Mental Health Residential Treatment – Page 7 – Mental Health Collaboration Hub

MHF-F15-3741

Came to our ED after physical altercation with another resident at Prairie Care Residential, can not return there. History of multiple inpatient admissions and PHP. Grandma is guardian and pt is unable to return there due to another child living there that pt can’t be placed with. CMH worker has made multiple RTC referrals and patient has been denied by almost all. Currently looking into a RTC out of state in TN, however this provider does not have a contract so would be a long time before this placement was obtained. Also looking at shelter options.

PH-F14-3695

Update 4/23/24: Patient discharged from inpatient on 4/23/24. Patient scheduled to begin PrairieCare PHP on 4/24/24 while continuing to pursue Group Home placement as recommended by the county.

Patient is a 14-year-old female presenting to inpatient on 03/19/2024 from the ED due to running away from shelter placement. Patient has a history of participating in PHP two times, DBT, ongoing outpatient mental health services, and being in shelter placement.

Discharge Plan:
RTC:
-North Homes (on the wait list)

CD-RTC: Referrals submitted/considered for the following facilities:
-Hazelden (Pt’s insurance not accepted in Minnesota)
-Rogers (Declined due to elopement risk)
-M Health Fairview (Declined due to elopement risk)
-Anthony Louis Center (referral sent 03/27/24)

Group Home Placement (as recommended by JST/county):
-Little Sands (Referral submitted by CM; declined d/t LON)
-Village Ranch (Referral submitted by CM; reviewing 4/10; pending additional review on 4/17)
-North Homes (Pt is on the waitlist for RTC; pt is not eligible for their group home due to age)

Existing Outpatient Providers:
CHMCH: Hennepin County
Psychiatry: Nystrom & Associates

PH-F16-3669

Update 4/29/24: Patient discharged from Inpatient on 04/19/24 to wraparound outpatient mental health services while continuing to pursue RTC options.

Patient admitted to PrairieCare Inpatient Hospital 3/19/24 from the ED following increased thoughts of suicide with a plan. Pt has had previous IP stays at PrairieCare, Mayo Clinic, Riverside and Prairie St. John’s. Pt had a previous residential stay at Gerard. RTC has been pursued and funding has been approved through Dakota County although currently pt has been declined by viable in-state options. Level 6/PRTF programming is also being explored.

Referral is currently pending at Bar None Haven. Referral also made to Acadia to explore out of state options. Referral will be made to Nexus East Bethel PRTF as CMHCM is willing to help pt switch to straight MA if Nexus is able to accept. Patient is medically ready for discharge and is pursuing an interim plan of dcing home with wrap around services while awaiting placement.

RTC (CASII LEVEL 5) (funding approved, in QI process):
-Acadia (referral sent to explore out of state options)
-Avanti (declined)
-PCR (declined)
-North Homes (declined)
-Gerard (declined)
-Northwoods (waitlist 2+ years, so not a viable option)
-Newport (Insurance not accepted, so not a viable option)
-Nexus Mille Lacs (only accepts biologically male patients, so not a viable option)

PRTF/CASII LEVEL 6
-Bar None Haven (referral pending)
-Nexus East Bethel (referral to be sent, CMHCM able to help switch to straight MA if accepted)
-Grafton (requires ID dx)
-Leo Hoffman (only accepts biologically male patients)
-Northwoods (2+ year WL)

CH-M8-3464

Update 4.18.24 – on wait list for Northwoods, admission wouldn’t be until summer. Looking for a foster family until residential.
update 4/15/24: The patient is medically stable and has been doing very well here on the unit. Has not shown aggression towards others. One minor episode of head banging when frustrated. Medications are providing therapeutic benefit.

Patient with a past history of RAD, PTSD, ODD and questionable FASD that presented to the ER with foster parents of 4.5 months for concerns of aggression, suicidal ideation, and sexually inappropriate behaviors towards others and pets. He has been in several foster/kinship homes since age 5 with significant trauma prior to this including witnessing mom overdosing on several occasions, witnessing the overdose and death of housemate, sexual abuse by bio father, homelessness, sister attempting to suffocate and strangle him on multiple occasions, and physical abuse by caretakers. He was recently found on video touching the house dog sexually and physically inappropriate and has been threatening and pushing his foster mom. Foster providers are unable to accept him back in their home.

PH-M17-3533

4/10/24: Patient discharged from inpatient on 4/10/24 and admitted to Gerard RTC.

4/3/24 Update: Accepted at Gerard, parent and pt excited for Gerard RTC. However, pt’s parent not in agreement to VPA for the purpose of RTC funding, thus, missed admission. Parent working with county to make some edits on VPA and then pt will admit to Gerard RTC on 4/10/24.

