Pt has been residing in foster homes since she was a few days old. Pt has lived in approximately 9 residences, some were with biological family members. She has been in her current foster home since October 2022. Pt is under guardianship through Hennepin County ICWA program with a Hennepin County Case Manager. According to her guardian, pt has been subjected to significant trauma from her previous placements, including physical/emotional/sexual abuse and neglect. Pt’s biological parents’ parental rights were terminated before pt was 1 year old. Pt is now enrolled in school through the MPLS public school, attending while boarding in the ED. She has frequent, chronic aggression in the community. Generally no concerns in the hospital.
Recommended Service: Mental Health Residential Treatment
Mental Health Residential Treatment offers specialized care for individuals with severe mental health issues in a residential setting, focusing on mental health treatment and support.
MHF-F12-635
Patient presented to the ED from CRTC due to increased aggressive behaviors in the facility towards staff and was unable to return to the facility. Patient not safe to return home due to behaviors and case manager is pursuing residential treatment.
C8SM8SP-F14-885
Patient has previous mental health history and does not want to return home to live with her parents. Patient makes efforts to elope from their care and will escalate her behaviors to ensure she does not return home. Patient has grabbed the steering wheel from mom in an effort elope from the car.
C8SM8M-M8-308
Presents with dysregulation, agitation, aggression, threats of SI/SIB. extensive mental health history. Sexual abuse at early age. In and out of residential treatment. He doesn’t meet inpatient requirement. Mom unable to meet his needs at this time. Mom working with county to find residential placement.
MHF-F16-357
AH-F13-470
Diagnosed with Disinhibited Social Engagement Disorder. Has been inpatient and in PHP continuously since October 2022. Was in residential treatment at Prairie Care in December 2022 but discharged early due to ingesting non-food items. She has not engaged in this behavior for several months. Current struggles include suicidal ideation and self-harm. Struggles with peer relationships. Presents as intrusive and has poor boundaries.
PH-M8-352
Admission: 2/24/23
Presenting concern: PTSD, Depression, Anxiety
Ongoing case conferences weekly with Itasca have occurred. Itasca County holds guardianship.
Discharge Plan:> UPDATE 4/20/23:ADMISSION IS 4/24/23> ADMITTED SUCCESSFULLY TO NORTHWOOD on 4/24/23
Patient is medically ready for discharge; will discharge as soon as RTC/living arrangement is identified.
Interim plan:
-PHP while awaiting RTC (foster parents share they are not able to have patient back into their home at this time)
-Itasca County has submitted referral for SMRT; once approved, this will provide access to disability status/waivers and additional placement options
-MNCHOICE assessment (Referral made to Hennepin County on 04/04/2023)
-Continue CMHCM at CMHS/REACH
RTC:
-Northwest Passage (2-3 month waitlist for patient’s age group; guardian declined referral due to waitlist and out of state)
-Gerard Academy (Referral made, Declined for admission on 3/24)
-Northwoods 35-day assessment (Screening meeting completed on 4/12/23, pending acceptance/admission)
-Clinical submitted on 4/5 to treatment placement specialist at Acadia Healthcare for consideration of out-of-state referral options
MCR-M16-378
16 year old, county ward, who has been at Gerard Academy for 1.5 months and had escalating SI in the context of conflict with peers at Gerard and then ultimately learning that father’s parental rights were terminated. Long previous history of neglect and possible abuse, multiple family members with substance use disorders. At Gerard was leaving the facility and finding sharps to potentially harm himself with. Initially was recommended for inpatient psychiatric care, but declined by all facilities due to history of aggression or behavioral issues in those facilities previously. Eventually acute SI resolved while boarding in the ED, but as plans have been made to work on return to Gerard, he has repeatedly stated he does not want to go back there and will hurt himself or others if he does. His case manager reports that similar statements have arisen repeatedly in the past as placement facilties start to challenge him and seem to serve the function of avoiding difficult emotions. Currently trying to work with Gerard staff and case manager to help him safety plan for a return to Gerard.