CH-F16-3633

Patient presented to the ER with her mom for concerns of suicidal ideation though patient denies this. She has had several presentations to the ER due to aggressive behaviors and kicked out of group home for aggression towards peers and staff. She has been in and out of crisis centers and alternative housing verses being at home along with several inpatient hospitalizations.
**Full details of patient history is unknown to writer as I am not currently following her***

CH-F16-3629

Patient presented to the ER via law enforcement for aggressive behaviors at shelter care resulting in property destruction. Patient is not able to return to the shelter and does not have any safe disposition options.

MHF-F13-3515

Patient presented from North Homes due to suicidal ideation and aggressive behaviors. Patient was initially recommended for IPMH however stabilized in ED and no longer required admission. Patient has been discharged from North Homes and is in need of long-term placement as she cannot return to guardian’s home. Case manager will be working on referrals for RTC and out of home placements.

HCMCECC-M13-3482

**Contact department: HCMC Acute Psychiatric Services (APS) 612-873-9300

13 y.o. male boarding in ED. Brought in by adoptive mother after running away from home 3 times. Multiple suspensions from school (including currently) for fighting. Mother unwilling to bring patient home. Physically assaulted mother after he was brought back home. Went to Uncle’s house and left via window. Has been making passive comments indicating suicidal ideation and not having any sense of danger- getting into cars with strangers. Significant increase in challenges since he began going through puberty about 6 months back.
Copied from ED note:

“Collateral from mother and family:
Foster mother took in his sister first, took him as well at 16 months old. States that when he first came to live with her he would eat out of the trash, and from bowls on the floor like a dog. Took several months to correct this. Patient was then returned to his paternal grandmother in chicago, but was only there for two months. Foster system asked mother to adopt him and keep him with his sister. Some school issues, briefly on IEP. Mother was kindergarten teacher.
In the past 6 months, since hitting puberty and undergoing a growth spurt, patients behaviors have been worsening. In Nov of 23 patient attempted to start a fire in his bedroom. He has been in a plethora of fights at school. Is currently suspended. Believes that everyone hates him. Since January he has been making comments to family about ending his life. Reportedly had knife in his room at one point. 3x running away from home. 1st time was not far and he came home quickly. 2nd he made his way from north Minneapolis to S St. Paul, and was with a complete stranger for approximately 9 hours. Family reports that patient refuses to speak about this time. Was acting strangely after he returned. 3rd was yesterday after he became angry and physically assaulted mother. Was found by police (allegedly engaging in burglary?) Was brought to uncles house per request of mother, as he had been quite belligerent with her earlier. Patient normally behaves well with uncles, but today he waited until he was unsupervised and climbed out of a ground floor window to run away again.”

Not appropriate for inpatient pediatric medical floor. Boarding in HCMC Emergency Department. HCMC Acute Psychiatric Services do not feel patient needs an inpatient psychiatric admission. Family and NEXXUS advocate not comfortable with discharge unless plan for significantly increased outpatient support. No formal diagnoses. Has been completely compliant and appropriately behaved since presenting to the ED 32+ hours prior.

RMC-M17-3365

This patient presented to Ridgeview Medical Center via P.D. after running from his home. He was found in the woods nearby his home with a knife (patient has an ankle monitoring device). Patient reportedly desires out-of-home placement and verbalized plans to use the knife to harm kids who bully him at school. Patient has a significant history of running away from home with more than 30 reported incidents. Patient maintains a desire not to return home at this time. Carver Co. holds temporary decision making authority over patient, by court order.

C8SM8M-M8-3342

Pt presents with behavioral escalations from out of home placement. Pt currently in hospital with no d/c plan at this time coordinated by county. Pt has a history of trauma and sexualized behaviors.

MHF-F14-3262

Patient brought in to ED by case manager after her group home discharged her due to ongoing behaviors and aggression. Case manager did not have alternate placement and therefore patient now boarding in ED until new placement can be found. Patient in need of shelter or crisis respite placement while longer term placement is found. Awaiting funding.

CH-F16-3295

Patient presented to the ER with concerns for SI. The patient has had multiple residential and inpatient hospitalizations and reports they will not be safe if they return home. The patient was discharged from a 13 month stay in residential in January and was discharged from a 2 week inpatient stay in February.

MCR-M14-3272

Comes from shelter placement (Von Wald) due to aggression. Has probation with court on 3/14/24. Voluntarily placed with Rice County by family due to safety concerns. The CASII score is 6 with strong recommendation for wilderness residential programming, as he has been through a few ‘traditional’ residential programs, so he has some buy-in for wilderness type residential. Looking for shelter vs group home as waiting for residential programming. Parents hesitant to look at out-of-state programs.

ADYC-M14-1768

Update: 1/19/24 Pt. still looking for placement.

15-year-old male looking for a group home and residential program. Children’s Mental Health Case Manager has tried everything, and doors are being shut. Client has a physical aggression, verbal aggression, history of PTSD and sexual abuse. Client has experienced abuse from biological father who is in still in the home, and sexual assault that happened possibility of more than one with an older cousin sister. Client mother is giving up on hope on trying to help her child. Client is struggling at home, school, and community. Children’s Mental Health Case Manager has been trying everything to find a placement for him. He’s been going in and out of the ER like every two months now. Children’s Mental Health Case Manager still trying to offer support the way she can by being there every hospital stay, seeing client like twice a month, and having mom keep her on speed dial to talk to client.

Because of experiences, client is chemical dependent on marijuana, perks, and opioids.