Update 5/23/24: Needs psycho-sexual eval, but there is no place to send him to have it done as it can’t be done in the hospital.
Pt was brought into ED on 5/11 by mother due to allegations of abuse. Mother resides in DV shelter and shelter is not allowing pt to return there due to pt behaviors (bangs his head, kicks walls, makes threats, aggression toward mother.) Mother is trying to find new housing so that pt can return to her. County referrals made to Northwoods, North Homes, Village Ranch and Mille Lacs Academy- programs thus far are months out. Barrier to many programs is pt age. County JST is meeting today at 10:30am to discuss further options. Planning to refer for Nexus YCT once discussed with all team members and ROI is received.


She has been in foster care placement for the past 3 years. She has four other siblings whom are also in the foster care system. mother’s rights are in the process of being terminated. She ran away from foster home and was staying with a friend. Friend’s mother called police for fear of being in trouble housing a runaway. She refuses to go back to foster provider and foster provider cannot keep patient safe from running. CPS guardian and seeking shelter placement


Patient came to the ED on 5/4 after running away from her foster care. Patient reports she does not want to return to that foster care. County is guardian and CPS/ICWA worker is exploring shelters, denied from Dignity House and Passageways, still waiting to hear from Brittney’s Place. Elopement is main behavioral concern currently, pt did not like the foster care she was in. Not suicidal or violent according to foster parent.


13 y.o. female with a Hx of Intellectual Disability (mild), Developmental Speech Delay, Craniofacial Dysmorphism (potential FASD?), GERD/GI issues, RAD, ODD, and PTSD who was brought to the ED by her foster mother due to becoming acutely agitated (on her way to PHP) and became aggressive towards foster sibling and foster mother (e.g. pulled foster sibling’s hair, attempted to bite foster sibling & mother, threw things). Current presentation appears consistent symptoms of hyperarousal (e.g. irritability, anger, agitation) likely related to her previously diagnosed ODD and PTSD. Based on her current presentation (e.g. lack of behavioral/safety issues, able to make her needs known, etc.), medication adherence, relatively limited behavioral issues in the community, and her current diagnostic picture (i.e. no significant, active symptoms of mental illness), acute inpatient psychiatric admission is not currently indicated. As she is no longer able to return to her foster home, a new placement will need to be made.


Patient was placed at Passageways shelter for 1 month. Near the end of that time, patient became upset that time was ending and would transition back to home. Is not recommended for IP MH care and needs a d/c plan from the ED. Several referrals to shelters have been made.


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.


Update: Has been accepted at CABHH but discharge there has been delayed due to pts not discharging from their facility.

Pt was at North Homes, then was in Fairview’s inpatient unit for 35 days. Was going to return to North Homes from there, in transport there on 3/27 pt attempted to overdose on pills stating he didn’t want to go back to North Homes and was brought back to Fairview ED where he is currently boarding. Prior to being at North Homes he was at CABHH. County team have referred to Nexus Mille Lacs- long wait and Passageways. Hospital referred to Nexus YCT.


Patient presented to the ER with her mom for concerns of suicidal ideation though patient denies this. She has had several presentations to the ER due to aggressive behaviors and kicked out of group home for aggression towards peers and staff. She has been in and out of crisis centers and alternative housing verses being at home along with several inpatient hospitalizations.
**Full details of patient history is unknown to writer as I am not currently following her***


Patient presented to the ER via law enforcement for aggressive behaviors at shelter care resulting in property destruction. Patient is not able to return to the shelter and does not have any safe disposition options.


Pt came to ED 3/25 after being on the run for a few weeks. Was previously at hotel crisis respite prior to being on the run, damaged property there and can not return. County is current guardian, though patient turns 18 very shortly and will be his own guardian at that time. History of behaviors, verbal and physical aggression and property destruction. Has been denied from shelters due to behaviors and previously denied from RTCs in and out of state, though due to age would no longer be an option. Refuses all mental health services and has not had a DA since 2020. Is on CADI waiver. Recommendation on weekly call to discuss benefits of IRTS program/treatment with him.