Youth came into our ED on 5/6 from the Bridge for Youth shelter. Shelter refusing to take her back. She has boarded with us before for a short time last June. Currently has CADI and CMH, both through contracted agencies. Unable to access County screening team due to contracted CM, so MH GH and residential are not options currently. MCCP referral is in, also have referral to CABHHS and Grafton- awaiting approval from Arkansas Foundation and for acceptance at the program.
Risk Factor: Aggression (chronic/ongoing)
This term describes a pattern of repeated and persistent aggressive behaviors, such as chronic physical or verbal aggression.
MHF-M12-5618
Youth came into our ED on 5/6 from the Bridge for Youth after an altercation there. They will not allow him to return. He currently has a CMH Case Manager through Fernbrook with Goodhue Co. They last screening him for in home care/services but Mom is refusing to have him go home. Looking at shelters, group homes and residential. Also has CADI, so crisis respite and CRS would be options as well. Denied by North Homes.
CH-F14-5404
Patient presents from group home. Patient is known to our ER and previously boarded 12/3/24-1/7/25. Patient presents after engaging in aggressive behavior that reportedly included verbal threats and chasing them with a shovel. She has had episodes of aggression with staff in the ER and has been targeting another patient that is boarding. The group home has provided a suspension of services and plans to submit a termination of services. County case worker has been making referrals and looking for crisis respite placement. She will likely need a home created for her.
AH-M15-5556
Impression of Crisis Behavior (precipitants): Patient presented to the ED due to agitation and SI. The identified precipitant for this crisis is a verbal and physical argument with his mother and her boyfriend at the home. Patient was released from the JDC to home on 4/5/25.
Vulnerabilities: adolescent, ASD, h/o trauma, recently released from JDC, parent-child conflict, inadequate outpatient supports
Behaviors / Symptoms to address in the ED: deferred
Methods to increase desirable behaviors in the ED: meet basic needs, set behavioral boundaries/limits,
Barriers to Discharge include: At this time, patient is NOT felt to meet criteria for inpatient hospitalization. There are no new acute safety needs that warrant admission. His mental health concerns are chronic and environmental.
Mom is refusing to take him home, JDC won’t take him back as there are no new charges and he has no place to go. CPS is investigating allegations of abuse by parents and child but are not seeking placement. Mom does not consent to use of a shelter or Nexus YCT.
MHF-F13-5407
Kiddo came to us on 3/17 from residing with aunt who adopted her, and aunt is refusing to let her return. She has previously been in PRTF and has a felony assault charge that she was deemed incompetent for via a rule 20. Due to that most placement options have declined her. She has a CMH CM and the County team is exploring getting MNchoices expedited to look at waiver placement options.
MFIUP-F13-5535
Pt presented to the FV Riverside ED on 3/17/25 from school for agitation and aggression in the context of being questioned by school security about misusing her medications (which was reported to school by her guardian). She has remained in the ED boarding awaiting placement at a residential facility as guardian/aunt has not felt safe to have her return home. In the ED, she has had multiple behavioral codes, has been aggressive to staff, and has self injured. Given her out of control behaviors and the ED’s inability to manage her, she was admitted to UMMC unit 7ITC on 4/11/25 as a boarder while she awaits placement. Significant symptoms on the initial presentation include irritability, aggression, out of control behaviors, impulsivity, and SIB. Was previously admitted to Nexus-East Bethel but assaulted staff so unable to return.
MHF-M16-5515
Came to our ED on 4/10 only because the County had no where else to bring him. Mille Lacs County has custody. He just left the lino lakes juvenile detention center. Has been to many juvenile detention placements, but is no longer required to be there. Has some history of substance use, but most SUD treatments have denied him due to aggression. Has been sober for 2 months now as he was at JDC and now the hospital. County is exploring out of state MH treatment facilities, as well as in state MH group homes, shelters, evaluation programs. Working on getting a recommendation for PRTF through a psychologist who had seen him for civil commitment. Working on SMRT and MNchoices for waiver placement options.
MHF-M9-5478
Youth came to our ED 3/30 after an altercation in the car with his foster care provider. Foster Care provider is not willing to accept him back. Has permanent custodianship through the County. Open to waiver and looking at crisis respite, getting updated DA for treatment placement information, and is on the list for foster care/shelters.
MHF-M10-5493
This youth came into our ED 3/31 after a behavioral altercation at his group home. They have issued a suspension notice. Parent is refusing to take home. He has both CMH CM and is open to CADI. CMH is making the CADI referrals currently, for crisis respite and CRS. The current DA does not recommend treatment placement however CMH is working with OP therapist to try and update the DA.
MCHSRW-M12-5457
Patients mother shared that the patient has an extensive treatment history, but has continued to struggle with challenging behaviors and emotion dysregulation. Mom described that “over the last few days he’s just been a terror, despite our best efforts. He freaks out when we try to redirect him. Mom reported that the patient has “aggressive towards people, getting physical and violent, he’s been assaulting his younger brothers.” Mom described that on the day of admission the patient had been going into his brother’s bedroom “trying to annoy them,” and hitting them. Mom called her husband, the patient’s step-father, who is currently out of state for work. The patient’s step-father spoke to the patient over the phone and told him that he needs to change his behavior and reminded him that he has been through so many different programs and should be able to “put on the breaks” with his behavior. The patient began talking back and got confrontational with his step-father, asking “what are you going to do about it?” The patient’s step-father indicated that their would be consequences when he returned and urged the patient not to put his job at-risk by making him return home early to deal with his behaviors. The patient challenged his step-father further making statements such as “fuck you, why don’t you say that to my face?” and “bet, come home then and see what happens.” The patient further stated “I’ll shoot you in the fucking face, right through the eyes.” Mom reported that their is a gun in the home, however it is locked in a gun safe and the patient does not have access to this. Mom then asked the patient where he would get a gun from and the patient indicated that his friends at school have guns. Mom expressed “this has escalated so far beyond me. We are walking on eggshells from the time he gets home from school until he goes back the next day.” Mom reported that she did not feel safe bringing the patient back home. She reported that she had attempted to press charges on the patient today, however police had declined and brought him to the emergency department instead. The patient is uninsured, county is working on his application, but he does not have a county social worker. Has a contracted mental health case manager through Fernbrook.