Youth came into our ED on 5/6 from the Bridge for Youth shelter. Shelter refusing to take her back. She has boarded with us before for a short time last June. Currently has CADI and CMH, both through contracted agencies. Unable to access County screening team due to contracted CM, so MH GH and residential are not options currently. MCCP referral is in, also have referral to CABHHS and Grafton- awaiting approval from Arkansas Foundation and for acceptance at the program.
Recommended Service: PRTF
PRTF facilities provide intensive psychiatric care in a residential setting for individuals, often children and adolescents, with severe mental health issues.
PH-F15-5562
Patient is a 15-year-old female, currently at PrairieCare Inpatient Hospital.
Recommendation is for level 6 PRTF.
Patient has had five previous inpatient hospitalizations through Abbott Northwestern and PrairieCare since April of 2022. Patient has had two admissions to PrairieCare partial hospitalization programming, and one admission to Anthony Louis Center RTC.
Establish PRTF:
-Nexus East Bethel (CMHCM sent referral, PC also sent a referral, declined for admission 04/16 due to believing PT needs a higher level of care- CABHH)
-Northwoods (Not a viable option due to insurance and 2 year waitlist)
-Grafton (Not a viable option due to patient not meeting admission criteria)
-Leo Hoffmann Center (Not a viable option due to patient not meeting admission criteria- only accept biological males)
PH-F12-5504
Patient is a 12-year-old female, currently at PrairieCare Inpatient Hospital.
Recommendation is for level 6 PRTF.
Patient would be able to discharge to a lower level of care while awaiting admission to a PRTF, although she does not have a current placement through the county.
Patient has had a previous inpatient hospitalizations, through UMMC for 38 days waiting for a placement through the county and
PrairieCare Inpatient Hospital 02/02/2025-03/17/2025. Patient was admitted to PrairieCare Residential 03/17/2025-03/20/2025 although was stepped back up to inpatient due to safety concerns.
She has a known history significant for MDD, GAD, and PTSD.
SEE UPDATES BELOW
Establish PRTF:
(eligibility form sent to AFMC on 3/26)
-Nexus East Bethel (referral sent & under review)
-Northwood (referral sent, pt’s mother revoked consent on 4/10 due to distance)
-Leo Hoffman (not viable option due to only male patients)
-Grafton (not viable option due to needing ASD, ID, or DD)
CH-F14-5404
Patient presents from group home. Patient is known to our ER and previously boarded 12/3/24-1/7/25. Patient presents after engaging in aggressive behavior that reportedly included verbal threats and chasing them with a shovel. She has had episodes of aggression with staff in the ER and has been targeting another patient that is boarding. The group home has provided a suspension of services and plans to submit a termination of services. County case worker has been making referrals and looking for crisis respite placement. She will likely need a home created for her.
AH-M15-5556
Impression of Crisis Behavior (precipitants): Patient presented to the ED due to agitation and SI. The identified precipitant for this crisis is a verbal and physical argument with his mother and her boyfriend at the home. Patient was released from the JDC to home on 4/5/25.
Vulnerabilities: adolescent, ASD, h/o trauma, recently released from JDC, parent-child conflict, inadequate outpatient supports
Behaviors / Symptoms to address in the ED: deferred
Methods to increase desirable behaviors in the ED: meet basic needs, set behavioral boundaries/limits,
Barriers to Discharge include: At this time, patient is NOT felt to meet criteria for inpatient hospitalization. There are no new acute safety needs that warrant admission. His mental health concerns are chronic and environmental.
Mom is refusing to take him home, JDC won’t take him back as there are no new charges and he has no place to go. CPS is investigating allegations of abuse by parents and child but are not seeking placement. Mom does not consent to use of a shelter or Nexus YCT.
MHF-F13-5407
Kiddo came to us on 3/17 from residing with aunt who adopted her, and aunt is refusing to let her return. She has previously been in PRTF and has a felony assault charge that she was deemed incompetent for via a rule 20. Due to that most placement options have declined her. She has a CMH CM and the County team is exploring getting MNchoices expedited to look at waiver placement options.
MFIUP-F13-5535
Pt presented to the FV Riverside ED on 3/17/25 from school for agitation and aggression in the context of being questioned by school security about misusing her medications (which was reported to school by her guardian). She has remained in the ED boarding awaiting placement at a residential facility as guardian/aunt has not felt safe to have her return home. In the ED, she has had multiple behavioral codes, has been aggressive to staff, and has self injured. Given her out of control behaviors and the ED’s inability to manage her, she was admitted to UMMC unit 7ITC on 4/11/25 as a boarder while she awaits placement. Significant symptoms on the initial presentation include irritability, aggression, out of control behaviors, impulsivity, and SIB. Was previously admitted to Nexus-East Bethel but assaulted staff so unable to return.
MHF-F13-5435
Youth came to our ED 3/24 after altercation at home with Mom. Mom is refusing to pick her up. Has briefly boarded with us twice in the recent past, discharged home both times with WARM and FRSS services. Has contracted CMH CM. Mom is wanting RTC or PRTF. Reportedly County is working on switching her to operated CM to potentially access the screening team and those services.
MCR-F8-5371
This 8 year old has been in two foster homes (skilled) that have been unable to keep her safe; no other foster homes available. Getting updated DA today. Has a YBH worker since 2022, in-home family therapy with family, in-home CTSS skills, individual therapy, medication management, partial hospitalization at PrairieCare Feb 2023 and March 2024, hospitalization Jan 2023; Level 3 at school.
Complex trauma (sex abuse, poor attachment, placement / moves); ongoing CPS case with pending charges. Parenting assessment indicates to cease parenting time
CH-M15-5352
Patient presented via law enforcement after jumping in front of a vehicle in an attempt to end his life with additional thoughts to jump off of the bridge he was standing on until law enforcement intervened. Patient reports a 3 year history of auditory hallucinations that tell him to harm himself or others which occurs when he is alone or stressed. (hallucinations appear consistent with audible thoughts). This is his 4th inpatient hospitalization for suicide attempts and he has had multiple ER visits. While here, he attempted to assault a younger peer and was assaulted by a different patient. He was placed in the BICU where he has attempted to “snap” his neck on multiple occasions, head bangs, ingested hygiene supplies x1, and tied towel around his neck x1. Suicidal thoughts are perseverative when they occur and can be difficult to redirect.