories about incident and what she remembers happened. Had been in residential over a year ago. Was recently suspended from school for 10 days after getting into a fight with another student. Unclear if there have been any other incidents of this nature with mom or family, however, mom is not feeling safe if patient were to return home. CPS is involved, Nexus is now involved, but no placement options on horizon at this time.

MHF-F11-1660

9/28: Youth still awaits placement to RTC.
9/19: Accepted to Nexus FACTS to assist with Placement Coordination.

9/14/23 UPDATE: Nexus YCT program looking into helping with this child.
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, significant behavioral change, abuse or neglect, anxiety, worsening psychosocial stress, suicidal ideation, depression. Patient was staying at a crisis residence after discharging from the ED on 9/1/23. Police were called due to patient becoming aggressive/violent, dysregulated and exhibiting SI/HI plans and threats. Staff at the crisis residence do not feel safe keeping patient at the home due to her violent outbursts, and fear for other residents’ safety.
Patient is a Hennepin County state ward. She has an extensive history of childhood trauma, including neglect, physical abuse, and suspected sexual abuse. She was also prenatally exposed to cocaine. Patient’s grandmother adopted her, who fled with the patient to a different state. Her grandmother’s rights were terminated, and patient has been living in foster care with her aunt since the end of June 2023. Prior to that, patient was living in a group home for approx. six months in Duluth, after completing residential treatment at Northwoods. She arrived to the ED on 08/09/23 following an episode of significant behavioral dysregulation involving throwing furniture down the stairs. She was subsequently admitted to 7ITC and discharged on 08/28/23, returning to the ED on 8/28, and discharging to crisis residence on 9/1. Has a CPS worker, who is her guardian, but no other services/case managers.

CH-M18-1987

Patient presents with SI and HI and auditory hallucinations. Attempted to wrap blanket around his neck in the ER on 10/28/23 in an attempt to end his life. Hears voices telling him to hurt others. Intellectual disability (FSIQ 67)

MHF-M13-1809

Patient presents to the emergency department for the 4th time in 12 days. Patient was discharged from the hospital, went home with his mother, and got into a verbal argument in the car. Patient reports his mother kicked him out of the house, so he went to school. Patient arrived at school and was told that he was not allowed to be there due to historical violent threats against other students, so school staff called police. Patient has recently engaged in property damage at his home and made homicidal threats towards his step-father.
Patient’s father is incarcerated for murder. Patient’s mother has history of childhood sexual trafficking. Patient has ongoing parent-child conflict. Patient has no history of inpatient mental health admission or intensive outpatient treatment. Patient is involved in a youth runaway program. Patient has a school social worker. Patient has established medication management.
Patient’s mother is refusing to pick patient up due to homicidal threats towards family.

RMC-M16-1022

16-year-old Caucasian male with disregulated behaviors and suicidal ideation. Patient was brought into the hospital by EMS from school. Patient punched a wall, made suicidal statements and began banging his head in response to a conflict with another student and teacher. Mother of child states “ramping up” behaviors at home recently. Patient carries a current diagnosis of ADHD, OCD, Autism, and Bipolar Disorder. Patient lives at home with his mother, father, and younger sister. Patient has has a history of mental health hospitalizations: at age 11 (Prairie St. Johns) and age 8 (Fairview Ridges).

MHF-M16-1797

Patient is presenting to the ED for the following concerns: physical aggression. Patient has prior diagnosis of ASD, ADHD, Intellectual Disability, and Mood Disorder. Patient has prior presentations for behavioral issues and outbursts at United, Mercy, and Abbott. Patient lives with his mother and 5 other siblings. Patient and his family were outside, when he says his sister started mocking him. Patient hit his sister twice, and then his brother. Patient then came up behind his mother, as if to hit her, and his brother stepped in. Patient’s mother is refusing to pick him up.
Patient’s family is moving this week, and he does not want to move.

SMCF-M14-1785

14yr old male who presents to Emergency Dept with homicidal ideations with dad from school. He denies making statements of a homicidal nature but per report he threatened to kill his school paraprofessional and “shoot up the school.” Patient has access to means and at the time reported intent. He also make threats to hospital staff when angry and has made several comments about owning a gun. He has a history of acting violently and notes when he is angry he could do something to harm others. He missed several days of his psychiatric medications which may be contributing to this escalating behavior. Medication was restarted two days ago but he needs a safe secure environment to restart medication and to further evaluated his risk of threat to others. Patient is perseverative in this thinking, restless, and with disorganized thinking which may be in part due to not receiving his ADHD prior to this assessment but also deserves further assessment.

MHF-F11-1552

UPDATE: Accepted to Gerard Pending date next week.
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, anxiety, worsening psychosocial stress. Patient was threatening to attack kids in her neighborhood with a knife, and threatened to stab her grandfather when he attempted to intervene. Patient’s grandfather locked her out of the house, so she wasn’t able to get anything else to hurt someone with, and patient kicked the lock off of the door.
Patient recently lived in a youth shelter/transitional home called Dignity House for 1.5 weeks until 8/3/2023. She was then sent to the ED for aggression. She had a warrant for arrest due to an assault and threatening homicide to family members. She was taken to JDC on 8/3/2023, had court, and then she was sent to the Bridge for Youth Shelter. Patient got into a physical altercation at The Bridge and was sent back to the ED on 8/8/2023. While in the ED, patient physically assaulted a nurse and was picked up by her grandfather.
Within this year, the patient has had approximately 13 ED visits due to concerns including runaway, aggression, abuse/neglect, and altercations with family members.

PH-F13-1646

UPDATE 9/7/23: Pending potential foster/emergency beds.
UPDATE 8/31/23: Possible emergency foster bed open 9/5, emergent SMRT application in process. Still waiting living placement.

13 y/o female with a history of PTSD, depression, ADHD, mild CD concerns. Patient has a history of previous psychiatric hospitalizations related to increase in SI, SIB, and/or suicide attempts. Patient currently has an outpatient therapist and children’s mental health case manager; treatment history includes outpatient therapy and psychiatric hospitalizations as well as one prior placement at Northwoods crisis stabilization program. Patient is in foster care under guardianship of St. Louis County. Patient was in a foster home prior to inpatient hospitalization but is unable to return to that placement after discharge. Patient has Ucare PMAP insurance.

Discharge Recommendations:
Continue individual therapy established provider
Continue CMHCM with established provider
Continue primary care/medication management with established provider
Establish psychiatry (SW to refer/follow up with outpatient team RE: pending referral)

Estimated length of stay:
Until placement is established by the County (Patient is medically ready for discharge as of 08/16/23)