MCR-F17-2442

Long history of trauma started ingesting non-edible items, batteries on 3 occasions. Waiting on County to help with disposition. Ward of state. No attempts at self-harm or ingesting since stay in ED. Last ingestion was day of admission. Surgically removed batteries then back to ED for MH care. Local school district working with her, tutoring. Turns 18 in May.

MCR-F14-2438

Ran away from home (resides with grandma) & stole from Scheels and air pods from a stranger Was tracked by air pods owner who confronted the patient at Red Lobster. Pt assaulted the mother of this individual. History of trauma & SA Kicked out of multiple schools brought gun to Willow creek & threatened to pistol whip classmate. Attempted treatment at Fountain Centers. Restraint chair multiple times.

Declined from Heartland Girls Ranch, Family/Foster Home is not an option due to behaviors, SERCC/Vonwald- patient has been to in the past and has either eloped or been kicked out of the program due to fighting. Trisha will follow up with PORT and Hunter’s Place. These are both sheltered care so similar to Vonwald but in a different geographic area. Neither of these are locked facilities which is also a concern.

Parents unwilling to take her home. Care conference with the county occurred after a week in the ED. Just starting the QRTP process.

MCR-F13-2434

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.

MCR-F11-2418

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.

HCMCH-F13-2406

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.

HCMCH-M17-2402

attempted strangulation with the dog leash. HX of MDD, PTSD, ADHD & anxiety.

HCMCH-M17-2398

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.

SBMC-F16-2371

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.

RH-F15-2367

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.

AH-F13-2355

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.