Patient came to ED on 7/19 from Nexus East Bethel PRTF after swallowing a foreign object. Was in our inpatient unit from 7/15-7/19 and discharged for only hours before returning. Reports that repeat behavior was pt seeking to be removed from program. Nexus PRTF is not accepting pt back at this time and Mom is unable to have pt return home. Sending referral to Nexus YCT to assist with placement.
Risk Factor: Self harm
This term refers to instances of isolated, non-repetitive aggressive behavior, such as a single incident of physical aggression or verbal aggression.
MHF-F17-4377
Pt came to our ED via ambulance after running away from Avanti, because they planned to discharge her home to family where she did not want to go. Avanti will not take her back. She has been cooperative and has not had any behavioral incidents in the ED. She is at her baseline, which includes non-suicidal self injurious behavior. Has history of therapy, psych, PHP, IPMH, foster care. Going to a different family member for kinship placement is currently being discussed though pt is not agreeable at this time.
PH-F17-4082
Recommendation is for CD residential treatment. Patient is currently inpatient.
17 year old female admitted from the ED. Pt was having increased panic attacks and engaging in self-injurious behaviors by hitting themselves. Patient has been having suicidal ideations. Patient has been using marijuana as a coping strategy. Patient has a history of numerous psychiatric hospitalizations. At this time mother feels the patient can not return home as the family has been staying at a motel.
Pt insured by BCBS PMAP and Medicaid.
Pt has the following outpatient supports:
Individual therapy
Psychiatry/medication management
Primary care
CH-F12-4277
Patient presents to the ER from PRTF twice in the same day after boarding for an extended period of time due to aggression towards staff. She has since been discharged from the PRTF as they felt a higher level of care was indicated. She is currently doing well here with intermittent verbal escalations though does struggle with peer relationships. She does express visual and auditory hallucinations though these do appear to be related to trauma.
AH-F16-4271
Adopted at birth with in utero meth exposure. Several inpatient, residential and outpatient avenues explored both instate and out of state. Patient is declined or asked to leave to due aggression to peers. Juvenile system has discharged back to mental health. Engages in self harm, significant aggression, stealing and fraud, fire setting, etc.
PH-M14-4228
Recommendation is level 5 QRTP, patient is currently inpatient.
Patient is a 14 y/o male w/ hx of depression, anxiety, ADHD, conduct disorder, ptsd , FSIQ 77, currently presenting due to ongoing mood/behavioral dysregulation resulting in hospitalization after aggression w/ mother and boyfriend. Biologically, there is a genetic predisposition for depression, anxiety, substance use. Patient w/ a long hx of impulsive/aggressive behaviors (runs away frequently, physically/verbally aggressive w/ authority figures, ect). Patient is a poor historian per outpatient psychiatrist and parents which impacts ability to know how he is actually doing. At this time, outpatient psychiatrist recommended RTC, and patient is on the wait list.
Patient has previously engaged in PHP, IT, CMHCM, and Intensive outpatient services
RTC
– Northwoods (referral submitted by CMHCM, year long waitlist 6/27)
– Gerard (referral submitted by CMHCM, under review 6/27)
PRTF
– Grafton (referral submitted 6.26)
PH-F13-4223
Recommendation is for level 5 QRTP, patient is currently inpatient.
Patient admitted on 5.29 to inpatient hospital. Patient has had 3 prior inpatient hospitalizations at Abbott Northwestern Hospital. January 2022, July 2023 and August 2023 her mother estimated. She also has participated in partial program. Patient had no incidents of aggression towards peers or staff. Referring information described her as needing to be on 1:1 staffing, due to aggression on the unit, however this was prior to the last inpatient hospitalization, in which no incidents of aggression were reported. The initial statement of ‘no incidents of aggression” was reported by the patient herself. Patient does have a history of psychiatric hospitalizations, day treatment, skills groups and individual therapy. Patient does not have a history of eating disorder treatment. Patient does have formal mental health history, including formal psychiatric evaluations, engagement in therapy, psychotropic medication trials and psychiatric hospitalizations.
Residential Treatment (referrals submitted 6/24, pending county funding)
– Avanti
– North Homes
– Nexus Gerard
PH-F14-4234
6/4/24 admission note: Patient is a 14-year-old female admitted to PrairieCare for suicidal ideation and self-injurious behaviors. Patient was recently discharged from a 45-days residential program. 2 days post discharge patient began threatening to kill her mom and reported SI with plan to jump in front of a car. Pt has a history of recurrent major depression SI, and SIB.
Discharge Plan:
SMRT-Hennepin County (7/8)
PRTF/QRTP – Level 6:
-Grafton (declined due to current milieu at facility)
-Nexus East Bethel (unable to refer due to insurance)
-Leo A Hoffman (unable to refer due to males only)
-Bar None Haven (SW to send referral once consent obtained)
-Northwood (SW to send referral once consent obtained)
-The Youth Village in Tennessee (guardian pursuing)
-Acadia Healthcare (SW to send referral once consent obtained)
Current Providers-
Therapy- Paula Ocampo at Lake Country Associates
EMDR therapy-Tiffany Rundquist, Sanford Health Bemidji
Pediatric Neurology- Dr. Ilgarli, Essentia Health
Psychiatry- Daniel Janiczak, MD and Kayla Scheneit, MD- Sandford Bemidji
CMHCM- Erika Kjellberg, Hubbard County
CTSS- Megan Berg, Hubbard County
EMPATH at Bemidji Sanford 2 times/week
PH-F15-4188
Recommendation is for level 6 RTC/PRTF – patient is currently inpatient.
15-year-old Female from RTC level 5. Patient admitted to inpatient after struggling with self-regulation after recent inpatient discharge. Patient has had 5 inpatient hopsitalizations since March 2024 with attempts at individual therapy, PHP, RTC (elopment), and In alignment with CMHCM, seeking RTC level of care. Referrals have been sent to Nexus East Bethel, Bar None Haven
Patient insured by Medicaid.
Pt has the following outpatient supports:
CMHCM
EHS-M16-4154
Patient was brought to ED after making suicidal and homicidal statements during his psychiatric medication appointment. He was evaluated and inpatient psychiatric stabilization was recommended. While in the ED he has been calm and cooperative. Denying suicidal ideation or Homicidal ideation at this time. He does recognize that he has been dysregulated and struggling to find effective coping skills. Recent increase in conflict at home. Has been engaging in self-harm. Mom does not feel safe having him in the home at this time.