Case Description: 17 y/o male w/ hx of MDD, GAD, ODD, PTSD, polysubstance abuse( in remission), multiple suicide attempts currently presenting due to SI w/ plan to hang self. Patient has been struggling w/ worsening symptoms of depression due to mothers upcoming death anniversary coming up.

Insurance is BCBS MN PMAP

Discharge Plan: RTC:
– Gerard (Referral submitted by IT, Tentative admit Weds 4/3 at 1300 pending county funding; 3.21.24 County funding approved but adoptive parent not in agreement to “sign custody to the county” for the purpose of RTC funding, thus, missed admission, next admission scheduled for 4/10/24)
– North Homes (Referral submitted by IT)
– Nexus Mille Lacs (Referral submitted)
– Village Ranch (Referral submitted)

Current Providers:
– Individual Therapy at Rooted Counseling in Moorhead
– Primary Care with Sanford Children’s Southwest Clinic
– Medication Management at Midwest Mental Health
– Group Home Case Management at Valley-Lake Boys Home
– Probation at Clay County
– Group Therapy through Valley-Lake Boys Home
– CMHCM at Clay County

PH-F12-3422

Update 4/15/24: Patient discharged from inpatient on 4/15/24 to home with outpatient services while awaiting level 6 RTC/PRTF placement.

Update 4/3/24: Bar None Haven (Referral submitted, Denied 3.22.24), Northwood Children’s (Referral submitted, On waitlist), Grafton (Referral submitted), Nexus East Bethel (Referral submitted). County also working on referral for MITH program (MN Intensive Therapeutic Homes). MN Choice Assessment done.

12-year-old female with DMDD and RAD presenting to PrairieCare Inpatient Hospital. Patient has had multiple psychiatric hospitalizations, 2 RTC placements and 2 JDC placements.

Discharge Plan:
Locked Level 6 RTC – Bar None Haven (Referral submitted)

Current Providers:
CMCHM at Beltrami County
Individual Therapy
Medication Management
Wavier Case Management Services through Beltrami County (In process)

MHF-F14-3452

Update: Has been accepted to out of state placement in MA however struggling with arranging secure transportation- not a County paid placement as family is guardian. Also moved to IP unit at hospital 4/13 to board there until placement.

Patient presented from guardians home due to aggressive behaviors and agitation. Patient has a history of autism and developmental delays. Guardian does not feel she can care for her any longer at home and feels she needs out of home placement. Has historically been in crisis respite placements and done well in these until guardian brings home, where behaviors will escalate.

CH-M12-3595

This patient is a 12 Y year-old male with a self-reported history of depression, anxiety, and ADHD who presented to the ER on 4/8/24 by EMS from his residential facility for assessment of suicidal ideation. He was a direct admit to residential from JDC where he was placed due to allegations of sexual offenses towards his 8 year old step-sister. He reports he has harmed his step-sister on multiple occasions and has been in 3 different JDC’s including Red Wing over the last year and reports he didn’t know doing those things were wrong until now. He also reports a history of defending himself against bullies as well as head butting a female staff in the chin while in juvenile detention. He has had “13 or maybe less” attempts to harm himself or end his life and has been hospitalized psychiatrically x2. He reports he has attempted to wrap a scarf around his neck, tried drowning himself in the toilet while in a juvenile detention facility, and attempted to wrap the vacuum cord around his neck. More recently attempted to jump from a stair well, got out a window, and makes attempts to look for glass to harm himself. Residential is not willing to accept him back at this time.

PH-F14-3375

Update 4/12/24: Patient discharged from inpatient to home, while waiting for RTC admission.

Update 4/11/24: Patient scheduled to discharge from inpatient on 4/12/24, stepping down to outpatient supports, while waiting for RTC. Intake process is moving forward at North Homes RTC, with potential admission on 4/18 or 4/19.

Update 4/4/24: Patient has been accepted at North Homes RTC with a potential admission mid-April. Patient has now been assigned a CMHCM, waiting on screening for county funding.

Update 3/21/4: Pt is under review for acceptance at North Homes pending county funding, Waiting assigned CMHCM, parent is currently doing the intake process at the county to get a CMHCM for the Juvenile Screening.

Patient is a 14-year-old transgender male presenting at PrairieCare’s inpatient hospital. Patient presented to Sanford Bemidji Medical Center on 3/4 when parents brought them. That night while parents were away from home patient was aggressive toward sister. Family called crisis and were directed to bring to ED for evaluation. This is after a similar event last week where patient attempted to stab sister with a knife and father had to intervene.