Mental Health Collaboration Hub
Recommending RTC/PRTF.
16-year-old transgender male who presents to PrairieCare Inpatient Hospital due to increased SI and SIB. Patient has a history of several inpatient stays and a significant trauma history.
Risk Factor: Eating/Ingestion problems
Eating/Ingestion problems involve difficulties with food consumption, such as selective eating, feeding problems, or disorders like avoidant/restrictive food intake disorder (ARFID).
PH-M15-6144
Recommedning PRTF/RTC
15 year old male who presents to PrairieCare Inpatient Hospital due to suicide attempt with increased SI and SIB.
He has a history of several inpatient stays, has engaged in PHP, individual therapy, family therapy, and RTC at Gerard
Funding is in place for RTC with Polk County
Discharge plan as of 9/29:
PRTF/Level 6 (referrals placed by CMHCM, Approved by AFMC for PRTF)
– Northwood (reviewing, waitlist 3-4 months)
– Nexus East Bethel (referral submitted, reviewing possible opening early Oct.)
– Grafton (referral submitted, under review, declined due to inability to support level of care)
– Leo Hoffman Center (CMHCM to resubmit referral, declined due to safety concerns and inability to provided 1:1 staffing, able to re-refer upon further stabilization)
QRTP/ Level 5:
– Return to Nexus Gerard (under review, declined to return. Discharge effective 9/12)
– Bar None Haven (referral submitted)
PH-F17-5685
17-year-old female with historic diagnoses of ADHD, depression, anxiety, PTSD, OCD, borderline who presented to address suicidal and homicidal ideation. Patient has two prior hospitalizations with PrairieCare and completed Partial Hospitalization Programming. Patient has outpatient therapy, medication management, and children’s mental health case management.
PH-F17-5283
17 yo female with hx of dep, anx, PTSD, eating d/o, mood lability, and personality concerns who lives with her dad and siblings in Menahga. She is in the 12th grade and reports having a 504 plan. She has a hx of around 10 inpatient hospitalizations and 3 stays in RTC. Stressors include family conflict, social stressors, and school. Family hx of MICD concerns. Patient has been struggling with worsening symptoms and safety concerns including SI with multiple plans (cut, OD, hanging, crash, etc) and SIB. She has been admitted for acute stabilization.
CH-F13-4756
The patient is a 13 year-old female with a history of ADHD, inattentive type, anxiety, depression, sexual abuse, suicidal ideation, and self-injurious behaviors that presented to the ER following an intentional overdose in an attempt to end her life. She has had 2 previous inpatient hospitalizations. Patient has a complicated home life with several CPS reports and basically does the caretaking for her younger siblings. Patient has several tattoos given to her by her mother and sister and mother is unwell as well and frequently struggles with suicide attempts and self-harm. Sounds like a significant sexual abuse history within the entire family that may still be occurring. The patient is at risk for sexual exploitation given increased sexuality.
MHF-F6-2388
Update: DIfficult to place, haven’t been successful at contact w family
Patient is presenting to the ED for the following concerns: physical aggression, significant behavioral change. Patient has Autism, is non-verbal, has a developmental delay, speech delay, PICA and behavioral issues at home that have been increasingly difficult for the family to manage. Patient was seen her earlier this month after ingesting a battery. Patient reportedly has been accepted for a residential treatment facility in Missouri – Lake Mary Center, though they currently do not have a funding source and intake is not until the end of December. Family has been working with Aurora Behavioral Services, as well as psychiatry and PCA services.
MCR-F17-2442
Long history of trauma started ingesting non-edible items, batteries on 3 occasions. Waiting on County to help with disposition. Ward of state. No attempts at self-harm or ingesting since stay in ED. Last ingestion was day of admission. Surgically removed batteries then back to ED for MH care. Local school district working with her, tutoring. Turns 18 in May.
MCR-F13-2434
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.
MCR-F17-2173
Ingesting items. Several ED trips to have items removed. Was at Gerard, couldn’t keep her safe. Significant sexual abuse history. Several referrals with denials due to the ingesting. looking at Group homes. takes responsibility for her actions. Parental rights terminated. Barriers are not being able to keep her safe (ingesting). medical issue with pancreas – very specific diet, ex. places don’t have medical staff on site. Turns 18 in May
MCR-F13-2165
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.
