Aggression (chronic/ongoing) – Mental Health Collaboration Hub

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.

Doing very well for the most part at CentraCare.

CH8SCH-M10-6691

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.

PH-M10-6705

Recommending PRTF/RTC
10-year-old male who presents to PrairieCare Inpatient Hospital after an episode of behavioral escalation at home.
This is his 2nd psychiatric inpatient hospitalization and had been engaging in outpatient therapy services.
Funding is in place for QRTP with Mower County

Discharge Plan as of 04/20/2026:
RTC/QRTP: (Funding approved 2/17)
– Gerard (Declined due to safety concerns, recommending Bar None Haven or PRTF level of care)
– PrairieCare Residential (Declined due to acuity)
– Northwoods (one year WL, not viable immediate option)
– Bar None Haven (Declined due to safety concerns)
– Nexus Mille Lacs (Declined due to safety concerns)
-Avanti (unable to refer d/t gender criteria)
-North Homes (unable to refer d/t age)
-Newport (unable to refer d/t insurance)

PRTF:
– Grafton (Declined due to request for further diagnostic clarity)
– Nexus East Bethel (reviewing)
-Leo Hoffman (unable to refer d/t age)
-Northwoods (one year WL, not viable immediate option)

Interim Plan:
Establish Psychological Testing
-Sagent Behavioral Health in Rochester
-Southern MN Psychological Services
Establish Occupational Therapy with School
Establish CTSS
-Fernbrook
-Independent Management Services
-Cedar House

Continue with following outpatient providers:
– Medication Management at Olmstead County Medical Center
– CMHCM with Mower County

MHF-F17-6700

Youth came to our ED on 4/9 after being on the run for 3 weeks. Has a long history of elopement and some aggression as well. Is open with CPS, ACT team, and DD waiver, and there is a VPA for placement currently. County team is looking at all placement options- all waiver options, RTC, out of state. Has been denied many places already primarily due to the elopement behaviors.

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.

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.