PH-F15-7244

Recommendation is QRTP or PRTF.
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

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

CH8SCH-M9-7291

Patient presents from home via law enforcement. Aggression towards parents, elopes from parents, runs into traffic. Was recently discharged from PHP with recommendation for higher level of care (PRTF)

C8SM8SP-F15-7263

Child residential treatment since April 2026. After she had assaulted someone at the resident, she was brought to JDC. After JDC, she returned home.
Child presented originally to ED 8/2 via EMS after intentional ingestion. She was recommended IPMH after MHCA. No units were accepting of child; after psychiatry consultation, she was appropriate for discharge to home. Mother refused to discharge child to return to home. Extended family members not willing to have her stay with them at this time.

PH-F16-7247

Recommending outpatient wraparound services.
16-year-old female who presented to PrairieCare after being brought to the emergency department from their group home after an increase in suicidal ideation after intervening twice with a peer’s suicide attempt in the group home.
Patient has a history of 5+ inpatient hospitalizations, group home and PRTF placement.
Children’s mental health case manager is pursuing RTC and group homes as an alternative to home. Referrals were sent to:
– Northwoods (PT has been on waitlist, anticipated timeline at least 1 year as of 07/29)
– Community Living Options
– Little Sands
– Nexus Gerard RTC
– Avanti
– PORT
– Acadia Healthcare
– South East Regional Crisis Center (SERCC)
– Boys Town RTC in Nebraska
– North Homes RTC
– Village Ranch

MFIUP-F15-7229

Admitted due to suicidal and homicidal ideation. Patient struggles with explosive outbursts when she does not get her way. Patient has a hx of calling CPS frequently alleging abuse against mom. Diabetes was managed with an insulin pump until recently, when the pump was removed for inpatient admission and she was transitioned to insulin injections. She reports that the pump was helpful in regulating her diabetes. She reports daily suicidal ideation, describing it as a persistent struggle, with plans to smother or strangle herself. She also experiences homicidal ideations, particularly directed toward her mother and sister.

MFIUP-F14-7201

Pt has hx of several suicide attempts, chronic SI, impulsivity, substance use, and PTSD with dissociative symptoms. Pt has a long history of IPMH and two residential stays at Heartland Girls Ranch. She recently was at a dual treatment center but was discharged following a suicide attempt. We were initially looking for dual RTC, but we have expanded our search to find placement as pt continues to struggle with prolonged hospitalization.

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.