UPDATE 9/21/23 – placement difficult due to the arson incident.
Patient presents to ED for aggressive behaviors. Today, patient lit a fire in the bathroom of his group home because he was “tired of living” and “tired of his group home staff”, after they turned off the wifi in the house. After lighting the fire, police and fire department arrived. Patient was still escalated and refusing to leave the group home while the fire was burning in the bathroom. Patient was brought outside by a police officer, and patient attempted to grab the officer’s handgun. Patient states he did this with intent of using on himself or his group home manager. Patient was quickly handcuffed and restrained into an ambulance.
Patient was reportedly hospitalized in Floriday last month while on vacation for aggression, agitation, med non-compliance. Patient has been living in his current group home since 2019. Patient attends an alternative school which he enjoys. Patient has PCP and psychiatry per his report. States he has been in “placements” his entire life since being adopted from Ethiopia at a young age by his current adoptive parents. Previous admissions in 2018 for DMDD, and aggression.
Hx of learning disability, aggressive behavior, agitation, outbursts.
Risk Factor: Aggression (chronic/ongoing)
This term describes a pattern of repeated and persistent aggressive behaviors, such as chronic physical or verbal aggression.
MHF-M15-1657
UPDATE 9/14/23: Discharge date to Companion Homes set for 9.22.23
UPDATE: 9.7.23 working on a group home placement.
Patient is presented to the ED via EMS. Patient was discharged from Chelida Residential Facility after 2 years, for assaulting another client. Patient was then admitted to Winnebago Mental Health Institue in WI. Patient was discharged, and returned home to parents. Patient has since demonstrated emotional and behavioral dysregulation such as following his mother around, threatening to hit and push her. Patient also biked to his neighbors, and pulled his pants down in their driveway. Patient has a history of assaulting neighbors and is not supposed to be there.
Patient has historically received services at St. Davids, Fraser, and the MN Autism Center.
MHF-F10-1695
UPDATE 9/14/23: Intake date at Gerard next week.
Patient is presenting to the ED for the following concerns: suicidal ideation, verbal agitation. Per Hennepin County workers, patient had been in inpatient at Prairie Care since June due to behaviors and suicidal ideation. Patient was abruptly discharged because she was not safe, and spending a lot of time in seclusion. Patient was to be transported to her grandmother’s home but ran away, and into traffic. Patient reports that she will kill herself and her grandmother if she is to live there. Patient would like to live with her mother, but is unable to due to a court order. Patient has a history of trauma, has witnessed parental domestic violence, and parental substance abuse.
Patient has a bed at Gerard for residential treatment, but not until 9/18.
MHF-F11-1552
UPDATE: Accepted to Gerard Pending date next week.
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, anxiety, worsening psychosocial stress. Patient was threatening to attack kids in her neighborhood with a knife, and threatened to stab her grandfather when he attempted to intervene. Patient’s grandfather locked her out of the house, so she wasn’t able to get anything else to hurt someone with, and patient kicked the lock off of the door.
Patient recently lived in a youth shelter/transitional home called Dignity House for 1.5 weeks until 8/3/2023. She was then sent to the ED for aggression. She had a warrant for arrest due to an assault and threatening homicide to family members. She was taken to JDC on 8/3/2023, had court, and then she was sent to the Bridge for Youth Shelter. Patient got into a physical altercation at The Bridge and was sent back to the ED on 8/8/2023. While in the ED, patient physically assaulted a nurse and was picked up by her grandfather.
Within this year, the patient has had approximately 13 ED visits due to concerns including runaway, aggression, abuse/neglect, and altercations with family members.
MHF-F14-1736
Patient presented to the ED via police due to physical and verbal aggression, threats to kill group home staff members, and damaging property. Patient became upset with group home staff after they questioned where she had received money during a shopping trip. After returning back to the group home, patient threatened to kill staff and threw a brick at their car. Group home staff report that patient is demonstrating a pattern of unsafe behavior and are not allowing her to return, citing police involvement on multiple occasions.
MCR-M14-1389
UPDATE: 9/7/23 – discharged to AMAS Inc (CADI group home)
UPDATE: 8/31/23 – Care conf tomorrow. Accepted by Sunset House, having zoom meeting with patient today to get to know him better before transition- waiting on them to get licensing.
