Patient and family unhoused, staying in shelter. Due to a behavioral incident of aggression, patient unable to return to shelter. Family unwilling to pick patient up from ED. Hennepin County now granted interim custody. Shelters unable to accommodate patient’s needs. Patient does need help with some cares and activities of daily living.
Recommended Service: Therapeutic Foster Care
Therapeutic Foster Care is a specialized form of foster care that provides children with structured, therapeutic, and supportive environments to address their emotional and behavioral needs.
CH-M8-5322
Patient presents to the ER from foster home with his 9-year-old brother after running from his foster home. Patient has no previous psychiatric history. Foster provider not able to have patient return. Patient’s county social worker is looking for foster placement.
AH-M15-5325
Patient arrived from home. Increased aggression over two weeks. Aggressive behavior not provoked or isolated to home (Home, school, hospital). Parents no longer feeling they can manage his cares at home and would like him in a long-term placement option. Patient is in an Emergency Department with no immediate discharge alternative.
MHF-F13-5313
This pt has boarded with us multiple times in the past. 2/13/24-3/27/24 and 2/14/25-2/21/25. Came to us again 2/27/25 after self harm in the shelter setting where she had discharged to on 2/21. Shelter is unable to take her back. County has custodianship currently and is searching for additional shelter and foster placements, as well as waiver placements. (Was in foster prior to 2/14/25) Previously had residential treatment, in 2024. Is open to CADI waiver.
CH-F11-5026
Pt presented from home, adopted parents, for aggressive behaviors. Third ER visit this month, unable to take pt back home due to frequency and intensity of behaviors as well as 4 other children in the home. Pt initially recommended IP hospitalization, however unable to find placement due to acuity, no beds, or declined due to IQ (56) and inability to participate in programming. Medications adjusted in ER. No violence since medication increase. Family/CADI worker have been looking for more support for several years and pt seems to fall through the cracks due to IQ and aggression.
CH-F14-4594
Patient presented to the Emergency Trauma Center at St. Cloud Hosptial with aunt. Patient presented after being on run from NW Passages in Wisconsin. During times of elopement, patient is known to spend time at the home of a person known for drugs and trafficking. Patient has a county mental health case manager that is working to make referrals for appropriate levels of care. Patient has a history of aggression towards their aunt. Patient does not have any contact with biological father as he is incarcerated and limited contact with biological mother. Parental rights have not been terminated, but patient’s aunt has physical and legal custody. Patient is very vulnerable and has no insight into the unsafe nature of his behaviors.
NMH8R0MGH-F12-4627
Presented to the ED in the evening, 9/18/24, with her parents after she ran away from school on Tuesday and made suicidal statements to a friend on Monday stating “I’m going to kill myself” which was relayed back to her parents. She also told another peer on Monday that she plans to run away. When she did run away the following day, Mom reports that she was missing for two hours before they found her and there were no known precipitating factors leading to this. Patient tells writer that she “doesn’t know” where she went on Tuesday and “I was walking towards home apparently.” Writer asked about why she is expressing confusion/poor memory of the event and if she was using any drugs/alcohol. She looked at writer, shrugged, then did not answer further. Throughout evaluation, patient is vague, intermittently evasive, and at times mute with writer. She presents with an incongruent and at times inappropriate affect and vacillates from a younger child-like presentation to a more adolescent presentation. She lacks insight into her parents’ concerns and demonstrates poor insight and poor judgement related to her personal safety. She is not willing or able to participate in reflection about why her parents/other adults are having significant concerns for her overall wellbeing, mental health and safety. When asked if she thinks she can maintain safety in the community/at home and also agree to not run away, she will not answer writer.
Area(s) of Risk: suicidal ideation, elopement, inability to care for self
Level of Risk: High for elopement and safety chronically for past few months which has been demonstrated repeatedly by running away and making unsafe choices such as getting in a stranger’s car and making pornographic videos of herself. Level of risk for SI statements is fluctuating and it is noted that pt does not have hx of suicide attempts.
Intent to Act: No
Referrals made to adolescent child psychiatric hospitals however no openings. Patient calm, cooperative and not having sx or bx thus appropriate to dc back home as of 9/20 however parents declining to have her discharge to home.
Child Protection involved as well as patient’s mental health case manager.
MHF-M9-4600
Came to ED 9/13 after Dad reported pt was threatening. Family came from out of state recently, have been homeless in MN, living in their car. CPS involved and took temp custody of pt effective 9/17. CPS looking for foster care/shelter placement for kiddo and sibling. Referral made for Nexus YCT.
MHF-F8-4597
Came to ED 9/13 after Dad reported pt was threatening. Family came from out of state recently, have been homeless in MN, living in their car. CPS involved and took temp custody of pt effective 9/17. CPS looking for foster care/shelter placement for kiddo and sibling.
PH-F10-4549
Recommendation for level 5 QRTP or level 6 PRTF. Patient is currently in psychiatric inpatient hospitalization.
Ten-year-old female patient with a history of in utero exposure and early childhood trauma and attachment concerns, with a historical diagnosis of FASD-Alcohol-Related Neurodevelopment Disorder (ARND). Patient presents with emotional dysregulation, violent threats and aggression, as well as passive suicidal ideation. Patient has been hospitalized multiple times and participated in several outpatient services.
Discharge Plan:
RTC (recommendation letter sent to CMHCM who is requesting county screening meeting)
-Nexus Gerard (referral sent, reviewing, will hear back week of 9/2)
-Northwood (referral submitted, next opening end of year, will review for acceptance at that time)
-North Homes (declined due not have staffing to meet needs related to aggression, SW requested reconsideration; declined 8/21)
PRTF (PRTF eligibility form sent to DHS 8/16)
-Nexus East Bethel (referral submitted w/PRTF eligibility approval 9/4)
-Grafton (referral submitted w/PRTF eligibility approval 9/4)
Bridging with Day tx
-Catholic Charities (referral pending although may not consider d/t RTC rec, IEP sent, 8 person WL)
Current Providers:
Med Management- Mayo Clinic
CM- Dakota County
CADI waiver- Dakota County contracted provider
CTSS