PRTF – Mental Health Collaboration Hub

AH-F16-7617

Previous psychiatric diagnoses: PTSD, depression, anxiety, eating disorder, ADHD, complex trauma, suicide attempts, self-harm

Patient presented to the ED after reporting SI to their guardian. Patient reports a near daily experience of SI and AH/VH of his brother who abused him. Therefore, this is not a new symptom. Patient reports that yesterday there was no particular trigger for his SI and AH/VH, that he took a PRN medication, which usually works for him, and then called his guardian who told him to go to the ED.

While in the ED (and as is common in the community), patient will attempt to use clothing to strangle themselves when dysregulated, often revolving around trauma.

Guardian is Dakota County (Tori Thompson). No contact order for anyone in the biological family.

Hospitalized in ND for a full year and a recent over month stay at Children’s for placement from which they were placed in Mn Care Counseling Crisis home.

Crisis home has given an immediate termination notice and state as they are a crisis home they do not require a 30 day notice, due to inability to keep pt safe. They report running into traffic as a particular concern.

Recommendation is discharge with ongoing outpatient support coping skills, distress tolerance, emotional regulation and behavioral support. Pt presentation appears to be baseline and unlikely to mitigated by an admission which may conversely increase risk of maladaptive coping skills and hospital seeking behavior.

Referrals:

· Wingspan is future development of home for patient; not ready until January

referrals made to all PRTFs
Grafton
Leo Hoffman
North Woods
Nexus East Bethel
No update on possible openings

CABHHS – pt has been declined multiple times due to various reasons including high acuity, Diabetic, Eating disorder – A new referral is in process
Bridgeview—-Dakota county crisis placement; on list but currently full (2 bed facility for Dakota County youth)
Kid Link – referral to all 50 of the facilities they work with, no update on potential openings.
Out of state (Rogers and Acadia)—active referrals, no timeline

MHF-M16-7539

Youth came to our ER on 10/9. He had eloped from his home last week, police found him and when brought home he physically aggressed toward his mother, so police brought him to JDC, they reported they could not keep him because Mom was not pressing charges so he was brought to the Bridge shelter, where he was discharged from for exposing himself to others and was then brought to the ER. Mom is refusing to pick him up. He has autism and selective mutism. There is a recommendation for PRTF and RTC from June however the County has not yet screened via JST. There is not a current waiver, though waiver placements are starting to be explored to rush that assessment if identified. Has previously been denied by Hoffman Center and Grafton.

RCCP-F6-7478

6yo girl presents with extensive trauma history of sexual abuse has led to obsessive-compulsive behaviors related to sexualized behaviors including constant thinking about how to touch herself and others and trying to follow through with those thoughts. She has a long documented history of inserting items into her vagina and anus, resulting in pain, leakage, incontinence, and sores on her genitals/fingers/mouth.

AMHT-M13-7452

Client was referred to my program but we are unable to support his needs.

Has been to residential before for 6 months last year. Mom reported that when he got home he regressed back into old behviors including physical agression regularly; at times multiple times at day. He has also been to PHP before. He is currently at a respite home for the next 80 or so days. Mom reported insurance has been tricky and waitlists at programs willing to assess him have been long as well. History of eloping from school as well.

LAHC-M14-6887

Has been with us since January. Arrived from Prairie care from Mayo Clinic before that for verbalized increase in SI and engaging in SIB. History of abandonment from bio mother and apparent abuse and substance use in the household per history. History of temporary foster care. Difficulty with boundaries and impulsive behaviors. Often losing his temper, being easily annoyed and irritable, arguing with adults of authority, and not complying with rules/structure. Current and historical property destruction and elopement. Behavioral instances at school, threatening gestures and actions. History of vaping nicotine “if I have it I will use it” mentality. Witnessed DV, history of homelessness, and physical abuse.

MCR-F16-7399

16 year old female who has multiple in state and out of state residential placements, and currently on the waitlist for CABS. Family is unable to meet her needs, and she is boarding in the ED. She is in need of residential placement until she is accepted to CABS.

C8SM8SP-M14-7394

Child presented to Children’s ED after becoming dysregulated at group home; he wanted to leave, became upset and began throwing staff’s badges across the room. GH called EMS and child was transported to ED-Saint Paul. He is no longer able to return to GH after this incident. Child has a long history of foster care since he was three years old.

MHF-F13-7342

Youth came to our ER 9/1 from a 35 day assessment program in WI. They will not allow her to return. It’s reported that they will likely be recommending higher level of care and possibly a locked facility. The County is meeting with the program on 9/10 to get their official recommendations. She has history of aggression toward staff, but not toward peers. There is no waiver currently and a MNchoices assessment has been requested.

MHF-F16-4834

Kiddo came to us on 11/7 from East Bethel PRTF. East Bethel has discharged reporting they are unable to meet his needs based on his ongoing SI and behaviors. They are completing a referral to CABHH. Has a long history of SI. There is currently no County involvement. Aunt is working on setting up CMH services, but County has reported they don’t have any placement options. Our team will be requesting County look at approval for out of state options once they are open due to limited options in MN for this level of care.

CH8SCH-M9-7291

Patient presents from home via law enforcement. Aggression towards parents, elopes from parents, runs into traffic. Was recently discharged from PHP with recommendation for higher level of care (PRTF)