UPDATE: 8/17/23 – Still in ED. Not able to go to Mille Lacs due to non-participation. There is a CADI group home willing to take him, working on licensing.
UPDATE 7/27 – had a video interview with Nexus Mille Lacs on 7/26, awaiting updates.
Previously MCR 1086: Discharged 6/15/23 to VonWald, returned ED 6/30. 14 year old with significant trauma history, ward of Hennepin County, recent placement at his request with young adult brother that was disrupted due to conflict. Briefly placed at Von Wald shelter but repeatedly eloped in an effort to reunite with his brother, and was brought to the ED. Calm overall except when relocated to a unit that required observation while in the restroom, then repeatedly escalated with verbal threats, closing himself in the bathroom, and hitting the walls. Had an interview with Nexus Mille Lacs on 7/26/23. He is familiar with Nexus Gerard and would feel comfortable there.
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-F10-1534
UPDATE 8/31/23: Discharge to family with wraparound services planned for 8/31/23 at 1300 while waiting next Gerard admission (tentative late September) as QRTP pre placement screening has now approved.
UPDATE 8/24/23: Pt remains accepted to Gerard, next admission now late September. QRTP pre placement screening team approved 60 days RTC as of 8/24/23. We will discharge home with wraparound services while waiting RTC admission.
UPDATE 8/8/23: Pt is accepted to Gerard and can admit tentative 8/21- pending preplacement screening/QRTP approval from Hennepin County.
10- year-old female with a history of anxiety, depression, social difficulties, anger and trauma. Aggressive behaviors and increase in suicidal ideations. Has participated in PHP, individual therapy, and psychiatry. Insured by BCBS PMAP.
DISCHARGE PLANNING EFFORTS:
Primary Recommendation: Residential Treatment.
Patient recommended to return to home/community with wraparound services while waiting for Residential. Discharges have been attempted, patient threatened grandmother. (Patient cannot return to mother or to grandmothers- CPS involved)
Wraparound:
Establish CMHCM (Referral to be made internally from CPS case worker)
Establish CTSS (Referral completed to Summer Counseling, reviewing; Referral completed to MN CarePartner, on waitlist, 2-3 months)
Establish FT (Referral completed to Family Attachment Center and Empower)
Continue Individual Therapy with Rachel at ELEOS Psychology Center
Continue Psychiatry with Catherine McCormick-Deaton, DO at Allina Health-St. Paul
Continue PCP at Allina Health-Maple Grove
Residential, when available due to waitlists*:
Consider Nexus-Gerard RTC (Declined due to aggression, being re-reviewed currently)
Consider Northwood Children’s RTC (Referral sent, waitlist 6-9 months)
*Juvenile Treatment Screening with Hennepin County needed to request funding for QRTP/RTC level of care. CPS worker aware of request.
Estimated length of stay:
Patient is medically ready for discharge as of 6/30/23
MHF-F14-1493
UPDATE: as of 8/24/23 she has been accepted to a residential facility in Georgia, and the family is waiting for some pieces from their insurance company. Transportation is ready to go once insurance is approved – hopefully end of this week or early next.
Pt is presented to the ED via EMS for the following concerns: verbal agitation, physical aggression, significant behavioral change, and anxiety. Pt has been in a residential treatment center for approximately 5 weeks, and had been in a “crisis state” all day, on day of admission. Pt was requiring frequent restraints, supervision and redirection for up to 8 hours. She was non-compliant with treatment activities, frequently trying to run away from program activities, and into the street. Pt kept searching for sharp objects to self-harm, and assaulted staff when they tried to take objects from her.
These are chronic behaviors for pt. Pt is currently in a 3rd residential treatment program (secure), with a hx of one prior group home placement. Pt has a hx of several mental health hospitalizations, with most recent in October 2022. Patient has a hx of refusing medications.
Residential facility stating that pt has been discharged, however there is no discharge paperwork available. From North Dakota. No case mgr or services in place. Her parents were able to get her into the residential treatment center she was at. Able to DC but nowhere to go at this point.