This child was previously on the HUB as MCR-F13-2165.
Returned 3/21/23 to Mayo ED after discharging to home on 1/9/23. Was at SERCC, brought to ED for ingestion of metallic items there. Had been in ED > 24hrs now admitted to inpatient unit to monitor his GI. Was in Fernbrook Day treatment. Transitioning to male. ED more related to PICA ingesting nonfood items regularly – batteries, tacks, chargers, etc. 1:1 support for keeping from self-harm. is at home with mom when not in day treatment program. Needs more than day tx support, needs 24 hr. Concern for medication mgt. Absence of psychiatric support. Has been in Prairie Care twice summer 2022 – dc’d for noncompliance. He describes a strong compulsion for ingesting things. He doesn’t claim it to be self harm. when he goes to Mayo, he claims that its a suicidal attempt. Was at Gerard in May and struggled, then inpatient at Children’s in summer. Then came back to Fernbrook. over 30 presentations to ED at Mayo and Metro for self-harm and ingestion. Some are SI. Ingested batteries, screws, chargers, needing med tx/attn. Spent 12 days at Gerard in May, 3 ingestions and elopements while there, they had to dc him as couldnt meet his needs. Just gotten a CADII waiver to help mom supervise at home. Case conf. yesterday – the hope would be that he could be in a residential settings with the understanding that he will ingest things. Licensure issues. He has been declined as he fits everyone’s exclusion criteria. When he is out of crisis, he’s lovely. bright, intelligent.
Seeking ideas for other options for keeping him safe. Consider Gerard? Prairie Care? (have both turned him down). Jennifer Butler working on this case. suggestions to mitigating risk? clear all things from units, reintroducing slowly when able. Mayo has been able to mitigate risk with using paper crafts, crayons, etc. Haven’t had an ingestion for a few months – has a sitter a Mayo though as he’s on a medical unit. Functional behavior analysis? Hasn’t had one, due to instability. Hopefully he will have one soon. *** Discharged to home on 4/3/23 with 24/7 PCS care.
This child has been on the HUB previously as MCR-10-283.
Patient was admitted to Prairie Care Residential on 11/8/22 but was transferred to Prairie Care’s inpatient psychiatric hospital on 11/10/22 due to aggression. Patient remains on the Northwoods Residential wait list. There will be additional residential treatment waitlist’s the patient can be added to, once they turned 11 on 1/16/23. Patient remained psychiatrically hospitalized at Prairie Care until she was discharged on 1/5/23 with the recommendation of returning to community-based treatment. Adopted but adoptive parents surrendered her to Goodhue County.
First episode psychosis. Admission to HCMC 12/26/22. Exception made to accept a minor patient to HCMC Adult Psych Unit 1/6/23 – 1/16/23 in effort to get patient out of restraints, medication regimen and agreement to return to Peds Unit. Returned to Peds Unit 1/16/23 and remains here. Efforts to transfer to Adolesent Acute Pysch unsuccessful due to no capacity and/or patient declined. Update: 1/24/23. Continues to be medically cleared, awaiting placement. Awaiting Hennepin County MH Casemanager to be assigned. Consider referral to PRTS, concern for long waitlists. Concern if we continue to board patient on Peds Floor where he is not getting the mental health care he needs, he is at risk for decompensation. Patient has a Continuance Agreement through District Court Probate/Mental Health Division for six months from 1/17/23. grandmother is open to having him return home with a structured program during the day.
Substance use history, family signed out from treatment program and has been on the run for the past 6 months after mom signed her out of facility in Brainerd. History of abuse from grandfather whom she was staying with. Leech Lake custody. Drinking since age 9. MH primary dx.
Emotional dysregulation, discharged from crisis respite home due to aggressive incident. Frequent episodes of dysregulation around electronics. Has been calm & cooperative in our hospital. Mom’s rights are terminated, but she had daily phone contact and monthly visits.
Was at SERCC, brought to ED for ingestion of metallic items there. Had been in ED > 24hrs now admitted to inpatient unit to monitor his GI. Was in Fernbrook Day treatment. Transitioning to male. ED more related to PICA ingesting nonfood items regularly – batteries, tacks, chargers, etc. 1:1 support for keeping from self-harm. is at home with mom when not in day treatment program. Needs more than day tx support, needs 24 hr. Concern for medication mgt. Absence of psychiatric support. Has been in Prairie Care twice summer 2022 – dc’d for noncompliance. He describes a strong compulsion for ingesting things. He doesn’t claim it to be self-harm. when he goes to Mayo, he claims that it’s a suicidal attempt. Was at Gerard in May and struggled, then inpatient at Children’s in summer. Then came back to Fernbrook. over 30 presentations to ED at Mayo and Metro for self-harm and ingestion. Some are SI. Ingested batteries, screws, chargers, needing med tx/attn. Spent 12 ays at Gerard in May, 3 ingestions and elopements while there, they had to dc him as couldn’t meet his needs. Just gotten a CADII waiver to help mom supervise at home. Case conf. yesterday – the hope would be that he could be in a residential settings with the understanding that he will ingest things. Licensure issues. He has been declined as he fits everyone’s exclusion criteria. When he is out of crisis, he’s lovely. bright, intelligent.
Patient has had several disrupted placements over the past year including shelters and foster homes. Patient has extensive trauma history and was most recently at a shelter where they engaged in self harm by cutting and expressed passive SI. Patient was sent to the ED and was not allowed back to the shelter.
Patient has a history of ADHD, DMDD, and trauma. He presented to the emergency trauma center with foster provider following an anger outburst where he hit himself. Patient also made comments about killing himself and threatened to kill another child in the home. Patient is unable to return to foster home.
Patient was receiving residential services through Aspen House and sent to the ED following an altercation with another resident. Aspen House would not take Pt back. County is guardian and Patient has spent time in and out of foster care settings.
