attachment difficulties, parent child difficulties, working towards either RTC or group home. Working w/ county – denied from most residentials due to IQ. Looking at group home placement. Home is disruptive. Attachment difficulties.
Risk Factor: Aggression (home only)
Aggression occurring primarily within the home environment.
AH-F15-2280
dysregulation of moods. referrals made.
HCMCH-F16-1812
A 16-year-old female with a history of mood disorder, borderline personality disorder, PTSD who presented to ED with suicidal ideation, threatening behaviors towards her family, and altered mental status. She also struggles with low frustration tolerance, severe emotional dysregulation, and a lack of coping skills. She is currently awaiting inpatient placement.
AH-M14-302
UPDATE 8/24/23 – remains at Abbott Northwestern.
ASD, lower functioning, home bound schooling, aggression towards family and staff. On wait list for MCCP crisis bed, out of state referrals being looked at. As of 4/11/23, still waiting on placement. got the waiver for group home, but no providers available.
PH-F14-1603
UPDATE: PT DISCHARGED HOME TO MOM.
Patient is a 14-year-old female with history of depression, anxiety, SI, SIB, trauma and aggressive behaviors. Has participated in PHP, RTC, and inpatient levels of care. Insured by Medicaid.
DISCHARGE PLANNING EFFORTS:
Primary Recommendation-
Establish Day Treatment (Patient currently refuses)
Continue CMHCM- Family Wise Services, contracted by Hennepin County
Establish outpatient individual therapy (CM is scheduling)
Establish med management (CM is scheduling)
Discharge has been attempted. Mother/LG will not accept patient back into the home. Patient was living at Passageways Shelter prior to admission and mother/LG consents for shelter placement at discharge. Patient’s aunt/uncle had agreed to take patient in with consent from LG, but aunt declined to pick patient up on day of scheduled discharge and rescinded the offer to accept patient.
Patient needs shelter placement due to family dynamics, thus the following are pursued-
Consider The Bridge for Youth (Denied d/t reported severity of aggression towards mother)
Consider Passageways (Denied again as of 8/16/23)
Consider Brittany’s Place (Denied d/t parent is still LG and would need to complete VPA)
Consider Hope House (No current availability, call back once per week to check)
Consider Itaskin Center Shelter (Referral sent by SW, additional referral needed by CMHCM)
Consider VOA Bar None Shelter (Referral sent by SW, additional referral needed by CMHCM)
Consider Ain Dah Yung Center (Referral sent by CMHCM, no current availability)
Consider RTC, as previously recommended by CMHCM prior to admission*-
Nexus-Gerard (Referral started by CMHCM, clinical sent by SW, awaiting records from CRTC for determination)
CRTC (Referral started by CMHCM, clinical sent by SW, declined for admission due to IQ)
*QRTP Pre Placement Screening with Hennepin County needed to approve funding for QRTP.
Estimated length of stay:
Patient is medically ready for discharge as of 7/18/23
MCR-F16-279
History of PTSD, RAD, ODD, mood issues, adopted at age 6, multiple foster placements prior. Struggling for many years, 4 suicide attempts fall 2021, placed in a shelter in St Paul and targeted by a sex trafficker and eloped for 2 weeks, repeatedly assaulted, given drugs. Admitted to SEY program at Heartland Girls Ranch March 2022, unsuccessfully discharged October 2022 after assaulting a peer. Receiving school-based CD services through ALC, but no mental health services. Case manager working on residential but no success. Admitted to hospital 1/23/23 after massive OD triggered by breakup. Medically cleared 1/27, declined by all inpatient psych because of assault history. Suicidality has resolved, no behavioral issues. She eloped from the peds floor on 3/16/23 and had to be brought back to the ED by law enforcement. Hospitalization not recommended; county looking at outside placement options.
MCR-F12-255
12 year old with trauma history, in-utero cocaine exposure, long history of behavioral outbursts with adoptive parents, participating in CIBS since November and moved to Phase 2 at Gerard in early January, but struggled and was sent to the ED within 48 hours due to severe outburst at Gerard. Appears to have mild autism spectrum disorder (difficulty with transitions, sensory sensitivity, communication struggles), and likely PTSD related to attempted kidnapping and multiple sexual assaults spring 2022. Has started Vyvanse, Prazosin, and Fluoxetine while boarding, and she has had much less extreme behavioral outbursts, has not needed IM or restraint in weeks. Oppositional, but generally can be verbally redirected. Outbursts tend to be tied to her difficulty with flexibility – eg when meals or medications arrive at slightly different times, or one nurse implements different TV rules than another – will start swearing, sometimes escalating to head-banging, but generally is able to calm on her own when given space (intervening/talking/etc once she is starting to dysregulate tends to escalate rather than de-escalate her). Has loving parents and want her in their home, but fear they cannot keep her safe right now. Regarding running – hasn’t tried to elope from peds floor. Sometimes ran from school or home when upset, walks around neighborhood and comes back. Issues at school have been more blowing up and headbanging. Update as of 4/11 still in ED
PH-M8-352
Admission: 2/24/23
Presenting concern: PTSD, Depression, Anxiety
Ongoing case conferences weekly with Itasca have occurred. Itasca County holds guardianship.
Discharge Plan:> UPDATE 4/20/23:ADMISSION IS 4/24/23> ADMITTED SUCCESSFULLY TO NORTHWOOD on 4/24/23
Patient is medically ready for discharge; will discharge as soon as RTC/living arrangement is identified.
Interim plan:
-PHP while awaiting RTC (foster parents share they are not able to have patient back into their home at this time)
-Itasca County has submitted referral for SMRT; once approved, this will provide access to disability status/waivers and additional placement options
-MNCHOICE assessment (Referral made to Hennepin County on 04/04/2023)
-Continue CMHCM at CMHS/REACH
RTC:
-Northwest Passage (2-3 month waitlist for patient’s age group; guardian declined referral due to waitlist and out of state)
-Gerard Academy (Referral made, Declined for admission on 3/24)
-Northwoods 35-day assessment (Screening meeting completed on 4/12/23, pending acceptance/admission)
-Clinical submitted on 4/5 to treatment placement specialist at Acadia Healthcare for consideration of out-of-state referral options