Self harm – Mental Health Collaboration Hub

AH-F16-7617

Previous psychiatric diagnoses: PTSD, depression, anxiety, eating disorder, ADHD, complex trauma, suicide attempts, self-harm

Patient presented to the ED after reporting SI to their guardian. Patient reports a near daily experience of SI and AH/VH of his brother who abused him. Therefore, this is not a new symptom. Patient reports that yesterday there was no particular trigger for his SI and AH/VH, that he took a PRN medication, which usually works for him, and then called his guardian who told him to go to the ED.

While in the ED (and as is common in the community), patient will attempt to use clothing to strangle themselves when dysregulated, often revolving around trauma.

Guardian is Dakota County (Tori Thompson). No contact order for anyone in the biological family.

Hospitalized in ND for a full year and a recent over month stay at Children’s for placement from which they were placed in Mn Care Counseling Crisis home.

Crisis home has given an immediate termination notice and state as they are a crisis home they do not require a 30 day notice, due to inability to keep pt safe. They report running into traffic as a particular concern.

Recommendation is discharge with ongoing outpatient support coping skills, distress tolerance, emotional regulation and behavioral support. Pt presentation appears to be baseline and unlikely to mitigated by an admission which may conversely increase risk of maladaptive coping skills and hospital seeking behavior.

Referrals:

· Wingspan is future development of home for patient; not ready until January

referrals made to all PRTFs
Grafton
Leo Hoffman
North Woods
Nexus East Bethel
No update on possible openings

CABHHS – pt has been declined multiple times due to various reasons including high acuity, Diabetic, Eating disorder – A new referral is in process
Bridgeview—-Dakota county crisis placement; on list but currently full (2 bed facility for Dakota County youth)
Kid Link – referral to all 50 of the facilities they work with, no update on potential openings.
Out of state (Rogers and Acadia)—active referrals, no timeline

PH-F16-7411

Recommendation is now for group home. Patient presented to the hospital from the ED for acute safety concerns related to self-injurious behaviors and suicidality following an assault on patient by other residents in a shelter. Patient has a history of multiple inpatient hospitalizations and residential treatment.

PH-F15-7244

Recommendation is now for group home
Patient presented to PrairieCare Inpatient Hospital after suicide attempt by hanging on two consecutive days while at Avanti Center for Girls Residential. She has been at 3 different residential treatments (North Homes, Bar None Haven, and Avanti). This is her 4th psychiatric inpatient hospitalization.

Discharge Plan:
Establish QRTP/PRTF:
-Avanti (discharged d/t suicide attempts and elopement concerns)
-PrairieCare Residential (declined d/t suicide attempts and elopement concerns at Avanti)
-Grafton (referral sent)

Outpatient Providers:
Red Lake Ombimindwaa Gidinawemaaganinaadog (OMBI) Program: Outpatient therapy
Sagent Behavioral Health: Medication Management/ Psychiatry Services

NMH8R0MGH-F14-7544

Patient presents for psychiatric evaluation in the setting of suicidal ideation and recurrent self-harm behaviors. Per nursing report, the patient has generally been calm but has repeatedly attempted to harm herself by scratching her arms. At times, her behaviors have escalated to lashing out at staff, requiring restraints to prevent further self-injury and maintain safety. Nursing reports that her parents have not been visiting because their presence appears to trigger increased emotional distress.

LAHC-M14-6887

Has been with us since January. Arrived from Prairie care from Mayo Clinic before that for verbalized increase in SI and engaging in SIB. History of abandonment from bio mother and apparent abuse and substance use in the household per history. History of temporary foster care. Difficulty with boundaries and impulsive behaviors. Often losing his temper, being easily annoyed and irritable, arguing with adults of authority, and not complying with rules/structure. Current and historical property destruction and elopement. Behavioral instances at school, threatening gestures and actions. History of vaping nicotine “if I have it I will use it” mentality. Witnessed DV, history of homelessness, and physical abuse.

MCR-F16-7399

16 year old female who has multiple in state and out of state residential placements, and currently on the waitlist for CABS. Family is unable to meet her needs, and she is boarding in the ED. She is in need of residential placement until she is accepted to CABS.

CH8SCH-F14-7113

Patient presented to ER following discharge from residential due to aggression to staff and eloping. No other placement locations as she is not able to return to previous foster placement. Patient with poor boundaries, impulsivity, and instigates other peers to engage in negative behavior. Behaviors worsen in an attempt for connection seeking and to obtain friendships with peers. Patient has been on a 1:1 or close observation through the entirety of her stay as she will engage in negative behaviors to seek connection including self harm, opposition, and defiance.

M8SAS-M12-7346

Has been living with aunt for 6 weeks while mom is in treatment. Aunt no longer willing/able for patient to remain with her due to behaviors. history sexually inappropriate talk, interest, and behavior. He has been observed watching pornographic content and then wanting similar aged peers to watch it with him and act out the scenes. He has been through a few placements at boy’s homes and is not welcome back to those facilities due to such behavior. He has a history of “destroying” the kitchen & bathroom of his aunt’s home by pouring out all the soaps/shampoos/conditioners/etc onto the floors. He recently stuck a sock in his aunt’s toilet causing some water damage at her house. He has been observed closely facing the wall and talking to himself; unsure if this is true hallucinations or behavior. He has a history of self-injurious behavior with sharp objects, so risky items were removed from his access at his aunt’s house. He has a history of swearing at staff at facilities where he has been before. Several referrals have been made while at aunts house and patient has mostly been declined.

PH-F14-7333

Recommending QRTP.
She presented to inpatient from the ED after increased SI and engaging in SIB via cutting. This is her 3rd psychiatric hospitalization.

Discharge Plan as of 9/9/2026:
Establish Residential Treatment Care
In State:
– PrairieCare , referral sent
– Avanti, requiring secondary county funding for placement
– Gerard, referral under review
– North Homes, referral under review
– Northwoods, not appropriate referral due to current two-year waitlist

Out of State:
– Altior, declined due to safety concerns related to ingestion
– Acadia, declined due to safety concerns related to ingestion
– Rosecrance in Illinois, declined due to safety concerns related to ingestion
– Rogers Behavioral Health in WI, declined due to safety concerns related to ingestion
– Embark Behavioral Health Utah, declined due to safety concerns related to ingestion
– Rolling Hills Ada, OK, declined due to safety concerns related to ingestion
– SunCloud in Illinois, declined due to safety concerns related to ingestion
– AMFM, referral sent by Acadia, declined due to safety concerns related to ingestion
– Kid Link Treatment Services, referral under review
– Perimeter Behavioral of Forrest City, AR, referral sent
– Lakeland Behavioral Health Springfield, MO, referral sent
– Springbrook in South Carolina, referral sent

PH-F15-7329

Recommendation is for QRTP.
Patient presented to Inpatient from the ED after disclosing suicidal thoughts to her outpatient therapist with a plan to overdose on her prescription medication she had been saving. This is her 2nd psychiatric hospitalization in 2026.

Discharge Plan as of 9/9/26:
-North Homes: Referral sent, guardian declined to pursue further
-Gerard: Referral sent, guardian declined to pursue further
-Newport: Patient declined for admission due to continued endorsement of SI/SIB and recent self-harm
-PrairieCare: Admission was available on 8/31, guardian declined in favor of pursuing Avanti
-Avanti: Accepted, awaiting admission timeline