Mental Health Residential Treatment – Page 9 – Mental Health Collaboration Hub

PH-M15-4148

Recommendation is for level 5 residential treatment.

Patient arrived at inpatient from ED due to an increase in suicidal ideation with plan. Patient’s legal guardian is Goodhue County. He currently lives with a foster family. This is his 5th psychiatric inpatient hospitalization. He has done PC PHP 3 times, receives outpatient mental health services, and did CIBS program.

Discharge Plan:
RTC: (will need county funding)
-Gerard (Referral sent)
-North Homes (Referral sent)
-Nexus Mille Lacs (Referral sent)

Referred for Trauma informed therapy and CTSS.

Continue with established outpatient providers:
CMHCM: Fernbrook Family Center
PCP/Medication Management: Allina Health
Guardian Ad Litem: Goodhue County
County Guardian: Goodhue County

PH-M14-4228

Recommendation is level 5 QRTP, patient is currently inpatient.
Patient is a 14 y/o male w/ hx of depression, anxiety, ADHD, conduct disorder, ptsd , FSIQ 77, currently presenting due to ongoing mood/behavioral dysregulation resulting in hospitalization after aggression w/ mother and boyfriend. Biologically, there is a genetic predisposition for depression, anxiety, substance use. Patient w/ a long hx of impulsive/aggressive behaviors (runs away frequently, physically/verbally aggressive w/ authority figures, ect). Patient is a poor historian per outpatient psychiatrist and parents which impacts ability to know how he is actually doing. At this time, outpatient psychiatrist recommended RTC, and patient is on the wait list.

Patient has previously engaged in PHP, IT, CMHCM, and Intensive outpatient services

RTC
– Northwoods (referral submitted by CMHCM, year long waitlist 6/27)
– Gerard (referral submitted by CMHCM, under review 6/27)

PRTF
– Grafton (referral submitted 6.26)

PH-F13-4223

Recommendation is for level 5 QRTP, patient is currently inpatient.
Patient admitted on 5.29 to inpatient hospital. Patient has had 3 prior inpatient hospitalizations at Abbott Northwestern Hospital. January 2022, July 2023 and August 2023 her mother estimated. She also has participated in partial program. Patient had no incidents of aggression towards peers or staff. Referring information described her as needing to be on 1:1 staffing, due to aggression on the unit, however this was prior to the last inpatient hospitalization, in which no incidents of aggression were reported. The initial statement of ‘no incidents of aggression” was reported by the patient herself. Patient does have a history of psychiatric hospitalizations, day treatment, skills groups and individual therapy. Patient does not have a history of eating disorder treatment. Patient does have formal mental health history, including formal psychiatric evaluations, engagement in therapy, psychotropic medication trials and psychiatric hospitalizations.

Residential Treatment (referrals submitted 6/24, pending county funding)
– Avanti
– North Homes
– Nexus Gerard

PH-F15-4188

Recommendation is for level 6 RTC/PRTF – patient is currently inpatient.
15-year-old Female from RTC level 5. Patient admitted to inpatient after struggling with self-regulation after recent inpatient discharge. Patient has had 5 inpatient hopsitalizations since March 2024 with attempts at individual therapy, PHP, RTC (elopment), and In alignment with CMHCM, seeking RTC level of care. Referrals have been sent to Nexus East Bethel, Bar None Haven
Patient insured by Medicaid.
Pt has the following outpatient supports:
CMHCM

MHF-F13-4168

Pt came into our ED on 6/13 after a verbal altercation at home with mom, where she left the house and walked to the police station who called crisis and brought pt to ED. Mom is refusing to pick up. Its reported pt was in residential treatment until April 2024, and prior to that was in PHP through Fairview. Mom reports that Case Manager is looking into residential treatment again however we have been unable to reach the CM and their offices are closed the rest of this week. Unsure if there is a recommendation for residential or county approval for that LOC.

PH-F16-3212

Update 5/16/24: No new information from 5/8 update. Accepted at Bar None Haven, county funding approved. QI completed with recommendation for secure residential setting that is able to accommodate both chemical dependency and mental health treatment. County is inquiring to see if this can be accommodated at Bar None Haven or if they have to look into additional placement options. Medical recommendation is locked mental health RTC. Comprehensive assessment (rule 25) recommends Mental Health Residential. Accepted at Nexus East Bethel PRTF- opening midsummer.

