Patient is presenting to the ED for the following concerns: verbal agitation, suicidal ideation, threats to harm others, property destruction. Patient became upset at school, threw items, and ripped things off of the wall. Patient left school grounds, and police/ambulance were called. Patient has been living with her aunt for the past few months. Patient’s biological mother died when she was an infant, and was abused by a family member who obtained guardianship. Patient makes suicidal and homicidal threats often.
Patient was in the Fairview PHP program earlier this year. She was in the ED in May ’23. Patient no longer has a medication management provider. She has a county CPS worker and a newer case manager. Patient is currently in Equine Therapy 1x/week at Hold Your Horses.
Recommended Service: Shelter
Shelters provide temporary housing and support services to individuals experiencing homelessness or in crisis situations, ensuring a safe and stable environment.
MHF-F14-2382
Patient ran away from Aspen House shelter with three other people. The car that patient and others had taken was stolen, and they crashed into a sign. Patient drove the vehicle to another girl’s house, where the police came. Patient had written a note that implied she was suicidal, and was brought to the ED.
Patient has a history of anxiety, depression, ADHD, PTSD. She has had numerous ED visits and hospitalizations. Patient has had 4 ED admissions in the past 6 months. Pt was most recently at Prairie Care from 4/9/23-4/27/23. She is currently seeing an individual therapist, a SIBS in home family therapist, and has a Dakota County case manager.
C8SM8SP-F9-2009
UPDATE 11.16.23 – Dragonfly is a potential placement.
Patient recently moved to Minnesota and was displaying sexualized behaviors at school (disrobing, touching herself, attempting to grope teachers, making sexualized comments) CPS was contacted and they were concerned Patient was being sexually abused at home. They were brought to our hospital in need of out of home placement after MCRC visit while dad is investigated. Carver County has temporary custody. Patient has history of developmental delay. No sexualized behaviors toward other kids, mostly with self, while playing with dolls and adults.
Having DX completed this week. County pursuing a variety of options
C8SM8SP-F13-1993
Patient has had several disrupted placements over the past year including shelters and foster homes. Patient has extensive trauma history and was most recently at a shelter where they engaged in self harm by cutting and expressed passive SI. Patient was sent to the ED and was not allowed back to the shelter.
MCR-M16-2046
sexual trauma history, currently in custody of Fillmore County
MHF-F16-1061
Patient arrived via EMS due to her mother calling 911 after the patient made suicidal comments at home and conflict with her mother. Patient was engaging in sexual behavior with a strange, in exchange for drugs. Patient went home and told her mother what she did, passively stating she wanted to kill herself.
The patient has a history of risky sexual behavior, self-harm, and suicidal ideation. Patient also has a history of physical and verbal altercations with others including family and EMS / hospital / treatment staff, and has a history of 3 suicide attempts, most recent attempt was 1 year ago by ingesting bleach.
Patient has a past psychiatric history of ASD, ADHD, MDD, GAD, and Cannabis Use disorder.
MHF-F17-1669
Patient is presenting to the ED for the following concerns: physical aggression, and suicidal ideation. Patient was brought in by EMS after the police were called due to patient becoming physically aggressive towards her 4 year old cousin. Patient said that that her older cousin started to film her when she was becoming physcially aggressive. Per patient, she called 911 on her cousin. Patient then became aggressive towards police, and EMS was called. Patient was placed in restraints and given medication. Patient reported that she made suicidal statements during the incident, but that she did not mean them. She tends to say she wants to kill herself when she’s mad. Patient reports that she has never attempted to hurt herself, and has no intention on doing so. Patient has been off of her medications since June due to her insurance no longer covering them. Patient has been staying with her cousin, while her mom is on vacation. Patient’s cousin is refusing to let her return due to her aggressive behavior.
Patient has had several therapists in the past, and has been to day treatment.
PH-F14-1603
UPDATE: PT DISCHARGED HOME TO MOM.
Patient is a 14-year-old female with history of depression, anxiety, SI, SIB, trauma and aggressive behaviors. Has participated in PHP, RTC, and inpatient levels of care. Insured by Medicaid.
DISCHARGE PLANNING EFFORTS:
Primary Recommendation-
Establish Day Treatment (Patient currently refuses)
Continue CMHCM- Family Wise Services, contracted by Hennepin County
Establish outpatient individual therapy (CM is scheduling)
Establish med management (CM is scheduling)
Discharge has been attempted. Mother/LG will not accept patient back into the home. Patient was living at Passageways Shelter prior to admission and mother/LG consents for shelter placement at discharge. Patient’s aunt/uncle had agreed to take patient in with consent from LG, but aunt declined to pick patient up on day of scheduled discharge and rescinded the offer to accept patient.
Patient needs shelter placement due to family dynamics, thus the following are pursued-
Consider The Bridge for Youth (Denied d/t reported severity of aggression towards mother)
Consider Passageways (Denied again as of 8/16/23)
Consider Brittany’s Place (Denied d/t parent is still LG and would need to complete VPA)
Consider Hope House (No current availability, call back once per week to check)
Consider Itaskin Center Shelter (Referral sent by SW, additional referral needed by CMHCM)
Consider VOA Bar None Shelter (Referral sent by SW, additional referral needed by CMHCM)
Consider Ain Dah Yung Center (Referral sent by CMHCM, no current availability)
Consider RTC, as previously recommended by CMHCM prior to admission*-
Nexus-Gerard (Referral started by CMHCM, clinical sent by SW, awaiting records from CRTC for determination)
CRTC (Referral started by CMHCM, clinical sent by SW, declined for admission due to IQ)
*QRTP Pre Placement Screening with Hennepin County needed to approve funding for QRTP.
Estimated length of stay:
Patient is medically ready for discharge as of 7/18/23
C8SM8SP-M10-1459
Pt is a 10 yo male presenting due to increased aggressive and impulsive behaviors at home. Pt was attempting to light fires in the home prompting mom to call EMS. Mom has other small children in the home and feels as though she is not equipped to care for him. Pt has trauma history and has had inpatient mental health stays in the past. County recently approved funding for PRTF. Looking for a shelter in the meantime. Has sexual concerns so that needs to be considered with shelter placement. Extensive sexual and physical abuse history. Mom unable to take him back at this time, other children in the home. Has not has any sexualized behaviors while at the hospital. Nexus Mille Lacs is able to take someone with potential sexualized behaviors – and is interested in this child. Connecting offline.
C8SM8SP-F12-889
Patient was receiving residential services through Aspen House and sent to the ED following an altercation with another resident. Aspen House would not take Pt back. County is guardian and Patient has spent time in and out of foster care settings.