Patient presented from foster care due to concerns of aggression and dysregulation in the context of trauma history and out of home placement. Unable to return to previous foster care. Being referred for residential treatment though needs a safe location while awaiting residential.
Risk Factor: Aggression (chronic/ongoing)
This term describes a pattern of repeated and persistent aggressive behaviors, such as chronic physical or verbal aggression.
MFIUP-M14-6668
Pt presented to ED with family after FBI visited family after an anonymous tip that patient was having SI and HI regarding a mass shooting in the context of worsening depression and anxiety. Pt acknowledged recent homicidal ideation as a means to justify ending his own life. Initially pt denied creating a written plan, denies attempts to get a gun or have possession of a gun, or thought of a specific school or time he would do this, though, he now states he identified two elementary schools as potential targets. During past assessments he has acknowledged reasons for not going forth with this shooting – like the attempt would fail and he would be in a worse situation and he does not want to actually hurt people. Similarly, suicidal thoughts are present with thoughts of shooting himself, but does not have intent or obtained means to act on it. Although these are moderate-high risk thoughts, patient is able to keep self and others safe while in the hospital at this time. Aspects of his clinical history that put pt at risk for progressing to future violence include pre-occupation with prior shooters, nihilistic beliefs, and time spent in a potentially radicalizing online community. Additionally, mom reported partner had a gun in the home and patient + step-brother was looking around the house for this gun. The leading drivers of current SI and HI seem to be significant anxiety and co-morbid depression. Has experienced significant neglect and sexual abuse that have impacted his current mood and outlook as well.
CH8SCH-M12-6473
Patient presented to the ER 1/21. Patient is familiar to us. Patient has a complex psychosocial history with prior CPS involvement and a chaotic home environment. Patient typically does well in the ER & hospital setting but struggles at home with severe aggression and behavioral dysregulation in relation to conflict with parents. Patient does not appear to comprehend the severity of his actions and feels like his actions are justified (which appears to be related to his level of functioning). Patient likely needs a crisis respite placement/group home placement, but his CADI waiver and insurance are on hold while transferring to Benton County.
MHF-M14-6607
Youth came to our ED this time on 2/21 after physical aggression at his GH where he injured staff. This is the 3rd time he has boarded with Fairview in the past month. The GH has taken him back previously however are reluctant this time and are considering an immediate suspension but may be willing to take him back one more time with additional supports. Trying to get started with Youth ACT for additional support, they are reviewing but have concerns related to DD and if they are a proper fit. County is also trying to pursue CABHH and PRTF simultaneously as they feel he needs a higher LOC but have not gotten acceptance. Was previously at Northwoods PRTF for 1.5 year. Looking for any additional supports that could be offered to this youth in the GH to make it successful. Currently has 3:1 staffing at the GH, psychiatry, therapy multiple times per week, has had MCCP behavioral analyst in the past and another referral is being made there, seeing if he may qualify for Youth ACT, and if not ACT looking to connect him to MIDB for psychiatry.
SMCF-M12-6505
Patient has had an increase in ED visits due to an increase in behavioral outbursts including aggression. Patient was transferred to an inpatient psychiatric facility, however, report they cannot meet his medical needs including his incontinence. He was transferred back to the ED. Parents continue to express safety concerns for patient and family members (mom, dad, and 9yr sister). Family report they cannot bring him home at this time. Patient has been denied for hospitalization. He continues to be physically and verbally aggressive towards hospital staff.
PH-F12-6449
Recommending PRTF
12 year old trans male who presents to PrairieCare Inpatient Hospital due to suicide attempt with increased SI, SIB, elopement, and aggression.
He has a history of several inpatient stays, has engaged in PHP, individual therapy, family therapy, and RTC at PrairieCare
Funding is in place for RTC with Hennepin County
Discharge Plan:
PRTF/RTC:
– PrairieCare Residential (administratively discharged due to acuity)
– Bar None Haven (under review)
– Nexus East Bethel ( under review)
– Grafton (referral submitted by PCR, Accepted )
Continue with established outpatient providers:
– Primary Care with Mhealth Fairview
– Psychiatry with Roman Becicka, MD at U of M
– CMHCM with Nakami Tongrit-Green at Hennepin County
CH8SCH-M10-6397
Patient presented to ER the same day he was discharged from 2 month inpatient hospitalization for aggression/safety concerns. Was threatening harm to self and others in the home. Was accepted for admission to Mille Lacs Academy with admission date unknown. Currently stable and no indication to remain in the hospital though family does not feel safe with him in the home. Looking for interim placement while awaiting admission to Mille Lacs.
MHF-F14-6421
Youth came into our ED on 12/28 after altercation at hotel crisis respite. Was in this setting for approx 5 months, and prior to that was boarding in our ED from 5/28-7/3. Hotel crisis will not take her back. She has 4 different felony charges pending, awaiting a rule 20 assessment. Most placements including non secure corrections settings will not accept due to aggression. Team is working toward a single site CRS home, but that is a few weeks from being completed, waiting on provider’s waiver enrollment with DHS and finalized staffing. Last DA done a few weeks ago recommended GH with supports, and scored a level 5, however not pursuing treatment placement as all MN options have denied and pt was in RTC in Florida for 2 years previously.
MHF-F13-6418
Youth came to our ED on 12/24 from the YSC, after being there for a week, boarding in our ED prior to that from 12/2-12/16. YSC has not yet finalized their decision about acceptance back to their program, County leadership is meeting with their team again today, but they have concerns about them returning. Has a crisis home via Wingspan that they can return to in mid Feb once they have established 3:1 staffing, but they can not get staffing set up until then. CABHH referral is being made however that will be a long time out. Pt has been to Grafton in the past, no current recommendation for community treatment placement, our team is not recommending acute IPMH. Has intellectual disability as well.
MHF-F13-6390
Youth came to ED on 12/13 after altercation at home with Grandfather. Was in at FV hospital, primarily in the IPMH unit from 11/11/25 until 12/12/25, discharged to Grandfather for one night before brought back to the hospital, Grandfather unable to take youth back again. Has previously been to Bar None and Divine GH. County currently has approval for therapeutic GH level of care, but many of these settings have denied. No current recommendation for RTC. County has temp custody, but Mom has parental rights. No waiver currently.
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