Update 5/8/24: Accepted at Bar None Haven, county funding approved. QI completed with recommendation for secure residential setting that is able to accommodate both chemical dependency and mental health treatment. County is inquiring to see if this can be accommodated at Bar None Haven or if they have to look into additional placement options.

Update 5/01/24: Accepted at Bar None Haven, county funding approved. Missed admissions on 3/20 and 4/30 due to county wanting to complete QI process and having VPA signed in front of a judge before approving placement.

Update 4/25/24: Accepted at Bar None Haven, second opening is now 4/30 and county approved for placement, they are not approving transition on 4/30 wanting a judge to sign the VPA in court and wait the QI process.
Accepted to Nexus East Bethel PRTF, estimated wait list out until August-September.

Update 4/17/24: County funding approved, awaiting open placement at Bar None Haven, previously missed admission due to no funding. Pending acceptance decision at Nexus East Bethel PRTF.

Update 4/3/24: Pt has MA now. CMHCM in process of being assigned and requesting preplacement screening for funding. Denied from Grafton. On waitlist at Bar None Haven, missed admission due to no funding. Pending East Bethel.

Discharge Plan:
Level 6 RTC/PRTF-
Grafton (Referral submitted; Not in network with Prime west, can contract with MA MCO’s and obtain SCA, Denied 2.8.24, re-reviewed, denied)
Nexus East Bethel (Referral submitted; pt will need straight MA; several month waitlist, now has MA so re-reviewing, accepted, admission waitlist til mid-summer)
Bar None Haven (Referral submitted, Tentative admit 3/20-3/21, dependent on county funding, county declining JST screening, requested again, approved)
CMHCM at Beltrami County (Guardian currently in communication with the county, case manager was not being assigned until pt has CD treatment, requested reconsideration)

Notably, Previous services/interventions attempted: Dual Diagnosis IOP, Outpatient therapy, outpatient psychiatry, PCP, CMHCM, CTSS, CD RTCs, Inpatient x3, JDC, previous foster placements.

CMHCM at Beltrami County (Referral completed, services in intake)
INSURANCE- NOW Straight MN MA (was a PRIME WEST MA)
Description: Patient is a 16-year-old Native American female who has a history of depression, anxiety, ADHD, nicotine use disorder, cannabis use disorder, and unspecified trauma. Patient experiences significant impairment(s) in the area(s) of social, emotional, and academical. Patient identifies current supports as her father, sisters, and grandmother. Patient has a history of inpatient psychiatric hospitalization through PrairieCare and Prairie St. Johns.

RMC-F16-4041

16 year old female who was brought in by EMS in 4-point restraints after being restrained by PD trying to enter river to “drown herself”. Patient argued with her mother just before she threatened to “drown herself in the river;” destruction of house/property per mother’s report. Patient admits to past similar behaviors and has multiple MH hospitalizations on record.

PH-F17-3785

Recommendation is for level 5 Residential Treatment; patient is currently inpatient.

Patient is a 17-year-old individual who identifies as non-binary and uses they/them pronouns. They admitted to PrairieCare Inpatient Hosptial via ED due to an increase in suicidal ideation. This is their 3rd psychiatric inpatient hospitalization, they have done PHP, and engaged in outpatient mental health therapy and psychiatry. County funding has been approved for RTC on 4/25/24.

Discharge Plan:
RTC: (county funding approved on 4/25)
-Avanti (ACCEPTED, scheduled admission Tuesday 6/4/24)
-Gerard (Referral sent & received, awaiting secondary review)
-North Homes (accepted with immediate opening – county and guardian declined placement)

Continue with established outpatient providers:
-Individual therapy: South Central Human Relations-Owatonna
-CMHCM: MN Prairie County Alliance

PH-F11-3982

The patient presented after expressing homicidal thoughts (threats of aggression) toward her grandmother with whom she lives. Patient was on her way home from school when she pulled her school lvan driver’s arm to the back of the van as she did not want to return home. Patient was then returned to her school where her grandmother picked her up and eventually brought her to the Emergency Department. Since her presentation to the Emergency Department, the patient has not displayed any aggressive behavior. Patient has irritability and emotional outbursts with grandparent(s) and has displayed these behaviors at school as well. Has mostly been pleasant and cooperative in the Emergency Department. Has some attention seeking behaviors when the Emergency Department is busy.