This child was previously on the HUB as MCR-F13-2165.
Returned 3/21/23 to Mayo ED after discharging to home on 1/9/23. Was at SERCC, brought to ED for ingestion of metallic items there. Had been in ED > 24hrs now admitted to inpatient unit to monitor his GI. Was in Fernbrook Day treatment. Transitioning to male. ED more related to PICA ingesting nonfood items regularly – batteries, tacks, chargers, etc. 1:1 support for keeping from self-harm. is at home with mom when not in day treatment program. Needs more than day tx support, needs 24 hr. Concern for medication mgt. Absence of psychiatric support. Has been in Prairie Care twice summer 2022 – dc’d for noncompliance. He describes a strong compulsion for ingesting things. He doesn’t claim it to be self harm. when he goes to Mayo, he claims that its a suicidal attempt. Was at Gerard in May and struggled, then inpatient at Children’s in summer. Then came back to Fernbrook. over 30 presentations to ED at Mayo and Metro for self-harm and ingestion. Some are SI. Ingested batteries, screws, chargers, needing med tx/attn. Spent 12 days at Gerard in May, 3 ingestions and elopements while there, they had to dc him as couldnt meet his needs. Just gotten a CADII waiver to help mom supervise at home. Case conf. yesterday – the hope would be that he could be in a residential settings with the understanding that he will ingest things. Licensure issues. He has been declined as he fits everyone’s exclusion criteria. When he is out of crisis, he’s lovely. bright, intelligent.
Seeking ideas for other options for keeping him safe. Consider Gerard? Prairie Care? (have both turned him down). Jennifer Butler working on this case. suggestions to mitigating risk? clear all things from units, reintroducing slowly when able. Mayo has been able to mitigate risk with using paper crafts, crayons, etc. Haven’t had an ingestion for a few months – has a sitter a Mayo though as he’s on a medical unit. Functional behavior analysis? Hasn’t had one, due to instability. Hopefully he will have one soon. *** Discharged to home on 4/3/23 with 24/7 PCS care.
This child has been on the HUB previously as MCR-10-283.
Patient was admitted to Prairie Care Residential on 11/8/22 but was transferred to Prairie Care’s inpatient psychiatric hospital on 11/10/22 due to aggression. Patient remains on the Northwoods Residential wait list. There will be additional residential treatment waitlist’s the patient can be added to, once they turned 11 on 1/16/23. Patient remained psychiatrically hospitalized at Prairie Care until she was discharged on 1/5/23 with the recommendation of returning to community-based treatment. Adopted but adoptive parents surrendered her to Goodhue County.
History of trauma, sexual exploitation, concurring with MH and substance use. Co-managed by psychology and addiction medicine in the hospital. Community PCP has been established who can also monitor suboxone. Patient in need of short-term placement. Has been referred to Heartland Girl’s Ranch.
attempted strangulation with the dog leash. HX of MDD, PTSD, ADHD & anxiety.
First episode psychosis. Admission to HCMC 12/26/22. Exception made to accept a minor patient to HCMC Adult Psych Unit 1/6/23 – 1/16/23 in effort to get patient out of restraints, medication regimen and agreement to return to Peds Unit. Returned to Peds Unit 1/16/23 and remains here. Efforts to transfer to Adolesent Acute Pysch unsuccessful due to no capacity and/or patient declined. Update: 1/24/23. Continues to be medically cleared, awaiting placement. Awaiting Hennepin County MH Casemanager to be assigned. Consider referral to PRTS, concern for long waitlists. Concern if we continue to board patient on Peds Floor where he is not getting the mental health care he needs, he is at risk for decompensation. Patient has a Continuance Agreement through District Court Probate/Mental Health Division for six months from 1/17/23. grandmother is open to having him return home with a structured program during the day.
Substance use history, family signed out from treatment program and has been on the run for the past 6 months after mom signed her out of facility in Brainerd. History of abuse from grandfather whom she was staying with. Leech Lake custody. Drinking since age 9. MH primary dx.
1 week prior to ED pt was found tied up in her home by her parents. She was taken to Children’s and placed into foster care. Mother didn’t believe in Western Medicine and was using THC and tying her up to treat pt’s agitation in the home. Pt presented to Regions ED from the foster home due to increase agitation and needing more staff support, pt has severe ASD, DD. Hx of violence towards self and others. She can’t eat without someone holding her hands because she hits everything away. She is mostly nonverbal, only knows a few words.
Has been in the ED for over 165 hours, she has been started on medications and we have seen a decrease in her level of agitation. She has been more cooperative with ADLs, takes medications, and eating meals w/ assist and staff have been able to redirect her before a code needs to be called. Pt has been declined by all inpatient facilities at this time. CPS in Anoka is current guardian. Has DD waiver. Regions providing sensory support, weighted blankets, stuffed animals, music. Needs 24/7 support.
Mom currently in custody.
Emotional dysregulation, high emotional reactivity in the home. Transgender. Housing insecure – soon to be evicted. Been in hospital 3 times this year. Recommend residential treatment. Meeting with mom today 12/22/22. Qualified person process can take up to 30 days.
PTSD, Disinhibited Social Engagement Disorder, Conduct Disorder, ADHD, ODD. Just got approval from HC for funding. Case mgr will start making calls. Doest present well on paper. Challenging behaviors – gets escalated and disreg. with peers. Is able to walk away. Threatens to hurt people but hasn’t yet. Remorseful about behavior. Learning about her dx. Fun kid, gets along with certain peers. Doesn’t work well with peers who have made statements about race. Ready to benefit from res. tx. and work with people 1 on 1. A lot of early childhood disruptions. Not sure why removed from bio mom – per aunt and gramma, she didn’t know how to be a parent. Aunt and gramma say that she has tried to kill them, threatens people, hard to know what’s what and what is recent behavior.
substance use, dysregulation, personality struggles and mania. Waiting for residential. Struggles with Substance dependance. ED. emotional disreg. Level 5 resid. being recommended. Accepted to VOA CRTC, 2-4 week wait. Discharging to home to wait for funding.
