Patients mother shared that the patient has an extensive treatment history, but has continued to struggle with challenging behaviors and emotion dysregulation. Mom described that “over the last few days he’s just been a terror, despite our best efforts. He freaks out when we try to redirect him. Mom reported that the patient has “aggressive towards people, getting physical and violent, he’s been assaulting his younger brothers.” Mom described that on the day of admission the patient had been going into his brother’s bedroom “trying to annoy them,” and hitting them. Mom called her husband, the patient’s step-father, who is currently out of state for work. The patient’s step-father spoke to the patient over the phone and told him that he needs to change his behavior and reminded him that he has been through so many different programs and should be able to “put on the breaks” with his behavior. The patient began talking back and got confrontational with his step-father, asking “what are you going to do about it?” The patient’s step-father indicated that their would be consequences when he returned and urged the patient not to put his job at-risk by making him return home early to deal with his behaviors. The patient challenged his step-father further making statements such as “fuck you, why don’t you say that to my face?” and “bet, come home then and see what happens.” The patient further stated “I’ll shoot you in the fucking face, right through the eyes.” Mom reported that their is a gun in the home, however it is locked in a gun safe and the patient does not have access to this. Mom then asked the patient where he would get a gun from and the patient indicated that his friends at school have guns. Mom expressed “this has escalated so far beyond me. We are walking on eggshells from the time he gets home from school until he goes back the next day.” Mom reported that she did not feel safe bringing the patient back home. She reported that she had attempted to press charges on the patient today, however police had declined and brought him to the emergency department instead. The patient is uninsured, county is working on his application, but he does not have a county social worker. Has a contracted mental health case manager through Fernbrook.
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.
MHF-F14-4898
Pt came to us 11/18/24 after an altercation at her ongoing GH in which she physically aggressed against another youth. Its reported that youth plans to press charges. She is not allowed to return to that GH, but that provider is working to see if they can set up a new setting for this pt, both temporary and ongoing. Team also has another GH they are looking into for her. This kiddo boarded with us previously, prior to discharge to her last GH, 9/24-11/1 of last year. Dakota County currently has custody. She is also open to CMH and waiver.
MHF-F13-5313
This pt has boarded with us multiple times in the past. 2/13/24-3/27/24 and 2/14/25-2/21/25. Came to us again 2/27/25 after self harm in the shelter setting where she had discharged to on 2/21. Shelter is unable to take her back. County has custodianship currently and is searching for additional shelter and foster placements, as well as waiver placements. (Was in foster prior to 2/14/25) Previously had residential treatment, in 2024. Is open to CADI waiver.
GC8S-F14-863
14-year-old adolescent female with a history of ADHD, witnessed verbal and physical abuse, multi-substance use with significant behavioral issues at school. Pt was admitted to Gillette Children’s on 4-30-2023 with an acute hypoxic ischemic brain injury secondary to hanging herself in a suicide attempt. Pt has made significant improvements in her cognitive and motor functioning since her initial presentation. Pt does not have a previous history of suicide attempts but does have a history of non-lethal cutting behaviors. She has been involved with various mental health providers on an outpatient basis over the past several years. She has never been hospitalized for mental health issues. Pt is currently not suicidal. Pt currently presents with a flat affect and difficulty comprehending the gravity of her suicide attempt. Pt will be ready for discharge from a medical standpoint mid-next week and is expected to be independent in mobility and self-cares, although she will require supervision in the home setting. Pt has the endurance to complete a full day of activity. Please consider Pt for intensive mental health services and parental support as she transitions back to her home setting.
Update 5/18/23 from Mallory at PrairieCare: Amy and I messaged, this pt will DC from RU 5/24/23 and has not had any SI or SIB plans, means, or intent. Likely initially declined for Inpatient due to medical condition. Once medically cleared, discussed referral for PHP due to needing intensive therapeutic intervention, but not imminent danger to self. Amy plans to refer for PHP.
MHF-M17-5398
This kiddo has boarded with us in the past. Was just with us 2/17/25 – 2/27/25 when he discharged to the Bridge shelter. Returned to us 3/17/25 after refusing to attend PHP for SUD and the shelter will not take him back. His parents are refusing to have him return home. He is a few weeks from being 18 and there is no plan to pursue guardianship of him at that time. He is not agreeable to any sort of SUD treatment. Has CMH and CADI waiver CM.
MHF-M15-5368
Kiddo came into ED on 3/11 after an altercation at home with parent over electronics. Parents are refusing to pick up. Mom has been working on CMH worker however current staff assigned explained they can not do anything currently as they have not met with parents yet and don’t have any paperwork signed, planned to meet next week Wednesday. Unclear if out of home placement would be supported even after that meeting. Mom is not agreeable to parent referred shelters as she wants longer term placement/residential.
MHF-F13-5365
Kiddo was just boarding with us 1/9/25 – 2/19/25, prior to that was in residential in FL for almost 2 years. Discharged to treatment GH 2/19 and had been doing fairly well there. Was supposed to start school yesterday and refused. GH staff gave her the option of going to school or back to the hospital and she chose the hospital so was brought back to our ED. Staff are saying that pt cant return without being willing to go to school. Pt reports that the school scares her because it has locked doors and they do holds.
MHF-M14-5362
Kiddo was just boarding with us 1/30/25 – 2/18/25, and returned to our ED 3/9/25 after aggression in the hotel crisis setting and they are not allowing him to return. Has also boarded on our IP unit for extensive time in the end of 2024. There was a GH set up originally for 3/14 however they are having staffing shortages and so admit date was pushed back to an unknown time. CM is continuing to look for additional placement options.
MHF-F17-5334
Kiddo came to our ED 3/4 from Aspen House, where she has been discharged from after an altercation there involving verbal and physical aggression. She has boarded with us multiple times in the past, 2/21/25-2/25/25, 1/3/25-1/10/25, and 1/19/24 – 2/2/24. She is just a few weeks from turning 18. PRTFs were being explored, but so far denied. Just had MNchoices yesterday 3/4 to re-start waiver, looking into waiver CRS placement. Previously was at NW Passages. Has had Nexus YCT involvement ongoing, since our team made the referral in January.
AH-M15-5325
Patient arrived from home. Increased aggression over two weeks. Aggressive behavior not provoked or isolated to home (Home, school, hospital). Parents no longer feeling they can manage his cares at home and would like him in a long-term placement option. Patient is in an Emergency Department with no immediate discharge alternative.
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