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.
Risk Factor: Elopement risk
Elopement risk indicates the potential for individuals, often children or individuals with cognitive impairments, to run away or leave without supervision, which can lead to safety concerns.
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.
MCR-F8-5371
This 8 year old has been in two foster homes (skilled) that have been unable to keep her safe; no other foster homes available. Getting updated DA today. Has a YBH worker since 2022, in-home family therapy with family, in-home CTSS skills, individual therapy, medication management, partial hospitalization at PrairieCare Feb 2023 and March 2024, hospitalization Jan 2023; Level 3 at school.
Complex trauma (sex abuse, poor attachment, placement / moves); ongoing CPS case with pending charges. Parenting assessment indicates to cease parenting time
CH-M15-5352
Patient presented via law enforcement after jumping in front of a vehicle in an attempt to end his life with additional thoughts to jump off of the bridge he was standing on until law enforcement intervened. Patient reports a 3 year history of auditory hallucinations that tell him to harm himself or others which occurs when he is alone or stressed. (hallucinations appear consistent with audible thoughts). This is his 4th inpatient hospitalization for suicide attempts and he has had multiple ER visits. While here, he attempted to assault a younger peer and was assaulted by a different patient. He was placed in the BICU where he has attempted to “snap” his neck on multiple occasions, head bangs, ingested hygiene supplies x1, and tied towel around his neck x1. Suicidal thoughts are perseverative when they occur and can be difficult to redirect.
CH-M9-5319
Patient presents to the ER with his 8-year-old brother from foster care. Patient was brought to the ER after running from foster home and making comments about using a kitchen knife to kill himself. Foster provider not able to have patient return. Has been recommended for residential care.
CH-M8-5322
Patient presents to the ER from foster home with his 9-year-old brother after running from his foster home. Patient has no previous psychiatric history. Foster provider not able to have patient return. Patient’s county social worker is looking for foster placement.
MCR-M16-5342
Arrives from 180 degrees / von wald shelter after eloping. Kicked out of family home in October 2024, was homeless and found shelter at Ain Dah Yung for a time until psychiatrically hospitalized. Has been at 180 degrees since 12/26/24-2/28/25.
NMH8R0MGH-F17-5257
Patient presented to the ER with PD following being on run for one week from a trial home visit with biological parents, was in shelter prior to that. Drug of choice is meth. Initially presented with psychotic symptoms that have since cleared, which has resulted in patient being cleared by psychiatry.
PH-F15-5177
Patient is currently inpatient and are unable to move further with discharge planning due to not having a County of Financial Responsibility. Stearns County and Wadena County have both been consulted and neither have accepted responsibility at this time.
Discharge Plan:
Establish PRTF; referral made to Nexus East Bethel, INTAKE SCHEDULED 3/3/25
Establish Level 6 Program; referral made to Bar None Haven
Establish County Support/Funding; assigned for CMHCM at VOA
Continue with established outpatient providers:
-PCP: Lakewood Health System
-MM: Lakewood Health System
-Therapy: Lakewood Health System
MCR-M15-5209
He completed day treatment on 1/23/25 but has been dysregulated off and on during that time, residing at foster home and eloping. Prior to presentation, eloped and was away from home for 12+ hours, sleeping outside in someone’s truck (not running) in zero degree temperatures. Nobody feels he can be maintained safely in the community.